Da Form 3349 - Physical Profile

ADVERTISEMENT

PHYSICAL PROFILE
For use of this form, see AR 40-501; the proponent agency is the Office of the Surgeon General.
INJURY? Or
ILLNESS/DISEASE?
2. CODES
3.
(Table
P
U
L
H
E
S
1. MEDICAL CONDITION:
(Description in lay terminology)
7-2 AR 40-501)
Temporary
Permanent
4. PROFILE TYPE
YES
NO
a. TEMPORARY PROFILE
(Expiration date YYYYMMDD)
(Limited to 3 months duration)
b. PERMANENT PROFILE
(Reviewed and validated with every periodic health assessment or after 5 years from the date of issue)
5. FUNCTIONAL ACTIVITIES THAT EVERY SOLDIER REGARDLESS OF MOS MUST BE ABLE TO PERFORM. IF SOLDIER CANNOT PERFORM ANY ONE OF
THESE TASKS, THEN THE PULHES MUST CONTAIN AT LEAST ONE "3" AND SOLDIER MUST BE REFERRED TO A MEB. CAN THE SOLDIER:
YES
NO
FUNCTIONAL ACTIVITY:
a. Carry and fire individual assigned weapon?
b. Evade direct and indirect fire?
c. Ride in a military vehicle for at least 12 hours per day?
d. Wear a helmet for at least 12 hours per day?
e. Wear body armor for at least 12 hours per day?
f. Wear load bearing equipment (LBE) for at least 12 hours per day?
g. Wear military boots and uniform for at least 12 hours per day?
h. Wear protective mask and MOPP 4 for at least 2 continuous hours per day?
i. Move 40lbs (for example, duffle bag) while wearing usual protective gear (helmet, weapon, body armor and LBE) at least 100 yards?
j. Live in an austere environment without worsening the medical condition?
6. APFT
YES
NO
ALTERNATE APFT
N/A
YES
NO
(Fill out if unable to do APFT run otherwise N/A)
2 MILE RUN
APFT WALK
APFT SIT-UPS
APFT SWIM
APFT PUSH UPS
APFT BIKE
7. DOES THE SOLDIER MEET RETENTION STANDARDS IAW CHAPTER 3 AR 40-501?
YES
NEEDS MMRB
NO
NEEDS MEB
8. FUNCTIONAL LIMITATIONS AND CAPABILITIES AND OTHER COMMENTS:
This temporary profile is an extension of a temporary profile first issued on
9. NAME, GRADE & TITLE OF PROFILING OFFICER
10. SIGNATURE
11. DATE
(YYYYMMDD)
12. NAME & GRADE OF APPROVING AUTHORITY
13. SIGNATURE
14. DATE
(YYYYMMDD)
15. Commanders can access the electronic profiles of Soldiers in their unit(s) by going to and clicking on eProfile in the list of
applications. Commanders will be required to register and be approved in eProfile before they can gain access to profiles.
17. HOSPITAL OR MEDICAL FACILITY
16. PATIENT'S IDENTIFICATION
a. NAME:
(Last, First)
b. GRADE/RANK:
c. SSN:
18. PROFILING OFFICER E-MAIL
d. UNIT:
Page 1 of 2
DA FORM 3349, SEP 2010
PREVIOUS EDITIONS ARE OBSOLETE
APD PE v1.00ES

ADVERTISEMENT

00 votes

Related Articles

Related forms

Related Categories

Parent category: Business
Go
Page of 2