Jun 19, 2008 requests for separation for pregnancy must. Af form 422 notification of air force members qualification. Copy of af form 422, physical profile serial report current within 12 months, must include pulhes copy of all dd 214ngb form 22 this document is required for former active service member and prior service in the national guard. The profile is also used to communicate with the health and wellness center exercise physiologist so they can develop an exercise prescription on form 422. Fac documents fa results on a hard copy score sheet see sample score sheets. Patient id use plastic card or typeprint name grade. Excessive use ofprofiles will cause airmento avoid mentalhealth care forfear.
These physicals are based primarily upon all of the body system functions. Personnel must have sufficient retainability to permit completion of tour of duty. Air force ots example 56, af imt 560, form 56, af form 56 commander interview, ots applicant profile examples. Applicants for enlistment, commission and training in the air force and air reserve component arc, united states air force academy usafa, air force. Airman leadership school and noncommissioned officer. An applicant on a medical profile may apply and be selected for an agr tour.
Must be signed and verified within 6 months from your medical group 4. Pulhes is a united states military acronym used in the military physical profile serial system. Imr printout this can be found via the af portal, my imrasims medical readiness screenshot the initial imr page with. Af form 422 fill online, printable, fillable, blank. Provides physical examinations in accordance with usmepcom. Other service components submit medical documentation that includes pulhes score and if any pulhes are a 3, a statement indicating that individual is worldwide deployable. Air force eligibility for the enlisted to medical degree. Area of consideration this position is open to current enlisted agr members in the louisiana air.
It should include as many of the following characteristics as necessary to express the minimum requirements of the government. The assessment must be current through course completion. Military physicians use a profile or duty limiting condition, form 469, to communicate duty restrictions to patient supervisors. The documents should be in pdf format only not in portfolio. Enterprise, afi 363212, physical evaluation for retention. Submit af form 422 validated by your medical personnel, current within 12 months. Af form 422 download printable pdf or fill online notification of. Preventive health assessment and physical examination techniques for further information. Medical ccode not a deployment disqualifier air forces. Physical profile serial report, to document exercise program evaluations, fitness prescription instructions, fitness testing exemption recommendations, and clearance for unrestricted fitness participation or fitness testing afi 10203 paragraph 2. If you do not know where to obtain a 422 contact your medic section. Members possessing an af form 422, physical profile serial report, identifying temporary physical restrictions are ineligible to attend without director of education contact info. Apr 07, 2020 accountability of air force personnel. Apr 03, 2020 af form 422, imr printout, dd form 2992 af form 422, physical profile serial report current within 12 months, must include pulhes this is not your phaq.
Air national guard 187th communications flight 187th fighter. Refer recommended changes and questions about this publication to the office of primary responsibility opr using the af form 847, recommendation for change of publication. Members must meet physical fitness standards iaw afi 362905, air force fitness program. Af form 422 fill online, printable, fillable, blank pdffiller. The physical profile serial system is created around the various military duties and provide a numerical standard that a medical doctor recommends during the routine recruit physical. Administrative data change in physical profile requred yes prepare af form 422 no meal card yes no 41.
Steps to help complete physical limitation form keesler. So the af 469 generated at your appointment for whatever co. Air national guard members must meet the physical qualifications outlined in afi48123. Airman leadership school and noncommissioned officer academy. Medical ccode not a deployment disqualifier air force. This document gives a clear picture of the official physical restrictions that are related to the medical condition, said green. Download printable af form 422 in pdf the latest version applicable for 2020.
The exercise physiologist will use air force form 422. A c1 coded airman may also move to most overseas bases without a waiver, as long as those bases have a fixed medical treatment facility, green said. Physical profile system to include physical profile serial chart pulhes. Air national guard 187th communications flight 187th. It must be signed by a designated profiling officer. Copy of current fitness test scores, if exemptions exist please include the af 469. Af form 422, imr printout, dd form 2992 af form 422, physical profile serial report current within 12 months, must include pulhes this is not your phaq.
