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DD Form 2493-1 — a Department of Defense document. Title of record: DD Form 2493-1, Asbestos Exposure Part I - Initial Medical Questionnaire, January 2000. Stated purpose: Asbestos Exposure Part I - Initial Medical Questionnaire. Edition date not stated; status not stated.
Issued under not stated, with not stated as proponent. A DD number marks a Department-wide instrument: the same blank form serves every military department and the defense agencies, rather than one service alone.
The form reaches military personnel across the services, civilian employees of the Department, and the personnel and records specialists who receive it.
When the form is filed is a matter of not stated and local instruction. The description here covers the document itself and how to obtain a copy.
Formats offered: PDF. Length: 2 pages. Fillable field count: roughly 188.
Every listed format is free to download. Modern pdf software handles the pdf files, with the caveat that browser-embedded viewers sometimes ignore field properties that a desktop reader honours.
What the form asks for
- Identification section. 1. Name (last, first, middle initial).
- 2. Social security number. Do not include dashes.
- 3. Clock number. Enter 5 digit number.
- 4. Present occupation.
- 5. Name of plant.
- 6. Street address of plant.
- 7. Plant city, state and zip code.
- 8. Telephone number, include area code.
- 9. Name of interviewer.
- 10. Date of interview (4 digit year, 2 digit month, 2 digit day).
- 11. Date of birth (4 digit year, 2 digit month, 2 digit day).
- 12. Place of birth
- 13. Sex. Press space bar to mark X in first box if male, second box if female.
- 14. Marital status. X first box if single, second box if married, third box if widowed, or fourth box if divorced/separated.
- 15. Race. X first box if white, second box if black, third box if Asian, fourth box if Hispanic, fifth box if Indian, or sixth box if other.
- 16. Highest grade completed in school.
- 17. Occupational history. a. In the past year, did you work full time (30 hours per week or more) for six months or more? X first box if yes, second box if no.
- b. If yeshave you ever worked for a year or more in any dusty job? X first box if yes, second box if no, third box if not applicable.
- (3) Dust exposure: X first box if mild, second box if moderate, third box if severe.
- c. Have you ever been exposed to gas or chemical funes in your work? X first box if yes, second box if no, third box if not applicable.
- If yes: (1) Specify job or industry.
- (2) Total years worked.
- If yes: (1) Specify job or industry.
- (2) Total years worked.
The document is filled from the top down. Identification precedes substance, substance precedes certification. Fields lower on the page are commonly keyed to entries made above them.
Verify the edition date against not stated before entry. Department-level revisions replace the blank across every service simultaneously, so an old copy in a desk drawer may no longer correspond to current field numbering.
Field-level instructions appear on the form itself and in not stated. The directive is the controlling text.
After completion, the copy goes to the office designated by not stated or by local procedure. Retention of a personal copy is ordinary practice and costs nothing.
Related documents are located by series and number. DD forms sit in a single Department-wide sequence, so a form referenced inside DD Form 2493-1 is normally found by its number alone, without regard to service.
A DD number and a DA number may appear in the same instruction without being related. DA forms belong to the Army alone; DD forms belong to the Department and are administered at Department level. The sequences are independent.
Editions change because the underlying directive changes, because collection requirements are revised, or because Privacy Act language is updated. Checking the edition date at the point of download is the practical response.
This page distributes a published Department of Defense document and describes it. It is not a source of legal advice and makes no representation about acceptance of any completed form. Questions of applicability, eligibility or procedure belong to not stated, the servicing personnel office, or the office named in not stated.
Questions and answers
- What is DD Form 2493-1?
- DD Form 2493-1, Asbestos Exposure Part I - Initial Medical Questionnaire, January 2000
- Which edition is current?
- Not stated by the publisher
- Who is responsible for this form?
- Not stated
- In which formats can it be downloaded?