So what is DD Form 2492? The short answer: a Defense Department document, officially DD Form 2492, DoDMERB Report of Medical History, March 2008, used to DoD Medical Examination Review Board (DoDMERB) Report of Medical History. Anything else you need follows from that.
Is there a version specific to your service? No. A DD number is issued at Department level, which is the whole point of the prefix — every military department and defense agency works from one identical document. Looking for a branch variant wastes time you do not have.
Where does the requirement come from? From not stated, with not stated responsible for the document itself. Those are the names to cite if anyone asks under what authority you filed.
Is this the right edition? The current one is dated not stated, and the publisher carries it as not stated. Check that against whatever copy you already have before going further.
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.
Download the form
Which files are here? These: PDF. How much work is involved? 2 pages, about 103 entry fields.
Why do two kinds of pdf exist? Because two kinds of user exist. One completes the form on screen and forwards a file; the other prints a blank and fills it by hand. The fillable release has interactive boxes, the printable release is a static image of the same page.
Is handwriting acceptable? Yes, but it is the weaker choice. Scanning flattens pen strokes and reproduction blurs them, while typed characters survive the whole chain intact. Print in capitals if you are working from a paper blank.
What opens an xfdl file? IBM Lotus Forms Viewer, or a compatible client. Will your pdf reader do it? No, and it will likely report the file as damaged. Xfdl was the Defense standard for electronic forms for years, which is why it still appears in the set.
Do you pay for these? No. Free download, every format. What should you avoid? Filling the form inside a browser tab; the fields frequently do not save.
In what order do you complete it? The printed order, top to bottom. Header data comes before the body, and the body before the signature block. The sequence is not decorative — later entries are keyed to earlier ones.
What if your copy is old? Replace it. Check the date printed on the form against not stated. Old blanks circulate for years in shared folders, and because a DD revision lands across the whole Department at once, the receiving office will be working from the new layout.
Which fields are required? Treat all of them as required, marking N/A where an item genuinely does not apply. What trips people on dates? Writing them in a familiar format instead of the one the form specifies.
What is the Privacy Act Statement doing on the form? Telling you, before you supply personal identifiers, under what authority the information is collected, what it will be used for, who else may see it, and whether answering is voluntary or mandatory. Is it worth reading? It is the only part of the form written for your benefit rather than the file's.
Is a typed name enough? No. The signature block takes an actual signature: pen on paper, or a digital signature applied with your Common Access Card where the receiving system accepts one. Add the date beside it before you close the file.
What goes wrong most? The same short list: old edition, empty fields, illegibility, wrong date format, missing signature or date.
Where do you look up an unclear entry? The form face first, not stated second. And when the two disagree? not stated controls.
Who receives it? The office not stated designates, subject to whatever local instruction your organization adds. What do you keep? A copy, made before the form leaves your hands.
What if DD Form 2492 points to another form? Search the series and number. Because the DD sequence is common to every military department, no branch qualifier is needed to land on the right file.
Can you assume a matching number is the same form? No, and this is where downloads go wrong. Read the prefix. Army numbering and Department numbering are independent systems, so the digits alone tell you nothing about which document you need.
Why do editions change at all? Three reasons, mostly: the prescribing directive gets reissued, the information collected changes, or the required notice language is amended. Are you notified when it happens? No. Which is why confirming not stated at the moment you download is worth the few seconds.
Is any of this advice? No. This page distributes a published Defense form and explains its contents, which is a different thing from telling you whether your circumstances qualify or whether a reviewer will accept your copy. Direct questions of eligibility, applicability and procedure to not stated, to your servicing personnel office, or to the office designated 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?