DA Form 3425-R "Medical Fitness Statement for Enrollment in Basic Course, Senior Rotc"

What Is DA Form 3425-R?

This is a military form that was released by the U.S. Department of the Army (DA) on September 1, 1968. The form, often mistakenly referred to as the DD Form 3425-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 1-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 3425-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 3425-R "Medical Fitness Statement for Enrollment in Basic Course, Senior Rotc"

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DATE
MEDICAL FITNESS STATEMENT
FOR ENROLLMENT IN BASIC COURSE, SENIOR ROTC
For use of this form, see AR 145-1; the proponent agency is ODSCPER
I have examined
and find no medical
(First Name - Middle Initial - Last Name)
condition or physical impairment that precludes his participation in the basic course, Army ROTC, a
program not more physically strenuous than a normal college physical education program.
SIGNATURE OF PHYSICIAN
DA FORM 3425-R, 1 SEP 1968
APD LC v2.00ES
DATE
MEDICAL FITNESS STATEMENT
FOR ENROLLMENT IN BASIC COURSE, SENIOR ROTC
For use of this form, see AR 145-1; the proponent agency is ODSCPER
I have examined
and find no medical
(First Name - Middle Initial - Last Name)
condition or physical impairment that precludes his participation in the basic course, Army ROTC, a
program not more physically strenuous than a normal college physical education program.
SIGNATURE OF PHYSICIAN
DA FORM 3425-R, 1 SEP 1968
APD LC v2.00ES