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 Forms

 

** Forms flagged in red are not available for download, please contact the proponent to obtain these documents

UMF No. Description Date Type Size
DD-4 Enlistment/Reenlistment Document - Armed Forces of the United States 05/01/2020 PDF 1.04 mb
DD-1966 Record of Military Processing - Armed Forces of the United States
12/07/2021
PDF
304 kb
DD-2807-1 Report of Medical History
10/29/2018
PDF
367 kb
DD-2807-2 Accessions Medical History Report
12/07/2021
PDF
346 kb
DD-2808 Report of Medical Examination
07/15/2019
PDF
63 kb
20-1-3-R-E Post IG Inspection Survey
11/01/2004
PDF
16 kb
20-1-4 USMEPCOM Inspector General Action Request
04/01/2019
PDF
15 kb
25-1-4 USMEPCOM Acceptable Use Policy 11/01/2017 PDF 836 kb
25-1-7-E USMEPCOM Sanitization Validation Form 06/01/2017 PDF 957 kb
25-50-4-E Record of Accountable Mail
11/01/2007
PDF 
14 kb
25-50-6-E Mail Manager's Inspection Guide
11/01/2007
PDF 
22 kb
25-50-9-E Justification for Next-Day Mail Service
11/01/2007
PDF 
12 kb
25-50-10-E Quarterly Positive Accountability Postage Administration System (PAPAS) Report
11/01/2007
PDF 
22 kb
25-50-11-E Official Mail Manager Weekly Inspection Log
06/17/2013
PDF 
61 kb
25-51-2 Records Management Program Evaluation Checklist  09/01/2017 PDF  1454 kb
25-52-1-R-E Privacy Act Information for Desk Top
04/01/2005
PDF
13 kb
37-1-E Daily Record of Civilian Medical Services
05/01/1997
PDF
24 kb
37-1-1-E Monthly Record of Civilian Medical Services
05/01/1997
PDF
456 kb
37-1-2-R-E Itemized Listing of Medical Services for Medical Examinations Public Vouchers
10/01/2004
PDF
46 kb
40-1-2-R-E Report of Medical Examination/Treatment
04/01/2017
PDF
2389 kb
40-1-3  Report of Vision Information Changes     04/01/2017 PDF    2389 kb
40-1-4  MEPS Refractive Eye Surgery Work Sheet  04/01/2020 PDF  184 kb
40-1-6 HCG Control Log
06/01/2016
PDF
1453 kb
40-1-7 Guiac Control Log
06/01/2016
PDF
886 kb
40-1-8 Uri-Stix Control Log
06/01/2016
PDF
960 kb
40-1-9 40 and Over Physical Suppliment Worksheet Sheet
04/01/2017
PDF
1887 kb
40-1-12-E MEPS Fee Basis Provider Work Record
03/01/2009
PDF
14 kb
40-1-14-E CME Conference/Training After Action Report
03/01/2009
PDF
15 kb
40-1-15-E Supplemental Health Screening Questionnaire
10/01/2019
PDF
12 kb
40-1-16-E Welch-Allyn Earwash System (WEWS) Cleaning and Maintenance Log
12/01/2013
PDF 
27 kb
40-1-18 Tattoos/Brands/Piercing/Ear Gauging/Scars/Birthmarks 06/01/2016 PDF 975 kb
40-1-19 Operator Preventive Maintenance Medical and Nonmedical Equipment Checklist 06/01/2021 PDF 282 kb
40-2-1-E Medical Provider Initial Application
09/01/2014
PDF
1626 kb
40-2-2-E Malpractice History and Status Questionnaire
09/01/2014
PDF
2033 kb
40-2-3-E Provider Clinical Assessment and Qualification
10/01/2015
PDF
1715 kb
40-2-4-E Contract Provider Quality Management Form
10/01/2015
PDF
838 kb
40-2-5-E CME Conference/Training After-Action Report
09/01/2014
PDF
900 kb
40-8-1-E Drug, Alcohol, and HIV Testing Acknowledgment form
04/01/2017
PDF
75 kb
40-8-2-E Breath Alcohol Analyzer Calibration Record
11/21/2013
PDF
1822 kb
40-8-3 Urine Sample Custody Document
06/01/2016
PDF
12 kb
40-8-7-R-E
Facts About HIV **
06/01/2018
PDF
268 kb
40-8-12-E HIV Screening Record
06/01/2016
PDF
12 kb
40-8-13-E HIV Indeterminate or Positive Processing Checklist
11/21/2013
PDF
1967 kb
40-8-14-E Release of Medical Information
11/01/2009
PDF
1085 kb
40-8-15-E HIV POSITIVE Initial Notification Counseling Checklist
12/02/2013
PDF
1085 kb
40-8-16-E HIV Notification Counseling Checklist
11/21/2013
PDF
11 kb
40-8-18-E Facts About HIV Indeterminate
11/21/2013
PDF
20 kb
40-8-19-E HIV Indeterminate Initial Notification Counseling Checklist
