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Defense Department form, series DD, number 2697. Full title: DD Form 26 97, Report of Medical Assessment, February 1995. Function: Report of Medical Assessment. Edition in force: not stated. Publisher status: not stated.
Prescribing authority: not stated. Proponent: not stated. Unlike service-specific publications, DD forms carry Department-level authority and apply across the Army, Navy, Air Force, Marine Corps, Space Force and Coast Guard when operating under Defense jurisdiction.
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 46.
Distribution centres on pdf. Two states exist: fillable, where field boxes accept keyboard input and retain it, and printable, a static blank produced for manual completion. Typed data reproduces cleanly across copies; handwritten data depends on the writer.
What the form asks for
- Report Control Symbol.
- Section 1 - to be completed by service member. Any service member who requests a physical examination may have one. 1. Name (last, first, middle).
- 2. Social security number. Do not include dashes.
- 3. Rank.
- 4. Component.
- 5. Unit of assignment.
- 6.a. Home street address (or RFD, including apartment number).
- 6.b. City.
- 6.c. State.
- 6.d. Zip code.
- 7. Home telephone number (include area code).
- 8. Date of last physical examination by the military (4 digit year, 2 digit month, 2 digit day).
- 9. Date entered on current active duty (4 digit year, 2 digit month, 2 digit day).
- 10. Compared to my last medical assessment/physical examination, my overall health is: Press space bar to mark X in first box if the same, second box if better, or third box if worse.
- 10. If worse, explain.
- 11. Since your last medical assessment/physical examination, have you had any illnesses or injuries that caused you to miss duty for longer than 3 days? X first box if no, second box if yes.
- 11. If yes, explain.
- 12. Since your last medical assessment/physical examination, have you been seen by or been treated by a health care provider, admitted to a hospital, or had surgery? X first box if no, second box if yes.
- 12. If yes, explain.
- 13. Have you suffered from any injury of illness while on active duty for which you did not seek medical care? X first box if no, second box if yes.
- 13. If yes, explain.
- 14. Are you now taking any medications? X first box if no, second box if yes.
- 14. If yes, list medications.
- 15. Do you have any conditions which currently limit your ability to work in your primary military specialty or require geographic or assignment limitations? X first box if no, second box if yes.
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.
Edition in use: not stated. Because DD forms are revised at Department level and distributed to all services at once, an obsolete printing may not match the fields an office expects. The date is printed on the form face.
Instructions printed on the form or in not stated govern individual field entries. Where the two differ, the governing publication controls.
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.
Associated forms are traced by number within the series. Because the DD sequence is common to all military departments, no service qualifier is needed to identify a referenced form.
Where a DA form is cited alongside a DD form, the two belong to different systems: DA numbering is Army-specific and administered by an Army proponent, while DD numbering is Defense-wide under not stated or an equivalent Department office. Numbers do not translate between the systems.
Forms are reissued for several reasons: directive revision, changed data requirements, updated notice language. Confirming not stated at the moment of download covers the risk.
The material here is descriptive. Nothing on the page constitutes legal or procedural advice, and no statement here determines whether a submitted form will be accepted. Such questions go to not stated, a servicing administrative office, or the authority identified in not stated.
Questions and answers
- What is DD Form 2697?
- DD Form 26 97, Report of Medical Assessment, February 1995
- Which edition is current?
- Not stated by the publisher
- Who is responsible for this form?
- Not stated
- In which formats can it be downloaded?