Ensure an explanation is attached for required answers given in section iv 2. Af form 422, physical profile serial report current within 5 years, validated within 12 months required for retraining only orang air technicians interested in converting to agr status. New profile system gives commanders more say sheppard. Air national guard members must meet the physical qualifications outlined in afi48 123. The fac uses the fitness test restrictions on the form 422 to determine which parts of the usaf fitness test can be safely evaluated. By order of the air force instruction 48 123 secretary of. These procedures have been developed to ensure maximum utilization and readiness of personnel, while. Member must have retainability to complete the tour of military duty. This instruction establishes procedures for the documentation and administrative management of airmen with injuries or illnesses that may impact their ability to perform their military duty. I have been notified that im eligible, and i am working to get all my required paperwork. The below definitions are derived from air force instruction 48123 medical.
Download printable af form 422 in pdf the latest version applicable for 2020. I n t e g r i t y s e r v i c e e x c e l l e n c e. Anyone know if its possible to have this portion waived. Establish procedures for processing af form 422, physical profile serial report, according to paragraph 7.
Changes to the medical profiling system were brought about due to a memorandum from air force chief of staff gen. Current af fitness assessment with current fit test score and fit test history member must provide current documentation from fitness monitor showing they meet fitness. For context im security forces trying to become a mwd handler. Ngb 341 dated 201111 application for active guardreserve agr position. Area of consideration this position is open to current enlisted members in the louisiana air national guard. Jun 25, 2019 for example, if a military job requires a serial profile of 123123, that means, in order to qualify for that job, a person would have to be medically rated the following. Copy of af form 422, physical profile serial report current within 12 months, must include pulhes copy of all dd 214ngb form 22 this document is required for former active service member and prior service in the national guard. Information file, not have an article 15 nonjudicial punishment, a current passing fitness assessment, no af form 422 serial physical profile that would prohibit them from performing honor guard missions, at least one year of retainablity from the date of contract signature, and approval from their commander, first sergeant, and flight chief. Medical ccode not a deployment disqualifier air force. Learn vocabulary, terms, and more with flashcards, games, and other study tools. The third component is the members af form 469, which is commonly known as a profile. Pulhes 1121 af form 422 required for retraining for additional information about asvab scores, reference the additional information section in this announcement. The p in pulhes is an overall inspection of the body and its living systems heart, lungs, digestion, reproductive, central nervous system, and hormonal.
Enterprise, afi 363212, physical evaluation for retention. Preventive health assessment and physical examination techniques for further information. For instance, the mos 19d cavalry scout requires a physical profile of 111121 or better. Member must meet the physical qualifications outlined in afi 48123, medical examination and standards, attachment 2 before being placed on an agr tour. Medical ccode not a deployment disqualifier air forces. Copy of current fitness test scores, if exemptions exist please include the af 469. I have never had any physical or medical issues so as far as the physical was concerned all i needed was an updated af form 422. This document gives a clear picture of the official physical restrictions that are related to the medical condition, said green. Af form 422, notification of air force members qualification status, to the idmts and their.
Copy of af form 422, physical profile serial report and dd form 2992 for flight status, flight physical. File for military pay, certified af form 938 is sent to hq riorpo. Pulhes is a united states military acronym used in the military physical profile serial system. P 1 in the area of physical capacity or stamina u 2 in the area of upper extremities l 3 in the area of lower extremities h 1 in the area of hearing and ears e 2. Assist bioenvironmental engineering be in writing the supplement to. Apr 14, 2020 af form 422 physical profile see your medical group only required if you do not have the 2a3x3 afsc orang air technicians interested in converting to agr status. Af form 469 is used to convey limitations related to the af fitness program fp as well as fitness assessment exemptions fae. Physical fitness test report from air force fitness management system ii affms ii. Place the flying class category and the duty performed using the references below. May 06, 2015 this attachment was fairly cut and dry for me. Af form 422, physical profile serial report validated within 12 months required if you are retraining into 2a6x1 orang air technicians interested in converting to agr status.
Air national guard members must meet the physical qualifications outlined in afi48123. A c1 coded airman may also move to most overseas bases without a waiver, as long as those bases have a fixed medical treatment facility, green said. Provides documentation of fa exemption andor exercise recommendations on af form. Af form 422, physical profile serial report current within 5 years, validated within 12 months orang air technicians interested in converting to agr status. The exercise physiologist will use air force form 422. Current af form 422, physical profile serial report 3. Completes all required forms to include af form 2631, palace chase statement of understandingcontract, and af form 1288, application for ready reserve assignment. I actually called the mdg to request an appointment and they clearly informed me i did not need to see my pcm. Completed af form 422 with the following statement. Refer recommended changes and questions about this publication to the office of primary responsibility opr using the af form 847, recommendation for change of publication. Please read this announcement completely af form 422, physical profile serial report current within 5 years, validated within 12 months orang air technicians interested in converting to agr status. Af form 422 download printable pdf or fill online notification of.
