Fitness Screening Questionnaire (pdf 127 kb) » PROTECT MEMBERS FROM BEING PLACED IN AN ENVIRONMENT WHERE THEY MAY NOT RECEIVE ADEQUATE MEDICAL CARE FOR A POSSIBLE LIFE THREATENING MEDICAL CONDITION AND TO PREVENT THE ASSIGNMENT OF NONQUALIFIED PERSONNEL TO OVERSEAS LOCATION, WHERE IS THE DEMOGRAPHIC INFO IN ASIMS IS AUTOMATICALLY GENERATED FROM, ORGANIZATIONAL EMAIL ACCOUNT MAY ONLY BE ACCESSIBLE TO, COMMANDER AND THEIR DESIGNEE, USUALLY UNIT HEALTH MONITOR AND FIRST SERGEANT. My profile was updated today and on my af form 469, it now states that I am being meb'd vs the box being checked saying I will be tree in 31-365 days. Capt XXXX’s AF FORM 469 limits (list exemption and/or restrictions: running more than 1 mile, pushups, sit-ups, etc.) -- The purpose of Air Force Form 469 duty limiting condition report is to convey physical limitations to the commander when a member's health, safety and well-being, mission safety or abilities to effectively accomplish the mission are at risk (Air Force Instruction 10-203 paragragh 1.1). members due an FA are assessed on non-exempted components per the AF Form 469. How do I find out who the PEBLO is on my base? If member is on a profile include a copy of the members AF Form 469, Duty Limiting Condition Report in the package. And then they have to give you con leave time and see if you get better or worse before they put in the MEB package. I had a copy of my af form 469 that just expired but now I can't find it and can't find where to print a new one since it's not current in MyIMR. Capt XXXX commissioned in XXXX, has a DOR to Captain in 20XX, and will meet the O4 promotion board in 20XX. USED TO CONVEY PHYSICAL LIMITATIONS TO THE COMMANDER WHEN A MEMBERS HEALTH, SAFETY AND WELL BEING, MISSION SAFETY OR ABILITIES TO … In general, the AF Form 469 will describe an Airman’s limitations and Fitness Assessment Clearance/Exemptions. I do have a PEBLO, but communication has been slow and unhelpful. If no surgery yet, they will put it in quicker. For a better experience, please enable JavaScript in your browser before proceeding. My profile was updated today and on my af form 469, it now states that I am being meb'd vs the box being checked saying I will be tree in 31-365 days. Physical Profile System. WING COMMANDER (OR EQUIVALENT) SIGNATURE BLOCK Physical Profile System. JavaScript is disabled. They probably did not click the code 49 because you have not been officially diagnosed by the Neurosurgeaon and a surgical recommendation needs to be made first. Do not use spaces when performing a product number/title search (e.g. On another note, I go see the orthopedic surgeon tomorrow for a carpal tunnel consult. UFPM ensures . MLO will review . (Or service equivalent medical report) 5. Also, we’ll get any medical records pertinent to your condition or injury. Current Point Credit Accounting Report System (PCARS); if Active Duty submit the equivalent form of an AF 1613 or Statement of Service. Available for PC, iOS and Android. You are using an out of date browser. If the member has a current fitness score, but was exempt during any portion of the award period, an AF Form 469 If servicemembers have mobility restrictions (what used to be referred to as a 4T profile), their squadron commander will have to sign the Air Force Form 469 and personally issue it to the servicemember. as well my neurosurgeon ordered a MRI of my shoulder to see if that has anything to do with my nerve pain at and near my neck. (Or service equivalent medical profile) 6. You must log in or register to reply here. Interagency Air Force Information Collections. I didn't notice it until I was back at my office. I had a EMG and it said SEVERE CARPAL TUNEL with denervation likely present. Start a free trial now to save yourself time and money! Capt XXXX’s AF FORM 469 2. is it someone in the hospital or at the legal office? The most secure digital platform to get legally binding, electronically signed documents in just a few seconds. Participation restricted to IDT and Annual FAC Front Desk: 731-1555 What to bring to an official Fitness Test: CAC Card; Fitness Screening Questionnaire; Any authorized combination of PT gear IAW AFI-36-2903; If on a profile, you must also bring an AF FORM 469 to document your Air Force Fitness Test Guidance.. Fill out, securely sign, print or email your af imt 1048 form instantly with SignNow. pubs: AFMAN33-361; forms: AFTO53, AF673, AFSPC1648) To minimize results, use the navigation buttons below to find the level/organization you are looking for, then use the "Filter" to search at that level Family Servicemen’s Group Life Insurance (FSGLI). If the score is not updated within 48 hours, contact either SSgt Jenkins . Nobody informed me of it, I believe it was my nurse who has been doing all the paper work for my Dr. was the one who updated it. This form may