DD Form 2697 Report of Medical Assessment
What Is DD Form 2697?
DD Form 2697, Report of Medical Assessment is a form used by the Medical Services to provide a comprehensive medical assessment for active and reserve component servicemembers separating or retiring from active duty. A copy of the Soldier's assessment will be later be released to the Department of Veterans Affairs.
The latest version of the DD Form 2967- sometimes incorrectly referred to as the DA Form 2697 - was released by the Department of Defense in February 1995. An up-to-date DD Form 2697 fillable version is available for download and online filing below or can be found through the Executive Services Directorate website.
DD Form 2697 Instructions
The form itself consists of two sections in total. The first section is completed solely by the servicemember and the second one is to be filed by an individually privileged healthcare provider.
- Filling out DD Form 2697 starts with completing Boxes 1 through 7 in Section I. These Boxes cover basic credentials, including the name, SSN, rank, component, unit of assignment, home address and telephone number of the soldier filing the form. Dates of the last physical examination and the date of entering current duty must be provided in Boxes 8 and 9 respectively.
- Boxes 10 through 18 are multiple choice questions with extra space for a detailed explanation in case there is one needed.
- Box 10 requires the servicemember to evaluate their current health status compared to previous medical or physical assessment.
- Box 11 is for specifying if there was an absence from duty for longer than three days due to injury or illness since the last medical assessment.
- Any hospital stays, surgeries or treatments must be described in Box 12.
- Any injury or illness was left untreated during service must be recorded in Box 13.
- Box 14 is for describing any current medication intake.
- If an illness or injury that may result in assignment limitations or hinder current service must be specified in Box 15.
- Box 16 is for acknowledging any dental problems.
- Any questions or concerns about health must be stated in Box 17.
- Box 18 is for expressing interest and intent to seek Department of Veterans Affairs (VA) disability.
- Box 19 is for certification and verifies that the provided information is true and complete. It requires a signature and date of the servicemember filing.
- Section II of DD Form 2697 consists of Boxes 20 through 25.
- Box 20 is completed in case there are any further comments.
- The need for any further evaluation is expressed in Box 21.
- Box 22 is for clarifying the overall purpose of the assessment.
- Boxes 23 through 25 are for verification and the required signatures.