Get Cg-6100 Rev

The CG-6100 Rev is an important form used for health screening related to overseas assignments and sea duty within the U.S. Coast Guard. This guide provides clear, step-by-step instructions to help users fill out the form accurately and efficiently, ensuring a smooth submission process.

Follow the steps to complete the CG-6100 Rev online.

1. Press the ‘Get Form’ button to access the CG-6100 Rev. This action will open the form within your selected editor.
2. Begin with section A: Examinee Data. Fill in your last name, first name, and middle initial. Input your rate/rank, social security number, assigned unit, examining facility, the purpose of the screening, transfer/deployment location, and the date.
3. Proceed to section B: Health History. Answer the questions regarding your general health, medical or dental problems, health-related duty limitations, prescription medications, pregnancy status, mental health care, hospitalizations, and provide any relevant explanations.
4. Move on to section C: Periodic Health Assessment (PHA) Review. Complete the questions concerning the date of your most recent PHA, the status of any recommendations, and a summary of significant health history since your last PHA.
5. In section D: Health Record & Individual Medical Readiness Review, answer questions about gynecologic examinations, glasses, gas mask inserts, DNA sampling, G-6PD screening, immunizations, HIV testing, baseline TST, force health protection requirements, and Type 2 dental examination.
6. If any questions in sections B, C, or D received a 'no' answer, provide explanations as needed.
7. In section E, include the signatures and dates from the medical and dental providers or IDHS.
8. Finally, in section F, ensure the approving authority's review and determine if the form is approved or disapproved.
9. After completing all sections, save your changes, and you may then download, print, or share the form as per your requirement.

Start filling out the CG-6100 Rev online today for your health screening needs.