Medical Fitness Statement for Enrollment in Basic Course, Senior ROTC - United States Army

DATE

SIGNATURE OF PHYSICIAN

condition or physical impairment that precludes his participation in the basic course, Army ROTC, a

program not more physically strenuous than a normal college physical education program.

For use of this form, see AR 145-1; the proponent agency is ODSCPER

MEDICAL FITNESS STATEMENT

FOR ENROLLMENT IN BASIC COURSE, SENIOR ROTC

(First Name - Middle Initial - Last Name)