Foot trouble e. Impaired use of arms, legs, hands, or feet b. Lived with someone who had tuberculosis c. Coughed up blood h. Swollen or painful joint s d. Asthma or any breathing problems related to exercise, weather, i.
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The form is used by military physicians to determine if an applicant can be accepted or should be disqualified on medical grounds. The DD Form is available on the Department of Defense documentation website or can be supplied through the chain of command. Before filling out the DD Form , you must first read the disclaimer and understand that you must answer truthfully to all questions or face criminal charges.
First, fill out your basic information in boxes 1 through 4, providing your name, social security number, and contact information. Put the examining location on box 5, giving the address of the location. Provide the information required in boxes 6 through 9, stating the military branch you are applying for, component, and purpose of the form. Next provide your position, usual occupation, current medication, and allergies.
Boxes 10 through 19 ask you to indicate whether you have a history of specific medical conditions or illnesses. Go through each medical issue and answer yes or no for each. You must fill in the corresponding bubble for each medical issue. Do not leave any answers blank, you must answer yes or no to each issue. If you answer yes to any question in boxes 10 through 19, you must provide an explanation of the medical condition in the provided space in box 29 or attach additional sheets explaining each yes answer.
Questions 20 through 28 ask additional personal questions, which you must answer yes or no for each question. On the second page, provide your name and social security number at the top. A physician must attest to your answers in boxes 10 through The physician may provide additional comments in box 30, adding additional information that they feel is important.
The examiner must sign and date the second page. The DD Form is now ready for submission to the Department of Defense for review of your medical history.
Fillable Form DD 2807-1 (2015-2017)
DD Form 2807-1 Report of Medical History
DD Form 2807-1 "Report of Medical History"