Get Tx Txmf Form 3349-r 2022-2026

Filling out the TX TXMF Form 3349-R online is essential for providing medical information about a service member to the Texas Army National Guard. This guide offers a clear and user-friendly approach to completing the form accurately and efficiently.

Follow the steps to successfully complete the TX TXMF Form 3349-R online.

1. Click the ‘Get Form’ button to access the form and open it in your browser.
2. Begin with Section I, Patient Data. Enter the service member’s name, date of birth, unique identification number, unit, and the date of request. Ensure that all details are accurate and up to date.
3. Move to Section II, Medical Conditions. Fill in the medical conditions the service member has experienced in the last 90 days. Provide the appropriate ICD-10 diagnosis codes and explain the conditions in lay terminology for clarity.
4. In Section III, Civilian Provider Treatment Plan, describe the treatment plan for each condition listed. Include any relevant laboratory tests, imaging results, and physical findings.
5. Proceed to Section IV, Civilian Provider Prognosis. Specify whether the recovery time is expected to exceed one year and provide projected recovery periods in weeks or months. Additionally, indicate whether the service member can return to limited or light duty.
6. In Section V, Service Member’s Physical Fitness Training Assessment, evaluate the service member's ability to participate in various fitness tests. Indicate yes or no for each assessment and provide maximum lift weights or other relevant metrics.
7. Continue to Section VI, Military Common Tasks Assessment. Assess the service member’s capability to perform military tasks, confirming or denying their ability to carry out specific duties.
8. Complete Section VII with the provider's details, including signature and date. Confirm if any restrictions are permanent and input relevant case numbers if necessary.
9. Once finished, carefully review all entries for accuracy. Finally, save the changes, and choose to download, print, or share the completed form as required.

Complete your TX TXMF Form 3349-R online today to support the service member's medical assessment.