DA Form 5643-R "Physical Demands Analysis Worksheet"

What Is DA Form 5643-R?

This is a military form that was released by the U.S. Department of the Army (DA) on June 1, 1987. The form, often mistakenly referred to as the DD Form 5643-R, is a military form used by and within the U.S. Army. As of today, no separate instructions for the form are provided by the DA.

Form Details:

  • A 2-page document available for download in PDF;
  • The latest version available from the Army Publishing Directorate;
  • Editable, free, and easy to use;

Download an up-to-date fillable DA Form 5643-R down below in PDF format or browse hundreds of other DA Forms stored in our online database.

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Download DA Form 5643-R "Physical Demands Analysis Worksheet"

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PHYSICAL DEMANDS ANALYSIS WORKSHEET
PAGE
OF
PAGES
For use of this form, AR 611-1; the proponent agency is DCSPER
MOS
CMF
DATE COMPLETED (YYMMDD)
SECTION I - DUTIES
SECTION II - TASK SUMMARY
SECTION III - CRITICAL TASK ELEMENT
SECTION IV - CRITICAL PERFORMANCE MEASURE
SECTION V - ANALYSIS
FACTOR
WEIGHT/
HORIZ-
VERTICAL
WORK RATE/PERFORMANCE
MOS FREQ
LOAD
DISTANCE
DISTANCE
STANDARD
f
a
b
c
d
e
NP
O
F
C
1.
LIFT/LOWER
2.
CARRY
3.
PUSH
4.
PULL
5.
LOAD BEAR
6
WALK/MARCH
7.
CLIMB/DESCEND
8.
RUN/RUSH
9
SWIM/DIVE
10.
DIG
11
CRAWL
12.
THROW
DA FORM 5643-R, JUN 1987
APD LC v2.00
PHYSICAL DEMANDS ANALYSIS WORKSHEET
PAGE
OF
PAGES
For use of this form, AR 611-1; the proponent agency is DCSPER
MOS
CMF
DATE COMPLETED (YYMMDD)
SECTION I - DUTIES
SECTION II - TASK SUMMARY
SECTION III - CRITICAL TASK ELEMENT
SECTION IV - CRITICAL PERFORMANCE MEASURE
SECTION V - ANALYSIS
FACTOR
WEIGHT/
HORIZ-
VERTICAL
WORK RATE/PERFORMANCE
MOS FREQ
LOAD
DISTANCE
DISTANCE
STANDARD
f
a
b
c
d
e
NP
O
F
C
1.
LIFT/LOWER
2.
CARRY
3.
PUSH
4.
PULL
5.
LOAD BEAR
6
WALK/MARCH
7.
CLIMB/DESCEND
8.
RUN/RUSH
9
SWIM/DIVE
10.
DIG
11
CRAWL
12.
THROW
DA FORM 5643-R, JUN 1987
APD LC v2.00
FACTOR
WEIGHT/
HORIZ-
VERTICAL
WORK RATE/PERFORMANCE
MOS FREQ
LOAD
DISTANCE
DISTANCE
STANDARD
f
a
b
c
d
e
NP
O
F
C
13.
HANDLE
14
FINGER
15
HAMMER/POUND
16.
SIT
17
RECLINE
18
REACH
19.
STAND
20.
STOOP
21
KNEEL
22.
CROUCH
SECTION VI - EXPLANATION/COMMENT - PHYSICAL DEMAND FACTORS
SECTION VII- (PHYSICAL DEMANDS RATING) FOR USE BY APPROVING AUTHORITY
LIGHT
MEDIUM
MOD. HEAVY
HEAVY
VERY HEAVY
EXPLANATION AND SPECIFIC INSTRUCTIONS FOR COMPLETION OF WORKSHEET ARE CONTAINED IN WOMEN IN THE ARMY POLICY REVIEW, ODCSPER, DA 12 NOV 82.
APD LC v2.00
REVERSE OF DA FORM 5643-R, JUN 1987
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