1. EXAM DATE (DD/MM/YY) INTERIM (ABBREVIATED) FLYING DUTY MEDICAL EXAMINATION For use of this form, see AR 40-501; the proponent agency is OTSG 3. SSN 2. NAME (Last, First, MI) 6. COMPONENT (Check.
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How to fill out the Da Form 4497 online
The Da Form 4497 is a crucial document used for interim flying duty medical examination. This guide will provide clear and detailed instructions on how to complete this form online, ensuring a smooth and efficient process for all users.
Follow the steps to successfully complete the Da Form 4497 online.
- Click the ‘Get Form’ button to access and open the form in your preferred editor.
- Enter the exam date in the 'EXAM DATE (DD/MM/YY)' field. Make sure to use the correct format.
- Input your Social Security Number (SSN) in the designated field to maintain identification.
- Fill out your name by writing your last name first, followed by your first name and middle initial.
- Indicate your rank in the corresponding section to provide your military identification.
- Add your birth date in the 'BIRTH DATE (DD/MM/YY)' field using the correct format.
- In the 'COMPONENT' section, check the box for your appropriate status: AD-RA, AD-USAR, ARNG-AGR.
- Select your aviation duty by checking one of the available options in the 'AVIATION DUTY' section.
- Provide the complete unit address and name of your unit of assignment.
- Enter your unit phone number and your home phone number in the respective fields.
- List any medications you are currently taking along with their dosages as requested.
- Detail any existing aeromedical waivers in the specified field.
- Acknowledge the statement regarding clearance by a flight surgeon by marking it appropriately.
- Fill in the exam facility address where the medical examination took place.
- Provide your blood pressure reading in the specified field.
- Input your pulse rate in the designated area.
- Enter your height in inches as required.
- Record your weight in pounds.
- Detail your body fat percentage as needed.
- Complete the vision and hearing examinations by filling in the respective results.
- If applicable, enter findings from the electrocardiogram in the appropriate section.
- Provide any pertinent history and examination details as stated in 'HISTORY AND EXAMINATION'.
- Finally, review all entries for accuracy and completeness before proceeding.
- Once finished, save your changes, and choose to download, print, or share the form as required.
Start filling out the Da Form 4497 online now to expedite your medical examination process.
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Get answers to your most pressing questions about US Legal Forms API.
What is a DA Form 2 1?
The DA Form 2-1 is also known as a Personnel Qualification Record. It will be used to keep track of a U.S. Army soldier's information and records, such as overseas service, awards and honors, or job details.
What is a DA Form 3955 used for?
PRINCIPLE PURPOSE: To route and forward (Directory) mail. ROUTINE USES: Used by Army military and civilian personnel in mail functions and address inquires.
Where can I download Army forms?
Visit http://.e-publishing.af.mil/ To access their Forms.
What is a DA 31 form military?
The purpose of the DA 31 form is to authorize military leave; document the start and stop of such leave; record address and telephone number where a soldier may be contacted in case of an emergency during leave; and certify leave days chargeable to a soldier's leave account.
What all do you need for a leave form Army?
The letter should include the following information: leave dates including expected date of return, contact information of the authorized official, your rank and duty station. 5. If applicable, notify your department of the name, address and telephone number of your designated Power of Attorney.
What is the DA 31 form for military leave?
What is DA 31 form? The purpose of the DA 31 form is to authorize military leave; document the start and stop of such leave; record address and telephone number where a soldier may be contacted in case of an emergency during leave; and certify leave days chargeable to a soldier's leave account.
What does a flight physical consist of army?
Check your eyesight and hearing. Perform a comprehensive physical examination including your lungs, heart, blood pressure, stomach, extremities, and nervous system. Perform an electrocardiogram (EKG) to determine any abnormalities in heart rhythm or other heart functions.
What is the DA Form 31?
The purpose of the DA 31 form is to authorize military leave; document the start and stop of such leave; record address and telephone number where a soldier may be contacted in case of an emergency during leave; and certify leave days chargeable to a soldier's leave account.
What is a DA Form 2142?
DA Form 2142, Pay Inquiry, is a document submitted by the service members when they have questions or concerns regarding their payments.
What is the DA form for address change?
A fillable DA 3955 Form is used as a change of address form for Army soldiers. Also known as a Change of Address and Directory Card, the completed form helps soldiers ensure that their mail is delivered. The person completing the form can also request whether their new address should be kept private.
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