DA Form 3425 at a glance
What it is: DA Form 3425 is the medical fitness statement for enrollment in the basic course, Senior ROTC.
Who signs: The physician signs under SIGNATURE OF PHYSICIAN.
A filled-in DA Form 3425 example: a physician clears a student for the basic course
How to fill out DA Form 3425, box by box
Date
Enter the date as YYYYMMDD.
First name, middle initial, last name
Enter first name, middle initial, and last name.
The physician has examined them and finds no medical condition or physical impairment that precludes their participation in the basic course, Army ROTC, a program not more physically strenuous than a normal college physical education program.
Signature of physician
The physician signs under SIGNATURE OF PHYSICIAN.
More rules for DA Form 3425
For use of this form, see AR 145-1; the proponent agency is DCS, G-1.
Sources
[1] DA Form 3425 (APR 2023), Medical Fitness Statement for Enrollment in Basic Course, Senior ROTC, U.S. Army (the Official source link on this page).