11/21/2013
PDF
594 kb
40-8-20-E HIV/DAT Testing Control Log
11/21/2013
PDF
890 kb
40-8-22-E Label Disposal Log
10/01/2013
PDF
887 kb
40-9-1-R-E Hepatitis B Vaccination Declination
03/01/2004
PDF
888 kb
40-9-2-R-E Viral Testing Consent
03/01/2004
PDF
1381 kb
40-9-3-R-E Sharp Injury Record
03/01/2004
PDF
8 kb
40-9-5-E Refrigerator Temperature Log
12/17/2012
PDF
1072 kb
55-2-1-R-E Meal Ticket Register
03/01/1989
PDF
957 kb
55-2-2-E Bulk Ticket Register
12/01/2007
PDF
952 kb
55-2-3-E Orders Consolidation Sheet/Control Log
04/06/2012
PDF
1386 kb
55-2-5 Request For Modification of Recruit Travel Orders 01/12/2020 PDF 2258 kb
55-2-R-E Government Transportation Request Register
03/01/1989
PDF
956 kb
58-1-1 Motor Vehicle Utilization
03/01/2009
PDF
53 kb
58-1-2-R-E Vehicle Credit Card/Negotiable Media/Key Control Register
09/01/2004
PDF
13 kb
58-1-3 Commander's Domicile-To-Duty Log
03/01/2016
PDF
13 kb
58-1-4 ESS Domicile-to-duty Request Form
03/01/2016
PDF
13 kb
58-1-R-E Monthly Mileage and Fuel Consumption Report
03/01/2009
PDF
790 kb
350-1-1 Unit Training Schedule
04/01/2014
PDF
6 kb
350-1-2 Training Development Division Request for Support
04/01/2014
PDF
8 kb
350-1-3-R Run/Walk for Your Life Program - Entry Request
12/01/1998
PDF
11 kb
350-1-4 Record of Individual Training
08/01/2007
PDF
87 kb
350-1-5 Annual Training Plan
08/01/2000
PDF
19 kb
350-1-15 Training Attendance Roster
04/16/2012
PDF
126 kb
360-1-2-R-E Name, Photograph and Recording (Video/Audio) Release
02/01/1999
PDF
11 kb
380-1-1-E MEPS Annual Physical Security Questionnaire
04/01/2013
PDF
597 kb
380-1-2-E Blue Dart Report
04/01/2013
PDF
662 kb
385-1-1-E Deficiency Log
04/01/2013
PDF
39 kb
385-1-2-E USMEPCOM Deficiency Notice
04/01/2013
PDF
590 kb
420-3-1-R-E Facility Work Request,
01/01/2006
PDF
23 kb
420-3-2-R-E Above Standard Service Requirements
01/01/2006
PDF
19 kb
570-3-1 Headquarters/Sector Personnel Strength Feeder Report
05/01/2018
PDF 
2380 kb
570-3-2 MEPS Personnel Strength Feeder Report
05/01/2018
PDF
2380 kb
570-3-3 USMEPCOM Management Review Board Request Form
03/01/2022
PDF
2656 kb
600-25-1-E USMEPCOM Award Nomination
02/01/2016
PDF
1489 kb
600-25-2-E Spirit Certificate of Volunteer Recognition
07/01/2014
PDF
1875 kb
600-25-3-E Liberty Certificate of Volunteer Recognition
07/01/2014
PDF
1875 kb
600-25-4-E Freedom Certificate of Volunteer Recognition
07/01/2014
PDF
1875 kb
600-25-5-E Teamwork Certificate
10/01/2010
PDF
86 kb
600-25-6-E Certificate of Appreciation
10/01/2010
PDF
1996 kb
600-25-7-E Certificate of Achievement
10/01/2010
PDF
86 kb
601-4-R-E Student Test Answer Sheet Discrepancy List
12/10/2012
PDF
13 kb
601-4-2-R-E Processing and Distribution Control Record
07/01/2005
PDF
17 kb
601-4-3-E Student ASVAB Test Record
10/01/2017
PDF
1071 kb
601-4-4-R-E Receipt of Armed Services Vocational Aptitude Battery (ASVAB) Booklets
07/01/2005
PDF
10 kb
601-4-5-R-E Student Testing Database Maintenance Form
07/01/2015
PDF
12 kb
601-4-6-R-E Centers of Influence (COI) Event Fund Cite Request
07/01/2005
PDF
11 kb
601-4-7-R-E Centers of Influence (COI) Event After-Action Report
07/01/2005
PDF
10 kb
601-4-11-R-E Educational Staff Agreement
02/01/2020
PDF
1164 kb
601-4-12-R-E Educational Staff Agreement for Voluntary Services
07/01/2005
PDF
10 kb
601-4-13-R-E State/Local Marketing Event - Funding Request
07/01/2017
PDF
1101 kb
601-4-14-R-E Professional Organizational Membership Reimbursement Request
07/01/2005
PDF
10 kb
601-4-15-E Proctor Support Form
07/01/2005
PDF
13 kb
601-23-E Report of Additional Information
06/01/1995
PDF 
951 kb
601-23-1-R-E Orders Consolidation Sheet/Control Log
[see UMF 55-2-3-E above]
07/01/1995
 
