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Provide the requested information in the area LIST ANY OTHER SPECIAL MEDICAL OR, A NAME OF MPDPSC REPRESENTATIVE, B TITLE, C SIGNATURE, D GRADE, E DATE YYYYMMDD, DA FORM MAR, PREVIOUS EDITIONS ARE OBSOLETE, and Page of APD LC vES.
In the A PHYSICAL PROFILE SERIAL CODE, PULHES, YES, B PHYSICAL CATEGORY CODE, C MEDICAL RECORDS REVEAL THE, LIMITATIONS, ITEM, A Does the member meet the medical, B IF CONDITION IS TEMPORARY, A Has member completed HIV, A Is the member pregnant, A All active duty and reserve, B DATE TIME AND LOCATION OF, B IF YES EXPECTED DATE OF DELIVERY, and B IF YES INDICATE DATE TIME AND field, point out the key data.
The area REQUIRES, HAS, MISSING, ITEM, DATE TIME AND LOCATION OF, A Two pairs of spectacles, B Protective mask spectacle, insert, C Two hearing aids, D Medical warning tag, NAME OF MEDICAL OFFICER, B TITLE, SIGNATURE, D GRADE, and E DATE YYYYMMDD is going to be where to insert all parties' rights and obligations.
Terminate by taking a look at the following sections and completing them correspondingly: A If item is checked yes can the, B IF YES THE MEMBER and family, A NAME OF DENTAL OFFICER, B TITLE, C SIGNATURE, D GRADE, E DATE YYYYMMDD, DA FORM MAR, and Page of APD LC vES.
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Frequently Asked Questions about DA Form 4036
Who must complete this form?
Soldiers receiving overseas duty assignments under AR 600-8-11 must complete this form. Command-sponsored family members joining the soldier overseas are also screened.
When should the form be submitted?
Submit the completed form before your reporting date. Your unit S-1 or medical officer can advise on the exact deadline based on your gaining command’s requirements.
Does the form cover dental fitness?
Yes. The dental section certifies the soldier’s Class 1 or Class 2 dental readiness. Soldiers who do not meet dental standards are referred for treatment before departure.
Are there related forms I may need?
You may also need the DA Form 31 for leave requests and the SF 600 for your chronological medical record as part of the overseas clearance packet.
