Form Navpers 1300 21 PDF Details

Understanding the NAVPERS 1300/21 form is crucial for members of the naval service and their commanding officers. This form, titled "Medical Suitability Certification," plays a vital role in determining a service member's readiness for expeditionary roles, including assignments beyond their usual duties or deployment to specific locations. It requires comprehensive information such as the member's name, rank, the date, and their current ship or station, alongside the unique identifier code (UIC) and the intended Individual Augmentee (IA) or Global Support Assignment (GSA) location. The heart of the form lies in the commanding officer's (or their designee's) assessment of the member's expeditionary suitability, a decision that must consider all necessary medical waivers as referenced by the NAVMED 1300/4 guidelines. Additionally, it mandates the protection of the service member's health information, adhering strictly to the Privacy Act and the Health Insurance Portability and Accountability Act (HIPAA), emphasizing the confidentiality and sensitivity of the healthcare information contained within. This underscores the importance of securing the member's medical details while ensuring their fitness for the duties ahead. The NAVPERS 1300/21 form is not just a document; it's a crucial step in the meticulous process of maintaining the operational readiness of the Navy’s personnel, highlighting its role in safeguarding the health and privacy of those who serve.

QuestionAnswer
Form NameForm Navpers 1300 21
Form Length1 pages
Fillable?No
Fillable fields0
Avg. time to fill out15 sec
Other namesUSC, EXPEDITIONARY, NAVMED, MILPERSMAN

Form Preview Example

Not Fillable

MEDICAL SUITABILITY CERTIFICATION

(Forward To Member's Commanding Officer)

 

Supporting Directive MILPERSMAN 1300-318

 

 

 

1. MEMBER NAME (Last, First, MI, Rank/Rate)

 

2. DATE

 

 

 

3. PRESENT SHIP/STATION

4. UIC

5. IA/GSA LOCATION

RECOMMENDATION OF COMMANDING OFFICER OR DESIGNEE

6. MEMBER DOES / DOES NOT MEET EXPEDITIONARY SUITABILITY REQUIREMENTS.

Ensure all waivers have been completed before signing Medical Suitability (see NAVMED 1300/4 part II C).

7. COMMANDING OFFICER OR DESIGNEE (NAME, RANK)

8. COMMANDING OFFICER OR DESIGNEE

9. DATE

 

(SIGNATURE)

 

 

 

 

This document may contain information covered under the Privacy Act, 5 USC 552(a), and/or the Health Insurance Portability and Accountability Act (PL 104-191) and its various implementing regulations and must be protected in accordance with those provisions. Healthcare information is personal and sensitive and must be treated accordingly. If this correspondence contains healthcare information it is being provided to you after appropriate authorization from the patient or under circumstances that don't require patient confidential manner. Redisclosure without additional patient consent or as permitted by law is prohibited. Unauthorized redisclosure or failure to maintain confidentiality subjects you to application of appropriate sanction. If you have received this correspondence in error, please notify the sender at once and destroy any copies you have made.

NAVPERS 1300/21 (Revised 07-09)

FOR OFFICIAL USE ONLY

PRIVACY SENSITIVE

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