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How do I fill this out?

Filling out this assessment is straightforward. Begin by gathering your medical records and previous health assessments. Ensure you follow the guided sections to accurately report your health status.

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How to fill out the Defense Health Agency Annual Health Assessment?

  1. 1

    Gather necessary medical records.

  2. 2

    Follow the structured sections of the form.

  3. 3

    Provide accurate health status information.

  4. 4

    Check for completeness.

  5. 5

    Submit the assessment form as instructed.

Who needs the Defense Health Agency Annual Health Assessment?

  1. 1

    Active duty military personnel need this form to assess their health readiness.

  2. 2

    Military healthcare providers use it to evaluate service members' medical conditions.

  3. 3

    Administrative staff require it for maintaining record compliance.

  4. 4

    Deploying service members need it for deployment readiness evaluations.

  5. 5

    New recruits fill it out to establish initial health status.

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  1. 1

    Open the PDF file in PrintFriendly PDF editor.

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    Input or modify the information as necessary.

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What are the instructions for submitting this form?

For submitting the PHA, service members need to ensure that all sections are fully completed. You can submit the form via email to your designated health office or fax it to the appropriate department. Physical submissions can be made to your commanding officer's office; ensure that it's delivered within the specified deadlines for compliance.

What are the important dates for this form in 2024 and 2025?

Important dates for submitting the Annual Periodic Health Assessment include the annual review deadline, which is typically set at the end of the calendar year. Service members should also be aware of any upcoming deployment-related assessments which may have earlier submission deadlines.

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What is the purpose of this form?

The purpose of the DoD Annual Periodic Health Assessment (PHA) is to ensure that service members are medically ready and fit to perform their military duties. It serves as a comprehensive evaluation of individual health status, identifying any conditions that may affect readiness. This assessment helps in the proactive management of health issues to maintain an effective military force.

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Tell me about this form and its components and fields line-by-line.

The form consists of several key sections that gather essential health information from service members.
fields
  • 1. Personal Information: Includes name, rank, service number, and contact information.
  • 2. Health History: Records past medical conditions and treatments.
  • 3. Current Medications: Details all medications currently being taken.
  • 4. Deployment Status: Indicates current readiness for deployment.
  • 5. Signature Section: Confirms the accuracy of provided information.

What happens if I fail to submit this form?

Failure to submit the PHA on time may result in consequences regarding military readiness and deployment status. Service members could be deemed non-compliant or unfit for duty until the assessment is completed.

  • Deployment Delays: Not submitting the PHA can lead to delays in deployment readiness.
  • Impact on Medical Care: Service members may face disruptions in receiving necessary medical care.
  • Potential Fines: Failure to comply may result in administrative penalties.

How do I know when to use this form?

This form should be used annually or whenever there are changes in health status or deployment readiness. It is critical for service members to keep their health information up to date.
fields
  • 1. Annual Review: Complete the PHA every year as part of readiness evaluations.
  • 2. Before Deployment: Necessary to confirm health status prior to deployment.
  • 3. Following Injury or Illness: Required if there has been a significant change in health.

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What if I have a question about the assessment?

For questions, you can refer to your medical officer or consult the instructions provided in the document.

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Defense Health Agency Annual Health Assessment

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