Dd Form 2370 PDF Details

The DD Form 2370 provides a rigorous framework for the thorough examination of blood pressure and pulse rates, serving a critical role within the context of medical evaluations for individuals seeking to join the United States service academies, Reserve Officer Training Corps (ROTC) Scholarship Programs, or the Uniformed Services University of the Health Sciences (USUHS). With a structure that demands a three-day tracking of an applicant's blood pressure and pulse readings both in the morning and evening, the form highlights the importance of accuracy in medical assessments, contributing significantly to the decision-making process regarding an applicant's medical fitness for service. Moreover, the form outlines specific instructions for examiners, emphasizing the need for the correct cuff size based on the applicant's arm circumference to ensure precise blood pressure measurements, thereby avoiding potential errors that could affect an applicant's candidacy. The disclosure is voluntary, but the implications of failing to provide accurate information are substantial, underlining the role of this form in facilitating a fair and effective selection process for military and related health sciences education and training programs. Significantly, the form also adheres to privacy and information handling standards as mandated by federal authority and routine uses, ensuring applicants' data is managed with the utmost confidentiality and integrity.

QuestionAnswer
Form NameDd Form 2370
Form Length1 pages
Fillable?No
Fillable fields0
Avg. time to fill out15 sec
Other namesSSN, DODMERB, form dde 2370, dd form 2370

Form Preview Example

A.M .
BLOOD PRESSURE
A.M .
BLOOD PRESSURE

DOD M EDICAL EXAM INATION REVIEW BOARD (DODM ERB)

THREE DAY BLOOD PRESSURE AND PULSE CHECK

Form Approved

OMB No. 0704 -0396

Expires Aug 31, 2003

The public report ing burden f or t his collect ion of inf ormat ion is est imat ed t o average 90 minut es per response, including t he time f or review ing inst ruct ions, searching exist ing dat a sources, gat hering and maint aining t he dat a needed, and complet ing and review ing t he collect ion of inf ormat ion. Send comment s regarding t his burden est imat e or any ot her aspect of t his collect ion of inf ormat ion, including suggest ions f or reducing t he burden, t o Depart ment of Def ense, Washingt on Headquart ers Services, Direct orat e f or Inf ormat ion Operat ions and Report s (0704 -0396), 1215 Jef f erson Davis Highw ay, Suit e 1204, Arlingt on, VA 22202 -4302 . Respondent s should be aw are t hat not w it hst anding any ot her provision of law , no person shall be subject t o any penalt y f or f ailing t o comply w it h a collect ion of inf ormat ion if it does not display a current ly valid OMB control number.

PLEASE DO NOT RETURN YOUR FORM TO THE ABOVE ADDRESS. RETURN COM PLETED FORM TO DODM ERB/DR, 8 0 3 4 EDGERTON DRIVE, SUITE 1 3 2 , USAF ACADEM Y CO 8 0 8 4 0 -2 2 0 0 .

PRIVACY ACT STATEM ENT

AUTHORITY: Tit le 10, USC 133, 3012, 5031, 8013, and Execut ive Order 9397 .

PRINCIPAL PURPOSE: To det ermine medical accept abilit y or updat e a medical f ile as part of t he applicat ion process t o a Unit ed St at es Service Academy, Reserve Of f icer Training Corps (ROTC) Scholarship Program, or t he Unif ormed Services Universit y of t he Healt h Sciences (USUHS).

ROUTINE USES: This inf ormat ion may be disclosed t o t he Coast Guard Academy and Merchant Marine Academy f or applicat ions t o t heir Academies.

DISCLOSURE: Volunt ary; how ever, f ailure t o f urnish t he request ed inf ormat ion w ill impede t he select ion process and hamper your candidacy. Use of t he Social Securit y Number (SSN) is used f or posit ive ident if icat ion of records.

1 . NAM E OF APPLICANT (Last , First , Middle Init ial)

2 . SSN OF APPLICANT

INSTRUCTIONS TO EXAM INERS

St udies have show n t hat t he sphygmomanomet er cuf f must be t he correct w idt h f or t he circumf erence of t he pat ient ' s arm. If it is t oo narrow , t he blood pressure readings w ill be erroneously high. If it is t oo w ide, t he readings may be erroneously low . For t he average adult , a cuf f 12 t o 14 cm w ide is sat isf act ory. For arm circumf erence great er t han 28 cm a larger cuf f , 18 t o 20 cm w ide, must be used.

3 . ARM CIRCUM FERENCE

4 . WIDTH OF THE BLOOD PRESSURE CUFF

5 . M EDICATION CURRENTLY TAKEN (If none, so st at e.)

6 . BLOOD PRESSURE AND PULSE READINGS

DAY ONE

DATE

A.M .

 

P.M .

 

 

 

 

 

 

 

BLOOD PRESSURE

PULSE

BLOOD PRESSURE

PULSE

 

 

 

 

 

SITTING M ANDATORY

 

 

 

 

 

 

 

 

 

DAY TWO

DATE

 

P.M .

 

PULSE

BLOOD PRESSURE

PULSE

SITTING M ANDATORY

DAY THREE

DATE

 

P.M .

 

PULSE

BLOOD PRESSURE

PULSE

SITTING M ANDATORY

7 . EXAM INER (Doct or/Nurse/Paramedical Technician)

TYPED OR PRINTED NAM E (Last , First ,

Middle Init ial)

TITLE

SIGNATURE

DD FORM 2 3 7 0 , SEP 2 0 0 0

PREVIOUS EDITION IS OBSOLETE.

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The right way to fill in USUHS stage 1

2. Right after performing the previous step, go on to the next part and fill out all required particulars in these blank fields - DAY THREE, DATE, SITTING MANDATORY, BLOOD PRESSURE, PULSE, BLOOD PRESSURE, PULSE, EXAMINER DoctorNurseParamedical, SIGNATURE, DD FORM SEP, and PREVIOUS EDITION IS OBSOLETE.

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