Follow the steps to successfully complete your medical waiver request

1. Click ‘Get Form’ button to obtain the form and open it for editing.
2. In Section 1, enter the member demographics and assignment specifics. Fill in the patient’s name, rank, status, home station departure date, date of birth, service, report date, height, weight, body mass index, sex, home station/unit, tasking duration, and most recent periodic health assessment date. Include the EUCOM destinations and Department of Defense identification number, along with the military occupational specialty/Air Force specialty code and a brief job description.
3. Proceed to provide medical unit point of contact information, including name, title, position, email, and phone number, along with the date and digital signature.
4. In Section 2, the healthcare provider should summarize the medical narrative. This includes relevant clinical information such as diagnosis with ICD10 codes, current treatments, medications, ongoing medical issues, limitations imposed by conditions, prognosis, and a comprehensive case summary detailing the condition's onset and history.
5. Ensure that additional documentation is included as required, such as a specialist's letter if applicable, a commander’s endorsement letter, and any necessary supporting documents like medication control measures and medical equipment specifications.
6. In Section 3, gather the required signatures from qualified medical providers, ensuring to denote approval or disapproval of the waiver request with appropriate comments as needed.
7. After reviewing the completed form, save your changes. Users can download the form, print it, sign using a digital signature, or share it as needed.

Complete your USEUCOM Medical Waiver Request online today to ensure a smooth submission process.