You need DD Form 503, and this page gives you the blank plus the steps for handling it. Start with what the form does: Health Assessment Certificate for Segregation. Its official title is DD Form 503, Health Assessment Certificate for Segregation, March 2013.
Next, check the edition. You want not stated, currently carried as not stated by the publisher. Then confirm the form applies to you — this is a Department of Defense form, so you use it whether you serve in the Army, Navy, Air Force, Marine Corps, Space Force or Coast Guard under Defense jurisdiction.
Once you know the form fits, find out when you file it. not stated sets the requirement, and not stated maintains the form itself. Your own command or agency adds local timing on top of that, so ask your administrative office if the deadline matters to you.
Before you download, pick your approach — editable file or printed page. What follows covers the formats first, then the entries, then what you do afterward.
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.
Check the edition before you type a word. The date appears on the face of the form; it should read not stated. When it does not, discard the file and take a fresh copy from this page. Department-level revisions replace the blank across all services simultaneously, which means an old printout can be out of step everywhere.
Take the fields in order and answer all of them. Mark inapplicable items N/A instead of leaving white space. When you reach a date, copy the format shown on the form, since a reviewer reading a different convention may misread your entry entirely.
When you reach a Privacy Act Statement, read it before you continue. It tells you the legal authority for collecting your information, what the Department does with it, who else may see it, and whether you have to answer at all. That last point is worth knowing before you supply personal identifiers, not after.
Finish with the certification. Print the form and sign in ink, or apply a digital signature with your CAC if the receiving office accepts one. Do not type your name in the signature box and consider it done; that is a name, not a signature. Date the block immediately after signing.
Then check your work against the usual failures: an obsolete edition, empty required boxes, handwriting nobody can read after scanning, wrong date format, missing signature or date.
Look up an unclear item on the form face before anywhere else, then in not stated. Should the two texts conflict, the directive is the one you follow.
Download the form
Step one is picking the format. You have PDF to choose from, across 1 pages, with approximately 128 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.
Go with the typed route whenever the choice is yours. Consider what happens after you submit: the copy gets scanned, forwarded and filed, and each pass costs handwriting some legibility. Block letters help if you are stuck with a pen.
Check your software before choosing xfdl. That format belongs to IBM Lotus Forms, long used for Defense form distribution, and it needs the matching viewer. Get the viewer installed, then come back for the file.
You will not be charged for any of these; the whole set is free. Before you start entering data, save the file to your computer and open it there. Fields behave far more reliably in a desktop reader than in a browser preview.
What the form asks for
- ContentArea1
- Page1
- PageArea1
- R10
- R100
- R102
- R103
- R104
- R105
- R106
- R107
- R109
- R11
- R110
- R111
- R112
- R12
- R13
- R15
- R16
- R17
- R18
- R20
- R21
Submit the completed form through the channel not stated or your local guidance specifies. Save a copy for yourself before it leaves your hands, whether that means a scan, a photograph or a duplicate file.
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.
Watch out for one trap here. If your instructions cite a DA form as well, do not assume the numbers are connected. DA numbering belongs to the Army alone; DD numbering belongs to the Department and is administered by not stated or another Department office. The same number in each system means two unrelated forms, so read the prefix before you download.
Come back and check the edition next time you need this form. Editions change when the prescribing directive is reissued, when the information collected changes, or when the required notice language is updated, and none of those events reaches you directly. Verifying not stated at the moment you download is the whole defence.
Before you go, note what is not covered here. You have the blank form and instructions for completing it; you do not have legal guidance, and no statement on this page determines what any office will do with your submission. Direct those questions to not stated, to the personnel office that serves you, or to the office designated in not stated.
Questions and answers
- What is DD Form 503?
- DD Form 503, Health Assessment Certificate for Segregation, March 2013
- Which edition is current?
- Not stated by the publisher
- Who is responsible for this form?
- Not stated
- In which formats can it be downloaded?