No Worries
For use of this form, see AR 40-501; the proponent agency is the Office of the Surgeon General.
1. MEDICAL CONDITION: (Description in lay terminology) INJURY? Or ILLNESS/DISEASE? 2. CODES (Table
7-2 AR 40-501)
PHYSICAL PROFILE
3. Temporary Permanent
P
U
L
H
E
S
Pseudofolliculitis barbae; Ingrown facial hair; Razor bumps. Shaving Profile
A
4. PROFILE TYPE a. TEMPORARY PROFILE (Expiration date YYYYMMDD)
(Limited to 3 months duration)
2
1
1
1
1
1
YES
NO
b. PERMANENT PROFILE (Reviewed and validated with every periodic health assessment or after 5 years from the date of issue) 5. FUNCTIONAL ACTIVITIES THAT EVERY SOLDIER REGARDLESS OF MOS MUST BE ABLE TO PERFORM. IF SOLDIER CANNOT PERFORM ANY ONE OF THESE TASKS, THEN THE PULHES MUST CONTAIN AT LEAST ONE "3" AND SOLDIER MUST BE REFERRED TO A MEB. CAN THE SOLDIER:
FUNCTIONAL ACTIVITY:
YES
NO
a. Carry and fire individual assigned weapon? b. Evade direct and indirect fire? c. Ride in a military vehicle for at least 12 hours per day? d. Wear a helmet for at least 12 hours per day? e. Wear body armor for at least 12 hours per day? f. Wear load bearing equipment (LBE) for at least 12 hours per day? g. Wear military boots and uniform for at least 12 hours per day? h. Wear protective mask and MOPP 4 for at least 2 continuous hours per day? i. Move 40lbs (for example, duffle bag) while wearing usual protective gear (helmet, weapon, body armor and LBE) at least 100 yards? j. Live in an austere environment without worsening the medical condition? 6. APFT 2 MILE RUN APFT SIT-UPS APFT PUSH UPS YES NO ALTERNATE APFT (Fill out if unable to do APFT run otherwise N/A) APFT WALK APFT SWIM APFT BIKE N/A YES NO
7. DOES THE SOLDIER MEET RETENTION STANDARDS IAW CHAPTER 3 AR 40-501? YES NEEDS MMRB NO NEEDS MEB
8. FUNCTIONAL LIMITATIONS AND CAPABILITIES AND OTHER COMMENTS:
Soldier is not to shave with a razor. Facial hair is to be trimmed regularly - not to exceed
1. MEDICAL CONDITION: (Description in lay terminology) INJURY? Or ILLNESS/DISEASE? 2. CODES (Table
7-2 AR 40-501)
PHYSICAL PROFILE
3. Temporary Permanent
P
U
L
H
E
S
Pseudofolliculitis barbae; Ingrown facial hair; Razor bumps. Shaving Profile
A
4. PROFILE TYPE a. TEMPORARY PROFILE (Expiration date YYYYMMDD)
(Limited to 3 months duration)
2
1
1
1
1
1
YES
NO
b. PERMANENT PROFILE (Reviewed and validated with every periodic health assessment or after 5 years from the date of issue) 5. FUNCTIONAL ACTIVITIES THAT EVERY SOLDIER REGARDLESS OF MOS MUST BE ABLE TO PERFORM. IF SOLDIER CANNOT PERFORM ANY ONE OF THESE TASKS, THEN THE PULHES MUST CONTAIN AT LEAST ONE "3" AND SOLDIER MUST BE REFERRED TO A MEB. CAN THE SOLDIER:
FUNCTIONAL ACTIVITY:
YES
NO
a. Carry and fire individual assigned weapon? b. Evade direct and indirect fire? c. Ride in a military vehicle for at least 12 hours per day? d. Wear a helmet for at least 12 hours per day? e. Wear body armor for at least 12 hours per day? f. Wear load bearing equipment (LBE) for at least 12 hours per day? g. Wear military boots and uniform for at least 12 hours per day? h. Wear protective mask and MOPP 4 for at least 2 continuous hours per day? i. Move 40lbs (for example, duffle bag) while wearing usual protective gear (helmet, weapon, body armor and LBE) at least 100 yards? j. Live in an austere environment without worsening the medical condition? 6. APFT 2 MILE RUN APFT SIT-UPS APFT PUSH UPS YES NO ALTERNATE APFT (Fill out if unable to do APFT run otherwise N/A) APFT WALK APFT SWIM APFT BIKE N/A YES NO
7. DOES THE SOLDIER MEET RETENTION STANDARDS IAW CHAPTER 3 AR 40-501? YES NEEDS MMRB NO NEEDS MEB
8. FUNCTIONAL LIMITATIONS AND CAPABILITIES AND OTHER COMMENTS:
Soldier is not to shave with a razor. Facial hair is to be trimmed regularly - not to exceed