It is used to qualify an enlistees physical profile for each military skill. United states air force honor guard officer application. The fac uses the fitness test restrictions on the form 422 to determine which parts of the usaf fitness test can be safely evaluated. Do you have a health condition not addressed in a physical profile af form 422 that participating in the pt programtesting. The assessment must be current through course completion. Ngb 341 dated 201111 application for active guardreserve agr position.
Af form 422, physical profile assessment if applicable provide 1 copy and maintain 1 copy includes waivers same as above same as above af form 469, duty limiting condition report if applicable provide 1 copy and maintain 1 copy same as above same as above af form 4428, tattoobrandbody marking screeningverification if applicable. In general, the af form 469 will describe an airmans limitations and fitness assessment clearanceexemptions. They then send you the information they need for your af form 422. By order of the secretary of the air force medical examinations air force instruction 48123 24 september 2009 incorporating through change 2. 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. Af form 422, physical profile assessment if applicable provide 1 copy and maintain 1 copy includes waivers same as.
Notify usaf honor guard recruiting office that application has been submitted by emailing. Call them and tell them what you need and that it is just for pulhes. Steps to help complete physical limitation form keesler. If the member has a current fitness score, but was exempt during any portion of the award period, an.
A current air force fitness management system print out of members physical fitness history. Air force, united states federal legal forms and united states legal forms. 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. These physicals are based primarily upon all of the body system functions. Af form 422, physical profile serial report, current within 12 months af form 1042, only required if announcement requires applicant to be on flight status medical documents which indicates a permanent profile higher than a 1 in any of the pulhes fields of the physical if applicable. Af form 422, physical profile serial report current within 5 years, validated within 12 months orang air technicians interested in converting to agr status. Purpose of af form 422, notification of air force members qualification status. Af form 422 notification of members medical qualification status and af 469 duty limiting condition report if currently onrestrictionsor service equivalent medical profile 6. If application does not follow instructions outlined above the applicant will be contacted with further instructions. So, at my base we have to visitemail the medical standards office. Learn vocabulary, terms, and more with flashcards, games, and other study tools. Feb 05, 2018 tab 6 recent report of medical examination dd form 2808, completed within 60 days of application tab 7 recent physical profile serial report af form 422. The physical profile serial system is created around the various military duties and provide a numerical standard that a medical doctor recommends during the routine recruit physical.
Af form 422, physical profile serial report current within 12 months, must include pulhes this is not your phaq. 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. Who should i contact if i have questions about waps testing. Af form 422, imr printout, dd form 2992 af form 422, physical profile serial report current within 12 months, must include pulhes this is not your phaq. Each letter in the acronym see box below is paired with a number from 1 to 4 to designate the service members physical capacity. 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. Copy of af form 422, physical profile serial report and dd form 2992 for flight status, flight physical. 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. Both forms must be current within 12 months this form can be obtained from your wing clinic. If member is on a profile include a copy of the members af form 422, physical profile serial report in the package. Sign, fax and printable from pc, ipad, tablet or mobile with pdffiller instantly no software. Download printable af form 422 in pdf the latest version applicable for 2020. Air national guard members must meet the physical qualifications outlined in afi48123.
Submit af form 422 validated by your medical personnel, current win 12 months. The chief of physical standards development is the opr for any changes and can. The fac will not allow an airman with physical limitations to test without a current signed form 422. Do you have a health condition not addressed in a physical profile af form 422 that participating in the pt programtesting could aggravate or that would preclude your safety. Usually theyll require you to go to your gym and do the xfactor before theyll upload your form. Jul 11, 2012 the exercise physiologist will use air force form 422.
Members possessing an af form 422, physical profile serial report, identifying temporary physical restrictions are ineligible to attend without director of education contact info. 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. Imr printout this can be found via the af portal, my imrasims medical readiness screenshot the initial imr page with current overall statuses. Fill out the notification of air force members qualification status online and print it out for free. Current af form 422, physical profile serial report 3. Pulhes is a united states military acronym used in the military physical profile serial system. Af form 469 is used to convey limitations related to the af fitness program fp as well as fitness assessment exemptions fae. Statewide announcement is made of the following active guard. Air national guard, air force reserve or the united states air force members who have not achieved a passing.
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. Members possessing an af form 422, physical profile serial report, identifying temporary physical restrictions are ineligible to. It can take five to seven days for a profile to go through the system. Tab 6 recent report of medical examination dd form 2808, completed within 60 days of application tab 7 recent physical profile serial report af form 422. Both forms must be current within 12 months this form can be.
An applicant on a medical profile, to include pregnancy, may apply and be selected for an agr tour. Statewide announcement is made of the following active. Airman leadership school and noncommissioned officer. Current point credit accounting report system pcars. Area of consideration this position is open to current officers in the louisiana air national guard. Pdf document will automatically disqualify your package portfolios will not be accepted.
If the member has a current fitness score, but was exempt during any portion of the award period, an af form 422 must be provided. Airman leadership school and noncommissioned officer academy. Usaf first sergeant of the year award air reserve personnel. If member is on a profile include a copy of the members af form 422, physical profile serial report. Tab 7 recent report of medical examination dd form 2808, completed within 60 days of application tab 8 recent physical profile serial report af form 422. Selection for the advertised position does not constitute acceptance into the agr program. 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. Steps to help complete physical limitation form keesler air. Copy of current fitness test scores, if exemptions exist please include the af 469. Retraining physical profile assessment section of the af form 422 and endorse section b of attachment. Applicants must provide a printed copy of the electronic air force fitness assessment results dated within the past 12 months of application close date, reference afi362905. 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. Jun 25, 2019 the physical profile serial system is created around the various military duties and provide a numerical standard that a medical doctor recommends during the routine recruit physical. The exercise physiologist will use air force form 422.
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