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DA 3349 2010-2024 free printable template

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UNIT DA FORM 3349 SEP 2010 18. PROFILING OFFICER E-MAIL PREVIOUS EDITIONS ARE OBSOLETE Page 1 of 2 APD PE v1.00ES PATIENT S NAME CONTINUATION From page 1 Item 8. PHYSICAL PROFILE For use of this form see AR 40-501 the proponent agency is the Office of the Surgeon General* ILLNESS/DISEASE 2. CODES Table INJURY Or 1. MEDICAL CONDITION Description in lay terminology 7-2 AR 40-501 P U L H E S Temporary Permanent 4. PROFILE TYPE YES a* TEMPORARY PROFILE Expiration date YYYYMMDD NO Limited to 3...
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How to fill out da form 3349 2010-2024

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How to fill out DA Form 3349?

01
Start by obtaining a copy of DA Form 3349 from a military medical treatment facility or download it from the official Department of Defense website.
02
Begin with the first section of the form, which requires personal information such as the patient's name, rank, social security number, and contact information. Fill in these details accurately.
03
Move on to the second section, which involves providing information about the medical condition. State the diagnosis, including any applicable medical codes, and describe the limitations imposed by the condition.
04
In the third section, document the specific profiles or limitations recommended by medical professionals. This may include physical limitations, duty restrictions, or additional healthcare requirements.
05
The fourth section involves the patient's acknowledgement and understanding of the form. Ensure that the patient signs and dates this section.
06
If additional medical documentation is available, such as medical examinations or consultation reports, attach them to the form in the provided spaces or as instructed.
07
Finally, the completion of DA Form 3349 requires the signature of the healthcare provider or medical professional who provided the diagnosis and recommendations. Make sure they sign and date the form.
08
Review the filled-out form for accuracy and completeness before submitting it to the appropriate authority or organization.

Who needs DA Form 3349?

01
Service members who have medical conditions or limitations that may impact their military duties require DA Form 3349.
02
This form is crucial for establishing the necessary profiles and restrictions, ensuring that the limitations are properly documented and communicated within the chain of command.
03
In particular, soldiers seeking a medical retirement or a change in military occupational specialty (MOS) may need to fill out this form to provide evidence of their medical condition and limitations.
04
Additionally, DA Form 3349 is necessary for determining eligibility for certain benefits, entitlements, or programs within the military healthcare system.
05
It is important to consult with the appropriate medical personnel or chain of command to determine if filling out DA Form 3349 is necessary based on the individual's circumstances and medical condition.

Who needs a DA 3349 Form?

The United States Department of the Army uses DA 3349 forms, filed separately for every soldier.

What is the DA 3349 Form for?

Regarded as a Physical Profile, DA Form 3349 is serves as a mode to register soldiers’ physical fitness level, capabilities, and abilities to perform certain activities, typical during the service. Therefore, it is proof that health of all the military members is strong enough for service.

Is the DA 3349 Form accompanied by other forms?

A DA 3349 form can be used as both a permanent and temporary physical profile. A temporary physical profile is required in case of the event (injury or illness) causing certain physical limitations. As a temporary profile, DA Form 3349 is filed along with a DA Form 689 — Individual Sick Slip.

If the DA 3349 form cannot provide enough space for all the information on the limitations for physical activities as SF 600 form should be used as a continuation of the DA 3349.

When is DA 3349 Form due?

If used as a temporary physical profile, DA 3349 cannot exceed 30 days. When used to register permanent physical condition, it applies for the next 12 months.

How do I fill out DA 3349 Form ?

The primary point to specify on the form, is whether it is permanent or temporary.

The completed Form must provide the information as for:

the soldier’s medical condition

ability/inability to perform functional activities

description of physical limitations (if any)

the soldier’s name and grade

name and grade of approving authority

soldier’s patient identification

Where do I send DA 3349 Form?

The submitted DA 3349 forms are kept by the NCO’s so that they can elaborate appropriate activities and to be performed by their teams.

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DA Form 3349 is an official U.S. Army form used to record medical evaluation board (MEB) proceedings. It is used to document an individual's medical condition and any medical treatment or tests that are performed. It also contains information about the medical board's recommendations for the individual's medical status.
All U.S. military personnel are required to file a DA Form 3349 when they are medically cleared for duty or when they are released from a medical condition that prevented them from performing their duties.
DA Form 3349 is a Department of the Army (DA) form used to document a physical examination. It assesses the health of an individual and helps determine whether or not they are qualified to perform military duties. It is also used to document any health problems or medical conditions that may affect one’s ability to serve in the Army.
There is no specific penalty for late filing of the DA Form 3349. However, service members are expected to submit the form in a timely manner, and a failure to do so could result in adverse action.
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