include work, mobility or fitness restrictions. You can see previous threads I have posted about my condition here in the spine and back forum. (Or service equivalent medical profile) 6. heart disease, sickle cell trait, asthma, etc.) 5.1.2. So would they give me con-leave again to see if I get better or just the con-leave from after the surgrey. KEESLER AIR FORCE BASE, Miss. • If you are on a profile, your exemptions must be documented on an AF Form 469 that you bring with you. Just got my signed copy of my 469, and not the "working copy" and all the MEB stuff was not on there...weird I guess being my nurse typed it and gave it to me when I was sitting right next to her in her office. I have a code 37 and I have a AF form 469, it was written July 31st. MEMBERS ARE NONDEPLOYABLE/ASSIGNMENT LIMITED TO SPECIFIC INSTALLATIONS BASED ON MEDICAL NEED AND AVAILABILITY OF CARE. -- A current Air Force Fitness Management System print out of member's physical fitness history as of 3 Jan 2020. AF Form 422 or AF Form 422/469 (if currently on restrictions). AF FORM 469 duty limiting condition report PURPOSE, USED TO CONVEY PHYSICAL LIMITATIONS TO THE COMMANDER WHEN A MEMBERS HEALTH, SAFETY AND WELL BEING, MISSION SAFETY OR ABILITIES TO EFFECTIVELY ACCOMPLISH THE MISSION ARE AT RISK, APPROPRIATE MEDICAL RECOMMENDATIONS ARE COMMUNICATED TO COMMANDERS SO THEY ARE ABLE TO DETERMINE THE OPTIMUM UTILIZATION OF MEMBERS IN THEIR UNIT WITHIN THE GUIDLEINES OF THE MEDICALLY IMPOSED RESTRICTIONS, IF ADMIN CHANGES ARE REQUIRED WHO IS THE FORM FORWARDED BACK TO, PCM TEAM FOR CORRECTIONS---IF NO CORRECTIONS NEEDED MSME WILL SIGN THE FORM, AF FORM 469 DUTY RESTRICTION ONLY WILL BE SENT TO WHAT THREE PEOPLE, MEMBERS SQUADRON COMMANDER, UNIT DEPLOYMENT MONITOR, AND THE FIRST SERGEANT, IF AF FORM 469 HAS NO MOBILITY RESTRICTIONS THE LAST SIGNATURE REQUIRE IS, IF MOBILITY RESTRICTION IS FOUND WHO WILL START THE AF FORM 469 PROCESS, HEALTHCARE PROVIDER OR DESIGNEE , ELECTRONICALLY SIGNS ON ASIMS AND SENDS TO MSME FOR QUALITY REVIEW, FORM 469 WITH MOBILITY RESTRICTION SENT TO, PROFILE OFFICER FOR FINAL REVIEW AND SIGNATURE IF NO FURTHER CHANGES NEEDED IT IS THEN FORWARDED TO MEMBERS SQUADRON COMMANDER, UDM AND FIRST SERGEANT, WHO IS RESPONSIBLE FOR ISSUING THE AF FORM 469 AND DETERMINING HOW MEMBER IS BEST UTILIZED IN THE WORK CENTER, 31-365 DAYS ---PROFILE NOT HAVE PENDING MEB/PEB ACTIONS/PREGNANCY ----CATCH ALL CODE (BROKEN LEG), CONDITION REQUIRES MEB/PEB , PHYSICAL LIMITATION 365 DAYS PLUS (DISLOCATED HIP), WHO IS RESPONSIBLE FOR MILITARY PERSONNEL DATA SYSTEM, DEDICATES AN ASSIGNMENT CODE TO ALL AIRMEN SO THEY MAY BE ABLE TO TRANSFER TO A PARTICULAR DUTY STATION, CONDITIONS TEMPORARY OR MILD REQUIRING FOLLOW UP BUT CLINICALLY CONTROLLED, AIRMEN MAY BE ASSIGNABLE TO GLOBAL DOD INSTALLATIONS, CONDITIONS BEING TEMPORARY OR MILD REQUIRING FOLLOW UP BUT CLINICALLY CONTROLLED AND MANAGED WITHOUT FREQUENT VISITS OR UNIQUE MEDICATION REGIMEN. Applicants who were on a profile and exempt from any part of the test must submit the AF Form 469, Duty Limiting Conditioning Report, reflecting reason(s) for waiver Most recent DD Form 214 (Member-4 copy), Certificate of Release or Discharge from Active Duty or NGB Form 22, Report of Separation and Record of Service Any suggestions on where to look would be greatly appreciated. Refer recommended changes and questions about this publication to the Office of Primary Responsibility (OPR) using the AF Form 847, Recommendation for Change of Publication; route AF Forms 847s from the field through the appropriate functional chain of command. The official website for Air Force e-Publishing. PEB and Disability Evaluation System Overview. (For example, an AF Form 469 or a “profile” or other medical restriction that keeps you from performing all duties of your rank and duty position?) I didn't notice it until I was back at my office. Capt XXXX has an AF Form 469 with an expiration date of XXXX. I found out about this 10 days ago so I find it hard to believe that AFPC has already seen my MEB and sent it back. Following your test, you must verify that AFFMS II is updated with your new score. 5.2.8. Capt XXXX commissioned in XXXX, has a DOR to Captain in 20XX, and will meet the O4 promotion board in 20XX. _____ (SIGNATURE/STAMP OF PROVIDER) FOR OFFICIAL USE ONLY . Members must provide current AF Forms 469 (Medical Profile) and 422 (Fitness Prescription), if applicable, during in-processing. I explained my situation and she said my case will be reviewed again in October. 5.1.4. 2 AFI48-123 5 NOVEMBER 2013 (AFRIMS). It has only been one day since then, so I am guessing if it is in fact started someone will contact me. PRIVACY SENSITIVE . AIRMEN MAY BE DEPLOYED TO CONUS INSTALALTIONS WITH INTRINSIC FIXED MTFS AND/OR DEPLOYABLE TO OCONUS INSTALLATIONS WITH APPROVAL OF GAINING COCOM/SG OR MAJCOM.