Fillable Military Forms

DA Form 2173 — STATEMENT OF MEDICAL EXAMINATION AND DUTY STATUS

statement of medical examination and duty status

A newer edition of this form has been issued (06/01/2021). Download the current edition.

First, confirm you are on the right form. DA Form 2173 carries the official title STATEMENT OF MEDICAL EXAMINATION AND DUTY STATUS, and you use it to statement of medical examination and duty status. Second, check the edition: the copy offered here is dated 06/01/2021 and its publication status is ACTIVE. Third, size up the job — 1 page(s) and about 200 entry fields, so you can decide whether to fill it now or set aside time. One thing to settle first: a later edition has been issued. Reach for this one only when you are working with a record already executed on it.

Now decide who does the writing. Normally you enter your own particulars, then hand the sheet to the unit administrative office for review. If you work in that office, you enter what the individual brings you. From there the path is the same for everyone: G-1 is responsible for the form, and AR 600-8-4 tells you what triggers it and where it ends up. Look at the directive first whenever your case departs from the ordinary.

Begin with the first block and follow the printed order. You will enter your name first, exactly as your official records show it, followed by your identification number, your organisation, and the date of preparation. Resist the urge to jump to the substantive blocks and return to the header later. Those first entries are the index for the whole record, and an error there costs you the ability to retrieve it.

Now for the body. Use tab to advance through the fields; the order was set when the form was built and following it keeps you from leaving gaps. Check boxes and option buttons take a click. Where the options are mutually exclusive, choosing one will clear another, which is how the group is meant to behave. As you type longer entries, watch the field edge. One-line fields do not wrap, and anything past the edge prints missing even when you can still read it on screen — when that happens, put the text in remarks or on a continuation sheet. Leave nothing blank because it does not apply; enter the mark that means it does not apply, so the reviewer knows you read the question.

Save the signature for last. Sign by hand, or by whatever electronic method your office accepts, and understand that until you do the document is a draft no matter how complete it looks. If the form calls for a reviewing official, an approving authority, or a witness, take those signatures in the order the blocks print, and have each signer date it on the day they sign rather than the day you prepared it. Before you hand it over, read it once more from the top. You are looking for three things in particular: a mandatory field you left empty, digits transposed in your identification number, and a date written with day and month the wrong way round. Check one more thing if you built this form from a copy you had lying around — old entries survive in a reused file, and they will go forward as though you meant them.

At some point while filling the form you will meet a Privacy Act statement, and you should read it when you reach it rather than after you finish. It tells you who is authorised to collect the information, what it will be used for, who else may see it, and whether you are obliged to answer or may decline. Once you have entered your details, treat the file accordingly: it now holds personal information about you, so store it and send it the way your office handles such records.

Download the form

Now pick your file. You have PDF, XFDL to choose from, and the choice depends on one thing: whether you will type the entries or write them by hand. Choose the fillable pdf when you want to type, tab between fields and keep a clean copy on your computer. Choose the printable pdf when you intend to print the blank first and write on paper. The pages look identical either way, so you are not giving anything up by picking the wrong one — you are only choosing how you work.

Once the file is on your machine, open it deliberately. A pdf will usually launch in your browser, which reads well enough but does not always hold what you type; certain viewers display the fields and then discard your entries. Save the download to a folder, open it from there in a dedicated reader, and test one field and one save before you commit to filling the whole thing. If the xfdl file is what you need, install the IBM Lotus Forms Viewer first. No pdf reader and no word processor will open it.

One last point before you move on: every format is free. No registration stands between you and the file, and what you download is the published form, unaltered.

What the form asks for

  • A11
  • ABSTO
  • ABSWAUTH
  • ABegan23
  • ACCDATE
  • ACCDETAIL
  • ACTDUTY
  • ADMITTED
  • AFrom20
  • ALCOHOL
  • APD
  • AWOL
  • AWOLDUTY
  • AWas11
  • AWasNot11
  • AbsenceWithout
  • AbsentAuthority29
  • AbsentWith
  • AbsentWith29
  • AbsentWithout
  • AccidentDetails
  • AccidentInfo
  • ActiveDuty
  • ActiveTrain

Now send it on. Follow the routing in the prescribing directive, which will point you to a named office, to your unit administrative channel, or to your own file. Take a copy before you release it. From there the record follows the retention schedule for the series, and neither you nor the receiving clerk shortens or extends that on local judgement.

When another document has to travel with this one, find it by series and number. Forms in the DA series sharing a proponent or a governing directive are commonly used in combination, and anything cited on the face of your form generally goes with it. Assemble continuation sheets, covers and transmittals before you send the package rather than in response to a query.

The next time you open this form from your own files, check the edition date first. Revisions come from the proponent without warning to you, so the only reliable step is to hold your copy against the current edition before filling it in again. Records you already completed under a superseded edition stand, and you do not go back to rework them.

One last thing to be clear about before you download. What you get here is a copy of a published Department of the Army document. This site is not part of the Department of the Army, issues no forms of its own, and cannot tell you that any office will accept what you submit. Nothing written on this page is legal advice. When you are unsure about a particular entry, a requirement or whether you are eligible at all, ask G-1 or the administrative office that services your unit — they answer those questions and we do not.

Questions and answers

What is DA Form 2173?
STATEMENT OF MEDICAL EXAMINATION AND DUTY STATUS
Which edition is current?
06/01/2021
Who is responsible for this form?
G-1
In which formats can it be downloaded?
PDF, XFDL, PDF

Publisher notes

  1. 42-ITEM ONLY PRODUCED IN ELECTRONIC MEDIA

Other forms in the series