OMB control number
Medical Screening of Military Personnel-Medical History Report and Accession Medical History Report
OMB 0704-0413 · DOD/DODDEP.
OMB 0704-0413
Title 10 U.S.C. Sections 504, 505, 507, 532, 978, 1201, 1202, and 4346 require military applicants to meet medical accession standards for enlistment, induction, and appointment to the Armed Forces. The referenced prescreening and medical history reports are needed from military applicants to elicit an accurate medical history past and present.
The latest form for Medical Screening of Military Personnel-Medical History Report and Accession Medical History Report expires 2028-01-31 and can be found here.
Latest Forms, Documents, and Supporting Material
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Form |
Supporting Statement A |
Supplementary Document |
Supplementary Document |
All Historical Document Collections
| Revision of a currently approved collection | 2024-10-22 | ||
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Approved without change |
Extension without change of a currently approved collection | 2021-09-27 | |
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Approved without change |
Reinstatement without change of a previously approved collection | 2018-08-17 | |
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Approved without change |
Revision of a currently approved collection | 2014-08-28 | |
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Approved without change |
Reinstatement without change of a previously approved collection | 2011-07-04 | |
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Approved without change |
Extension without change of a currently approved collection | 2010-03-31 | |
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Approved without change |
Extension without change of a currently approved collection | 2007-01-30 | |
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Approved without change |
Extension without change of a currently approved collection | 2003-07-31 | |
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Approved without change |
New collection (Request for a new OMB Control Number) | 2000-05-22 |