The new afi 10203 published the other month switched the pt restrictions on an af 422 from the exercise physiologist back to the pcm your normal doc and everything is documented on the af 469. Af form 63, active duty service commitment adsc acknowledgement statement af form 422, physical profile serial report af form 475, education fill af 422 form, download blank or editable online. The clinic here is closed for training, and i really need this form asap. Last complete physical and current af form 422, physical profile serial report. An applicant on a medical profile, to include pregnancy, may apply and be selected for an agr tour. C1 coded airmen can move to any continental united states assignment, elmendorf air force base, alaska, and hawaii, without a waiver. Af form 422, physical profile serial report current within 5 years, validated within 12 months orang air technicians interested in converting to agr status. Dd form 2946 dod telework agreement federal guidance.
Yes epts, lod not applicable af form 348 check if continued on reverse check if continued on reverse 40. Af form 56 pdf commanders comments and recommendations af form 56, page 6. What links here related changes upload file special pages permanent link page. Application must be scanned into one pdf file and emailed to. Knowledge is mandatory of basic mathematics, materiel management policies and procedures, air force property accounting, stoc k and inventory control. Learn vocabulary, terms, and more with flashcards, games, and other study tools. Both forms must be current within 12 months this form can be obtained from your wing clinic. Selection for the advertised position does not constitute acceptance into the agr program. Be supported by an af form 422, physical profile serial report, confirming the pregnancy. Reports discrepancies and recommends corrective action. Purpose of af form 422, notification of air force members qualification status.
Another document giving the same information, da form 3349, medical conditionphysical profile record, for example, may be. Air force instruction afi 48123, medical examination and. Imr printout this can be found via the af portal, my imrasims medical readiness screenshot the initial imr page. Air force instruction 10203 air force personnel center af. Sign, fax and printable from pc, ipad, tablet or mobile with pdffiller instantly no software. The af form 422 is used for initial qualification, qualification for retirement or separation. Current af fitness assessment with current fit test score and fit test history member must provide current documentation from fitness monitor showing they meet fitness. Purpose of af form 422, physical profile serial report, is to standardize. Af form 422, physical profile serial report, current within 12 months af form 1042, only required if announcement requires applicant to be on flight status medical documents which indicates a permanent profile higher than a 1 in any of the pulhes fields of the physical if applicable. Provides orders and distributes required documents for those ots. The purchase description should clearly describe the essential physical and functional characteristics of the item required. Employs ttps on air force and dod computer networks to defend against hostile information operations.
Inspects personnel activities for compliance with policies and directives. No preexisting or outstanding medical issues that require followup, to include a temporary profile permanent profile da form 3349, if applicable da form 3349 army ng af form 422 air ng retirement points accounting management rpam 23a print out within 30 days of duty yearly training calendar from the sm unit of assigned. Drafts and finalizes operating instructions, which include but are not limited to, alert plans, duty hour, and designation of delivery locations. Copy of af form 422, physical profile serial report and dd form 2992 for flight status, flight physical. Required documents for af form 422 also include medical and dental. Call them and tell them what you need and that it is just for pulhes. Current af form 422, physical profile serial report 3. Purpose of af form 422, duty limiting condition report. Statewide announcement is made of the following active.
Requests for records or documents cannot be made by phone. Air national guard members must meet the physical qualifications outlined in afi48 123. The below definitions are derived from air force instruction 48 123 medical. Maintains source document control and ensures validity and completeness. Af form 422 physical profile, my health manager log in, math concepts by grade level, recent questions and answers p, irans oil industry post sanctions, 2018 pr 26 form, paralegal responsibilities, chapter 2 pavement composition and behaviour, isbn 9781285749693, reference price for section 45i credit for, af form 1881 fillable, plan. Air force fitnessmanagement system ii affmsii report. Submit af form 422 validated by your medical personnel, current win 12 months. If its there, its the blue hyperlink at the bottom that says af422.
Like i have said in previous posts, i strongly recommend you talk to your commander. Medicine clinic to obtain a completed af form 422 physical profile serial report that is current as of the 30 september of the board year. This form may include work, mobility or fitness restrictions. The guided path from enlisted to officer squarespace. Another document giving the same information, da form 3349, medical condition physical profile record, for example, may be. Enlisted to medical degree preparatory program application. Fill out the notification of air force members qualification status online and print it out for free. Imr printout this can be found via the af portal, my imrasims. Statewide announcement is made of the following active guard. Air force, united states federal legal forms and united states legal forms. The third component is the members af form 469, which is commonly known as a profile. Analyzes risks andor vulnerabilities and takes corrective action to mitigate or remove them.
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