Da Form 3425 R - Medical Fitness Statement PDF

The DA 3425 R form is a Medical Fitness Statement used for enrollment in the Basic Course of the Senior ROTC. This form helps ensure that potential participants have no medical conditions or physical impairments that would prevent them from engaging in the program, which is comparable in intensity to a typical college physical education class. To get started, fill out the form by clicking the button below.

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DA Form 3425 R PDF Details

The DA Form 3425 R is a Medical Fitness Statement required for Senior ROTC Basic Course enrollment. This one-page document confirms that the applicant has no medical conditions or physical limitations that would prevent participation in ROTC activities, which are comparable in intensity to a college physical education class.

Who needs this form: Any student enrolling in the Army Senior ROTC Basic Course must complete DA Form 3425 R. A medical officer or ROTC program coordinator countersigns the form to verify the applicant's eligibility before enrollment is approved.

What the form covers: The form asks you to certify your general medical fitness. If you have a condition that affects physical activity, you must disclose it. The reviewing officer determines whether the condition affects your eligibility for the program.

Related military forms: Students completing ROTC enrollment paperwork may also need to submit the Army Functional Capacity Form 507 or review the Certificate of Medical Fitness. Keep copies of all submitted documents for your personal records.

Question	Answer
Form Name	Da Form 3425 R
Form Length	1 pages
Fillable?	No
Fillable fields	0
Avg. time to fill out	15 sec
Other names	3425r, da 3425 medical, 3425 r fillable, 3425r form

How to Edit Da Form 3425 R Online for Free

Follow the steps below to complete DA Form 3425 R using FormsPal's free online PDF editor. No software download or account registration is required.

Step 1: Open the Form

Click the button at the top of this page to open the form in the online editor. It loads directly in your browser within seconds.

Step 2: Enter Your Personal Information

Type your full name, date of birth, and the current date in the appropriate fields. If completing a paper copy, print clearly in black ink.

Step 3: Complete the Medical Fitness Certification

Review the medical fitness statement on the form carefully. Check the correct box to certify whether you have any medical conditions that limit your physical activity. Participation in the ROTC Basic Course requires fitness at the level of a typical college physical education class.

Step 4: Get the Required Countersignature

Take the completed form to your ROTC coordinator, medical officer, or student health center for countersignature. This form is not valid without an authorized signature in the designated section.

Step 5: Submit and Save a Copy

Submit the signed form to your Senior ROTC enrollment office. Keep a signed copy for your personal records. Students in the Air Force ROTC program may need to complete AFROTC Form 16 instead.

Common Questions About This Form

Is this the same as a standard Army physical? No. This is a brief medical fitness statement, not a full physical examination. It confirms general fitness for Basic Course activities, which are comparable to a college PE class.

Who can countersign the form? A military medical officer, licensed physician, nurse practitioner, or authorized ROTC coordinator can sign. Contact your ROTC battalion for specific signature requirements.

When do I submit this form? Timing varies by program. Some programs collect it at the start of the Basic Course. Others require it before enrollment begins. Check with your program coordinator for the exact deadline.

For related military documentation, see the Army Certificate DA Form 87 or the Army OER Support Form.