R for current fy current fy participation waivers if applicable section iv readiness indicators current af imt 422 physical profile if applicable current fitness assessment printout from affms. C1 coded airmen can move to any continental united states assignment, elmendorf air force base, alaska, and hawaii, without a waiver. I am not set to return until after my window closes out, as im based oconus. Medical exams must be conducted not more than 12 months prior to entry on agr duty.
Officers must also submit a personal memorandum explaining the reason for applying for early release. All active duty air force enlisted members need to obtain this form with a mandatory eligibility statement to assess the physical and mental standards. Other service components submit medical documentation that includes pulhes score and if any pulhes are a 3, a statement indicating that individual is worldwide deployable. Do not use spaces when performing a product numbertitle search e. The new system replaces air force form 422, physical profile serial report, with a twopart system using form 469, duty limiting condition and a new form 422a. Common diseases of any of these systems stemming from nutritional deficiencies, blood diseases, allergies, breasts, soft or hard tissues as well fall under the physical capacity. Sign, fax and printable from pc, ipad, tablet or mobile with pdffiller instantly no software. Af form 63, active duty service commitment adsc acknowledgement statement af form 422, physical profile serial report af form 475, education fill af 422 form, download blank or editable online.
Physical profile system to include physical profile serial chart pulhes. Secretary of the air force air force instruction 48123 24 september 2009 aerospace medicine medical examinations and. The fac will not allow an airman with physical limitations to test without a current signed form 422. Enlisted also complete dd form 412, enlistmentreenlistment document armed. In general, the af form 469 will describe an airmans limitations and fitness assessment clearanceexemptions. Purpose of af form 422, notification of air force members. Afto53, af673, afspc1648 to minimize results, use the navigation buttons below to find the levelorganization you are looking for, then use the filter to search at that level. Steps to help complete physical limitation form keesler. Public health office will document pulhes scores in the pme special duty application and afsc retraining physical profile assessment section of the af form 422 and endorse section b of attachment. Selection for the advertised position does not constitute acceptance into the agr program. The clinic here is closed for training, and i really need this form asap. Ngb form 34 1 application for active guard reserve agr position signed.
Purpose of af form 422, notification of air force members qualification status. Fill out the notification of air force members qualification status online and print it out for free. Ngb form 341, application for active guardreserve agr position, form version dated 11 november 20 o announcement number and position title must be annotated on the form o download the current form version from. Af form 422 notification of air force members qualification. Submit af form 422 validated by your medical personnel, current within 12 months. May, 2020 af form 422, physical profile serial report current within 5 years, validated within 12 months orang air technicians interested in converting to agr status. Af form 422 physical profile see your medical group only required if you do not have the 2a3x3 afsc orang air technicians interested in converting to agr status. If you do not know where to obtain a 422 contact your medic section. Af form 108, physical fitness education and intervention process af form 422, physical profile serial report af form 469, duty limiting condition report official statement from fitness assessment cell fac, physical training leader ptl, primary care manager pcm, unit commander. Enlisted to medical degree preparatory program application. An applicant on a medical profile may apply and be selected for an agr tour. Area of consideration this position is open to current enlisted agr members in the louisiana air.
If its there, its the blue hyperlink at the bottom that says af422. Af form 422 must be obtained from your medical group. An applicant on a medical profile, to include pregnancy, may apply and be selected for an agr tour. Current within 12 months af form 422, physical profile serial report. Applicants for enlistment, commission and training in the air force and air reserve component arc, united states air force academy usafa, air force. Copy of af webha, web based health assessment current within 12 months copy of af form 422, physical profile serial report current within 12 months, must include pulhes copy of all dd 214ngb form 22 this document is required for former active service member and prior service in the national guard. Purpose of af form 422, physical profile serial report, is to standardize.
Im a sra currently deployed and attempting to retrain. This instruction implements air force policy directive afpd 481, aerospace medicine program afpd 3632, military retirements and separations and afi 363212, physical evaluation for retention, retirement or separation and department of defense dod. Air force, united states federal legal forms and united states legal forms. It can take five to seven days for a profile to go through the system.
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