23 kb
601-23-2-E Records Flag
04/01/2013
PDF 
1382 kb
601-23-4-E Restrictions on Personal Conduct in the Armed Forces
09/01/2011
PDF 
9 kb
601-23-5-R-E Introductory Preaccession Interview
02/01/2020
PDF
3013 kb
601-23-6-E Good Idea Request Worksheet
04/01/2013
PDF
1144 kb
601-23-7-R-E Pre-Enlistment Interview (Non-MEPS) 02/01/2020 PDF 3013 kb
601-23-8 Exception to Policy Request 10/01/2020 PDF 2927 kb
611-1-R-E ASVAB Test Loss Compromise Telephone Report
12/04/2013
PDF 
10 kb
611-1-2-R-E Unverified Test Scores (Single Applicant)
12/04/2013
PDF
10 kb
611-1-1-R-E Inventory of Accountable Test Material
05/31/2022
PDF
2024 kb
611-1-1-i Inventory of Accountable Test Material Instructions 05/31/2022 PDF 54.7 kb
611-1-6-R-E MET Site Cost Analysis
12/01/2016
PDF
72 kb
611-1-7-R-E Aptitude Testing Processing List
06/01/2006
PDF
13 kb
611-1-8-R-E Inventory of MEPS Accountable Test Material
05/01/2003
PDF
9 kb
611-1-9-R-E Daily Inventory Log
12/04/2013
PDF
11 kb
611-1-11-R-E Statement of Disposition of Test Materials **
05/31/2022
PDF
2416 kb
611-1-14-I-R-E MET Site TA Review (ICAT)
08/01/2017
PDF
1900 kb
611-1-14-P-R-E  MET Site TA Review (Paper and Pencil)  08/01/2017 PDF  1899 kb
611-1-18-E Military Entrance Test Site Update
12/04/2013
PDF
13 kb
611-1-19-R-E MET Site Accountable Material Checklist for Test Administrators
12/01/2005
PDF
22 kb
611-1-21 Applicant High School Pull Request 10/01/2020 PDF 2929 kb
680-3-A-2
Authorization for Medical Records Release **
10/01/2021 PDF 2392 kb
680-3-A-2-i Instructions for Completing UMF 680-3-A-2 12/01/2021 PDF 138 kb
690-13-1-R-E Overtime Request and Authorization
05/01/2000
PDF 
1394 kb
690-13-2-E Request for Alternative Work Schedule (AWS)
12/01/2011
PDF 
644 kb
690-13-4-E Personnel Processing Checklists
03/01/2015
PDF
1481 kb
690-13-5-E USMEPCOM Time and Attendance Record Sheet
12/12/2012
PDF
19 kb
715-5-1 Purchase Request
10/01/2015
PDF
1097 kb
715-5-2 Purchase Request Exceeding Micro-Purchase Limit up to $25,000

04/01/2016

PDF

1517 kb

715-5-3 Government Purchase Card Log 08/01/2019 PDF 1481 kb
715-5-4 Convenience Check Purchase Log 08/01/2019 PDF 2034 kb
715-6-1 Acquisition Requirements Package Checklist
10/01/2014
PDF
1398 kb
727-E Applicant Meal/Lodging Authorization and Receipt Voucher
04/04/2008
PDF
2641 kb
728-E Applicant Meal/Lodging Authorization and Receipt Voucher for Late Arrival Add-ons
12/01/2004
PDF 
1382 kb
728-E-i Applicant Meal/Lodging Authorization and Receipt Voucher for Late Arrival Add-ons - Instructions
12/01/2004
PDF 
1381 kb
729-E Daily Invoice Lodging/Meal Services
12/01/2004
PDF 
21 kb
750-1-R-E  Operator Preventive Maintenance Checklist general Medical and Nonmedical Equipment 01/04/1990 PDF  958KB

 

** Forms flagged in red are not available for download, please contact the proponent to obtain these documents