Get DD 2808 2019-2023
Endocrine 43. DENTAL DEFECTS AND DISEASE Acceptable Class DD FORM 2808 OCT 2005 Please explain. Use dental form if completed by dentist. STIO 1. DATE OF EXAMINATION 2. SOCIAL SECURITY NUMBER YYYYMMDD REPORT OF MEDICAL EXAMINATION PRIVACY ACT STATEMENT AUTHORITY 10 USC 504 505 507 532 978 1201 1202 and 4346 and E.O. 9397. PRINCIPAL PURPOSE S To obtain medical data for determination of medical fitness for enlistment induction appointment and retention for applicants and members of the Armed Forces. The information will also be used for medical boards and separation of Service members from the Armed Forces. ROUTINE USE S None. DISCLOSURE Voluntary however failure by an applicant to provide the information may result in delay or possible rejection of the individual s application to enter the Armed Forces. For an Armed Forces member failure to provide the information may result in the individual being placed in a non-deployable status. 4. HOME ADDRESS Street Apartment Number City State and ZIP Code 3. LAST NAME - FIRST NAME - MIDDLE NAME SUFFIX 5. HOME TELEPHONE NUMBER Include Area Code 6. GRADE 7. DATE OF BIRTH 8. AGE 10. a* RACIAL CATEGORY X one or more 9. SEX American Indian or Alaska Native Asian Female Male Black or African American White 12. AGENCY Non-Service Members Only 11. TOTAL YEARS GOVERNMENT SERVICE a* MILITARY b. CIVILIAN 15. a* SERVICE c* PURPOSE OF EXAMINATION b. COMPONENT Navy Active Duty Reserve Marine Corps National Guard Air Force Not Hispanic/ Latino 13. ORGANIZATION UNIT AND UIC/CODE b. TOTAL FLYING TIME Army Hispanic/Latino Organization UIC code 14. a* RATING OR SPECIALTY Aviators Only Coast Guard b. ETHNIC CATEGORY Native Hawaiian or Other Pacific Islander c* LAST SIX MONTHS 16. NAME OF EXAMINING LOCATION AND ADDRESS Enlistment Medical Board Commission U*S* Service Academy Separation Include ZIP Code Retirement Retention ROTC Scholarship Program Other CLINICAL EVALUATION Check each item in appropriate column* Enter NE if not evaluated* Nor- Ab- NE mal norm 17. Head face neck and scalp 18. Nose 44. NOTES Describe every abnormality in detail* Enter pertinent item number before each comment. Continue in item 73 and use additional sheets if necessary. 19. Sinuses 20. Mouth and throat 21. Ears - General Int. and ext. canals/Auditory acuity under item 71 22. Drums Perforation 23. Eyes - General Visual acuity and refraction under items 61 - 63 24. Ophthalmoscopic 25. Pupils Equality and reaction 26. Ocular motility Associated parallel movements nystagmus 27. Heart Thrust size rhythm sounds 28. Lungs and chest Include breasts 29. Vascular system Varicosities etc* 30. Anus and rectum Hemorrhoids Fistulae Prostate if indicated 31. Abdomen and viscera Include hernia 32. External genitalia Genitourinary 33. Upper extremities 34. Lower extremities Except feet 35. Feet See Item 35 Continued 36. Spine other musculoskeletal 37. Identifying body marks scars tattoos 38. Skin lymphatics 39. Neurologic 40. Psychiatric Specify any personality deviation 41. Pelvic Females only 35. FEET Continued Circle category 42.
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