AF Form 422 Notification of Air Force Member's Qualification Status

What Is AF Form 422?

AF Form 422, Notification of Air Force Members Qualification Status is a document used for initial qualification, qualification for retirement or separation, military retraining, permanent change of station (PCS), professional military education (PME), and similar functions. The form describes what an airman is qualified to do based on a medical assessment. It exists to facilitate certain personnel, training or command actions, i.e. clearing an individual for worldwide service, effecting a temporary occupational duty restriction, effecting retraining, effecting a temporary assignment limitation, and reporting substance abuse. This form is updated when completing other medically related personnel functions, which include initial qualification, military retraining, permanent change of station, if appropriate, and professional medical education.

The form was originally implemented by the Air Force (AF). As of today, no AF Form 422 fillable copies are available online. You can download a printable version of the form through the link below.

AF Form 469, Duty Limiting Condition Report is a related form used to describe physical limitations and recommend duty restrictions to the commander when there is a potential risk to an airman's health, safety and well-being, the safety of the mission, or the ability of the airman to effectively accomplish the mission.

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Where Can I Find My AF Form 422?

Blank AF Form 422 copies are stoked and issued by Medical Treatment Facilities (MTFs). To request and receive a copy, it is necessary to contact the servicing MTF (Flight & Operational Medicine Clinic/Medical Standard Management Element). Additional information and filing guidelines can be found in the AFI 10-203, Duty Limiting Conditions. This document describes how to inform the commanders about the individual restrictions for airmen due to medical reasons throughout the Air Force.

All active duty Air Force enlisted members need to obtain this form with a mandatory eligibility statement to assess the physical and mental standards. Required documents for AF Form 422 also include medical and dental documentation, a current letter from the airman's private physician or dentist. Documentation from consultant evaluations, laboratory evaluations, and other studies must be made available as needed to the deployment availability working group (DAWG) for tracking and oversight, ideally in the notes section for the most current duty limiting condition in the aeromedical services information management system. Timely, complete, and concise summaries (narrative summary or clinical encounter documentation) regarding the airman's clinical status including specific functional limitations must also be provided.

How Long Is an AF Form 422 Good for?

The maximum allowable duration of this form is 365 days. This form must be reviewed for appropriateness and accuracy at every clinical encounter between the airman and a clinic provider.

The information noted on AF 422 Form has to convey necessary detail to allow the commander and personnel system specialists to make informed decisions concerning the management of personnel. The information must be timely, accurate and unambiguous and must be written in simple terms understandable by non-medical leadership and personnel system specialists. The diagnosis or other medical justification for the statements, along with the requirements for follow-up care, must not be included on the form.

Download AF Form 422 Notification of Air Force Member's Qualification Status

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