You have arrived looking for DD Form 2492. Before you download, confirm this is the right document: DoD Medical Examination Review Board (DoDMERB) Report of Medical History. Full title: DD Form 2492, DoDMERB Report of Medical History, March 2008.
Then look at the edition date: not stated, publisher status not stated. After that, ask whether the form covers your situation. It almost certainly does regardless of your branch — DD forms run Department-wide rather than through a single service.
Then settle the schedule. You are working under not stated, with not stated responsible for the document, and your organization layers its own deadlines on that. Ask before you assume a date.
Last in this stage, choose your method: complete it on screen, or print the blank form and fill it out in pen. The sections below take each route step by step.
Now fill it in. Work from the top of the page downward, and do not jump ahead — the identifying block comes first, the substance of your entry second, the certification last. Later boxes often depend on what you put at the top.
Your first action is verification. Find the edition date on the form and match it against not stated. A mismatch means you are working from a superseded printing, and because DD forms change Department-wide rather than service by service, the office receiving it will notice.
Work through the fields one at a time and leave nothing blank. When a box does not apply to you, write N/A rather than skipping it, so the reviewer can see you read the question. Follow the date format printed beside each date field instead of the one you normally use.
Do not skip past the Privacy Act Statement. It is placed ahead of the personal data fields on purpose: it explains under what authority you are being asked, what happens to the information, and what follows if you decline. Take the minute it costs.
Sign last, and sign properly. On paper that means ink in the signature block. Electronically it means a digital signature, usually applied with your Common Access Card in a reader that supports it. Typing your name into the field does not sign anything. Then add the date beside your signature — an unsigned or undated form is the most common reason one comes back.
Run a final pass over the form. The errors that send it back are the same ones every time: old edition, gaps in required fields, unreadable handwriting on a scan, non-conforming dates, no signature or no date.
If a particular field puzzles you, read the instructions printed on the form first, then go to not stated. When the two disagree, follow the directive.
Download the form
Step one is picking the format. You have PDF to choose from, across 2 pages, with approximately 103 fields to complete.
Choose pdf as your default. Next, click inside a box. A fillable pdf responds by outlining the field and letting you type; the text stays in the document when you save it. A printable pdf does not respond, which tells you to print the page and complete it by hand.
Type when you can. Printed entries stay legible after the form is scanned, copied and forwarded, and handwriting often does not survive that trip. If you must write by hand, use block capitals and press firmly.
What the form asks for
- 1. Name (last, first, middle initial).
- 2. Social security number. Do not include dashes.
- 3. Telephone number (include area code).
- 4. Purpose of examination.
- 5. Examination facility or examiner and address (include zip code).
- 6. Date of examination (4 digit year, 2 digit month, 2 digit day, no dividers).
- 7. Have you ever or do you now use any of the following: Amphetamines. Press space bar to mark X in first box if yes, second box if no.
- Barbiturates. X first box if yes, second box if no.
- Cocaine. X first box if yes, second box if no.
- Narcotic drugs. X first box if yes, second box if no.
- Marijuana. X first box if yes, second box if no.
- Alcohol. X first box if yes, second box if no.
- Chemical inhalants. X first box if yes, second box if no.
- Hallucinogens. X first box if yes, second box if no.
- 8. Do you wear glasses? X first box if yes, second box if no.
- 9. Do you wear contact lenses or corneal eye retainers? X first box if yes, second box if no.
- 10. Have you ever had your vision improved by methods other than stated in questions 8 or 9? X first box if yes, second box if no.
- 9.a. If you wear contact lenses, how many days have they been removed prior to this examination? X first box if less than 3, second box if 3 - 30, third box if 21 or over.
- Type lens: X first box if hard, second box if soft.
- Have you ever had or do you now have: 11. Eye trouble (exclude glasses, contact lenses). X first box if yes, second box if no.
- 12. Have fluctuating vision or double vision. X first box if yes, second box if no.
- 13. Have any allergies. X first box if yes, second box if no.
- 14. Take any medications regularly. X first box if yes, second box if no.
- 15. Stutter or stammer. X first box if yes, second box if no.
Now that it is complete, send it where not stated or your local procedure says it goes. Before you do, make yourself a copy — scan it or save the file elsewhere. It costs you nothing and saves you the whole exercise if the original goes missing.
Should you need a related form, look it up by its number. The DD sequence is Department-wide, which makes your search simple: no service qualifier, no branch-specific variant to track down.
Be careful when a procedure pairs this form with a service form. Read the prefix, not just the digits. Service forms answer to a service proponent, while DD forms answer to not stated or an equivalent Department office, and the two sequences were never aligned. Grabbing the wrong prefix gets you a form that has nothing to do with your task.
Do not archive this file and reuse it in a year. Forms are reissued as directives are revised, as data requirements shift, and as statutory notice text is amended. Your protection is simple: download fresh each time and confirm the edition date.
Finally, understand the limits of what you have read. This page distributes a published Department of Defense form and describes how to fill it out. It does not give legal or procedural advice, and it cannot promise any outcome for your particular case. For that, contact not stated, your administrative office, or the authority identified in not stated.
Questions and answers
- What is DD Form 2492?
- DD Form 2492, DoDMERB Report of Medical History, March 2008
- Which edition is current?
- Not stated by the publisher
- Who is responsible for this form?
- Not stated
- In which formats can it be downloaded?