Provides documentation of fa exemption andor exercise recommendations on af form. 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. 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. 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. Assist bioenvironmental engineering be in writing the supplement to. For instance, the mos 19d cavalry scout requires a physical profile of 111121 or better.
Ensure an explanation is attached for required answers given in section iv 2. Download printable af form 422 in pdf the latest version applicable for 2020. In general, the af form 469 will describe an airmans limitations and fitness assessment clearanceexemptions. 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. The p in pulhes is an overall inspection of the body and its living systems heart, lungs, digestion, reproductive, central nervous system, and hormonal. 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.
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. Do not use spaces when performing a product numbertitle search e. Sign, fax and printable from pc, ipad, tablet or mobile with pdffiller instantly no software. 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.
New profile system gives commanders more say sheppard. If its there, its the blue hyperlink at the bottom that says af422. Completes all required forms to include af form 2631, palace chase statement of understandingcontract, and af form 1288, application for ready reserve assignment. Officers must also submit a personal memorandum explaining the reason for applying for early release. Current within 12 months af form 422, physical profile serial report. The below definitions are derived from air force instruction 48123 medical. 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. Pulhes is a united states military acronym used in the military physical profile serial system. Steps to help complete physical limitation form keesler.
Copy of current fitness test scores, if exemptions exist please include the af 469. Medical exams must be conducted not more than 12 months prior to entry on agr duty. 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. 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. Current af imt 422 physical profile if applicable current fitness assessment printout from affms current family care plan if applicable. Ngb form 34 1 application for active guard reserve agr position signed. I have been notified that im eligible, and i am working to get all my required paperwork.
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. 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. 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. Fill out the notification of air force members qualification status online and print it out for free. Submit af form 422 validated by your medical personnel, current win 12 months. Establish procedures for processing af form 422, physical profile serial report, according to paragraph 7. These procedures have been developed to ensure maximum utilization and readiness of personnel, while. Physical fitness test report from air force fitness management system ii affms ii.
Anyone know if its possible to have this portion waived. Air force, united states federal legal forms and united states legal forms. Selection for the advertised position does not constitute acceptance into the agr program. Forms management office af portal web page for downloading. An applicant on a medical profile may apply and be selected for an agr tour. Ngb 341 dated 201111 application for active guardreserve agr position. Place the flying class category and the duty performed using the references below.
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. Area of consideration this position is open to current enlisted agr members in the louisiana air. 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. Air national guard members must meet the physical qualifications outlined in afi48123. It can take five to seven days for a profile to go through the system. 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 status, to the idmts and their. 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. Secretary of the air force air force instruction 48123 24 september 2009 aerospace medicine medical examinations and. 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. Preventive health assessment and physical examination techniques for further information. Submit af form 422 validated by your medical personnel, current within 12 months.
Member must have retainability to complete the tour of military duty. Enlisted also complete dd form 412, enlistmentreenlistment document armed. May 06, 2015 this attachment was fairly cut and dry for me. The fac will not allow an airman with physical limitations to test without a current signed form 422. Patient id use plastic card or typeprint name grade. The third component is the members af form 469, which is commonly known as a profile. Learn vocabulary, terms, and more with flashcards, games, and other study tools. Pulhes 1121 af form 422 required for retraining for additional information about asvab scores, reference the additional information section in this announcement. Af form 422 download printable pdf or fill online notification of. Member must meet the physical qualifications outlined in afi 48123, medical examination and standards, attachment 2 before being placed on an agr tour. Purpose of af form 422, notification of air force members. 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. For context im security forces trying to become a mwd handler.
Physical profile serial report, to document exercise program evaluations, fitness prescription instructions, fitness testing exemption recommendations, and clearance for unrestricted fitness participation or fitness testing afi 10203 paragraph 2. Applicants for enlistment, commission and training in the air force and air reserve component arc, united states air force academy usafa, air force. Af form 469 is used to convey limitations related to the af fitness program fp as well as fitness assessment exemptions fae. Copy of af form 422, physical profile serial report and dd form 2992 for flight status, flight physical. Im a sra currently deployed and attempting to retrain. The exercise physiologist will use air force form 422. Medical ccode not a deployment disqualifier air force. Area of consideration this position is open to current enlisted members in the louisiana air national guard.
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. 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. Enlisted to medical degree preparatory program application. Physical profile system to include physical profile serial chart pulhes. Copy of af form 422, physical profile serial report and af form 1042 for flight status, flight physical. 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.
By order of the air force instruction 48 123 secretary of. Af form 422, physical profile serial report current within 5 years, validated within 12 months orang air technicians interested in converting to agr status. Completed af form 422 with the following statement. Enterprise, afi 363212, physical evaluation for retention. Af form 422 notification of air force members qualification. Medical ccode not a deployment disqualifier air forces. 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 actually called the mdg to request an appointment and they clearly informed me i did not need to see my pcm. All active duty air force enlisted members need to obtain this form with a mandatory eligibility statement to assess the physical and mental standards. Af form 422 must be obtained from your medical group.
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. The clinic here is closed for training, and i really need this form asap. Purpose of af form 422, physical profile serial report, is to standardize. If you do not know where to obtain a 422 contact your medic section. Af form 40a from utapsweb for current fy af form 938 from arows.
This document gives a clear picture of the official physical restrictions that are related to the medical condition, said green. An applicant on a medical profile, to include pregnancy, may apply and be selected for an agr tour. 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. C1 coded airmen can move to any continental united states assignment, elmendorf air force base, alaska, and hawaii, without a waiver. Both forms must be current within 12 months this form can be obtained from your wing clinic. I am not set to return until after my window closes out, as im based oconus. 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.
Current af form 422, physical profile serial report 3. Purpose of af form 422, notification of air force members qualification status. 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. Changes to the medical profiling system were brought about due to a memorandum from air force chief of staff gen. 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. File for military pay, certified af form 938 is sent to hq riorpo.
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