Army Medical Checklist Template
Download
Army Medical Checklist
Soldier Information:
Item | Information |
|---|---|
Soldier Name | Marcelo Green |
Date of Birth | January 15, 1995 |
Soldier ID | 1234567890 |
Contact Email | marcelo@you.mail |
Pre-Deployment Health Assessment
Physical Health
Vision: Pass/fail on vision test
Hearing: Pass/fail on hearing test
Blood Pressure: Less than 140/90 mmHg
Height & Weight: Within military standards
Fitness Test: Successful completion of physical fitness test
Immunizations & Medical History
Immunization or Test | Status |
|---|---|
Hepatitis B | Up-to-date?
|
Tetanus & Diphtheria | Up-to-date?
|
Influenza | Up-to-date?
|
Malaria Prophylaxis | Required for deployment |
TB Skin Test | Negative |
Mental Health Evaluation
Psychological Screening: Pass/fail mental health evaluation
Stress Test: Pass/fail stress response test
Counseling: No unresolved mental health issues
Substance Abuse: Negative drug test
Medical Clearance for Specialized Roles
Role | Status |
|---|---|
Airborne Operations | Medically cleared?
|
Special Forces | Medically cleared?
|
Combat Medic | Medically cleared?
|
Soldier Confirmation
I confirm that the information provided is accurate.
I agree to undergo any necessary follow-up evaluations.
Contact Information for Queries
For further inquiries, please contact the medical office at:
[YOUR COMPANY NAME]
Address: [YOUR COMPANY ADDRESS]
Email: [YOUR COMPANY EMAIL]
Phone: [YOUR COMPANY NUMBER]
Templates
Checklist
Templates
