If you have been assigned to a three, four, or five day CRC class at ACADEMI the
following medical information must be collected before your chart will be submitted for review. For a printable checklist, click here. |
Official Documentation of the following…
- A copy of your most recent physical less than one year old.
Additionally, a DD Form 2795 less than one year old must be filled out and on file
prior to being submitted for medical clearance.
- A Body Mass Index of less than 35.
- Treated/ Untreated Sleep Apnea or BiPAP use without a waiver. NOTE: If you have Sleep Apnea bring initial sleep study and current 30 day usage, also CPAP must have battery backup.
- Blood Pressure that is less than 140/90.
- Blood Type (acceptable documentation includes Donor Card, Lab Test and in some cases a Drivers License.
- G-6-PD (enzyme deficiency test)
- DNA A DNA sample shall be submitted to the federal government. Mustang Medical will draw the sample free of charge. (Not required for Active Duty or Prior Military who have separated since 1995.)
The following laboratory results must have been drawn and collected within the last 4 months.
· HIV (Serum)
The following laboratory results must have been drawn or collected within the last 12 months.
· CBC (Complete Blood Count)
· CMP (Complete Metabolic Panel)
· Lipid Panel
· HbA1C
· Urinalysis
PSA (For students 50 years and older)
· PPD A documented PPD Tuberculosis test and reading must be less than three months old unless the participant has traveled OCONUS between the time the previous test was administered and the current screening. Click here for additional information regarding Tuberculosis testing and results.
Immunizations- Please bring any Adult Immunization (Shot) Records. If you are enlisted or prior service member bring
any medical records (to include your immunizations) when you come to medical. Shots are a requirement for CRC
however, some Immunizations are valid for life and will not be required again if we have the proper documentation.
· Hepatitis A (two shot series)
· Hepatitis B (three shot series)
· Adult MMR (Measles, Mumps and Rubella) (2 adult)
· Adult Polio (IPV annually)
· Varicella (two shot series - not required of students who have already had Chicken Pox)
· Zoster (for students over 60)
· Pneumococcal (for students over 65)
Boosters
· TDAP (within 10 yrs; deployment should be finished before the five year limit runs out.)
· Yellow Fever (within 10 years) Only for persons who are, or who may be deploying to Africa.
· Meningococcal (within 5 yrs; deployment should be finished before the five year limit runs out.) Only for students who may be deploying to Africa.
· Typhoid (an oral dose must be less than five years old/ injected dose, less than two years old)
Considerations for Women:
Pregnancy test results: Must be less than 30 days old.
any medical records (to include your immunizations) when you come to medical. Shots are a requirement for CRC
however, some Immunizations are valid for life and will not be required again if we have the proper documentation.
· Hepatitis A (two shot series)
· Hepatitis B (three shot series)
· Adult MMR (Measles, Mumps and Rubella) (2 adult)
· Adult Polio (IPV annually)
· Varicella (two shot series - not required of students who have already had Chicken Pox)
· Zoster (for students over 60)
· Pneumococcal (for students over 65)
Boosters
· TDAP (within 10 yrs; deployment should be finished before the five year limit runs out.)
· Yellow Fever (within 10 years) Only for persons who are, or who may be deploying to Africa.
· Meningococcal (within 5 yrs; deployment should be finished before the five year limit runs out.) Only for students who may be deploying to Africa.
· Typhoid (an oral dose must be less than five years old/ injected dose, less than two years old)
Considerations for Women:
Pregnancy test results: Must be less than 30 days old.
The Dental and Vision requirements can be collected by the student prior to the course date or coordiated locally at the student's expense.
Dental
A DD FORM 2813 must be completed and signed by a dentist within the last year. DISQUALIFIER: Only class one or class two will be authorized to deploy.
Proof of a Panoramic X-Ray that is less than 5 years old. (This will not be accepted if any additional dental work has been done since the date of the last Panoramic X-Ray. A new “Pano” will be required.)
A DD FORM 2813 must be completed and signed by a dentist within the last year. DISQUALIFIER: Only class one or class two will be authorized to deploy.
Proof of a Panoramic X-Ray that is less than 5 years old. (This will not be accepted if any additional dental work has been done since the date of the last Panoramic X-Ray. A new “Pano” will be required.)
Vision
Student must have had a current eye exam performed by an ophthalmologist within the last year. There is no official form for the vision portion of the screening.
Student must have had a current eye exam performed by an ophthalmologist within the last year. There is no official form for the vision portion of the screening.
* NOTE ¨ ALL PARTICIPANTS IN ALL PROGRAMS SHALL PROVIDE A SAMPLE FOR DRUG SCREENING UPON ARRIVAL. Please bring a Valid Drivers Licence with you to Medical.
THE FOLLOWING PHYSICAL CONDITIONS WILL NOT BE CLEARED FOR DEPLOYMENT. (Please see the form below)
Special Circumstances
Body Mass Index of greater than or equal to 35.
Untreated Sleep Apnea or BiPAP use.
+ HIV Results
Active Tuberculosis
Diabetes Type 1 and Type 2 with insulin use.
Pregnancy
THE FOLLOWING MENTAL CONDITIONS WILL NOT BE CLEARED FOR DEPLOYMENT.
Bipolar
Psychosis
USE OF THE FOLLOWING MEDICATIONS WILL NOT BE CLEARED FOR DEPLOYMENT.
Therapeutic anticoagulants, warfarin and coumadin
Anti-manic medications
Exenatide
Varenicline
Post procedure steroid eye drops