Da Form 3643 PDF Details

Last week, the Department of Defense issued a new form, Da Form 3643. Thisform is used to document medical exams for service members who are being consideredfor deployment or assignment to a combat zone. The form was developed in response to theDepartment of Defense's new policy on pre-deployment health assessments. Personnelwho complete this form will be better able to identify any medical conditions that mayimpact their ability to serve in a combat zone. The form can be completed by either aservice member's primary care provider or by a military health care provider.

QuestionAnswer
Form NameDa Form 3643
Form Length1 pages
Fillable?No
Fillable fields0
Avg. time to fill out15 sec
Other names3643 printable, 3643 form printable, how to 3643, 3643 form fillable

Form Preview Example

 

DAILY ISSUES OF PETROLEUM PRODUCTS

PAGE NO.

NO. OF PAGES

 

 

 

 

For use of this form, see AR 703-1; the proponent agency is DCSLOG

 

 

 

 

TYPE, GRADE AND UNIT OF ISSUES FOR EACH

 

ORGANIZATION

 

 

 

 

PRODUCT ISSUED

 

 

 

 

 

 

 

 

AND

 

 

 

 

 

 

 

 

 

VEHICLE USA

 

ISSUES

 

 

RECEIPTS

 

ADDRESS

SIGNATURE,

 

 

 

 

 

REGISTRATION

 

 

 

 

 

 

(Indicate service: A, Army; AF,

GRADE

NUMBER

 

 

 

 

 

 

 

 

 

 

 

 

 

Air Force; N, Navy; M, Marine

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Corps)

 

a

b

c

d

e

f

g

h

i

TOTAL

 

 

 

 

 

 

 

 

RECEIPTS

 

 

 

 

 

 

 

 

TOTAL

 

 

 

 

 

 

 

 

ISSUES

 

 

 

 

 

 

 

 

POST, CAMP OR STATION

 

 

 

DATE

 

SIGNATURE OF ATTENDANT

 

DA FORM 3643, APR 85

EDITION OF 1 OCT 70 IS OBSOLETE

RCAS V1.0