Policies
- BUMED Notice 6150, 19 Jul 2007
- PHA Policy (ASD(HA)-Signed) Feb 2006
- Periodic Health Assessment (PHA) SECNAVINST 6120.3
- Instruction, Physical Readiness Program 6110.1H (15 AUG 05) Physical Readiness Information Management System (PRIMS) (NAVADMIN) Mar 06
- PHA guidance regarding Students at Training Commands (BUMED Ltr) 9 March 04
- Implementation Guidance for Navy Reserve PHA Process
Forms
- Periodic Health Assessment (NAVMED 6120-4)
- Physical Fitness Assessment Medical Clearance/Waiver (NAVMED 6110/4)
- Annual Certificate of Physical Condition (NAVMED 6120/3)
- Adult Immunizations Record (Navmed 6230_4.pdf)
- Reserve Component (MRRS) DD Form 2766
- DD Form 2766 (PDF version)
- DD Form 2813 (Active Duty/Reserve Forces Dental Exam)
- NAVMED 6600/12 (6-93) Dental Assessment and Certification
- Physical Readiness Information Management System (PRIMS): Active duty or reserve members can log on and print out a PARFQ (Physical Activity Risk Factor Questionnaire). Please notice a block placed at the bottom of the form for signature and date by medical department representative saying the "PHA was completed" and "No other risk factors were identified."
Tools
- PHA Counseling DVD
- Civilian Health Care Providers
- PHA Step-By-Step Guide (A guide and worksheets for planning, implementation, and evaluation of the PHA process.)
- PowerPoint show for completing DD2766
- The following tools are samples to assist you in implementing the PHA. They may be altered to meet your command's PHA process:
- Naval Reserve Readiness Command South, PHA Process [PPT]
- DD Form 2766, completion guidance
- Guidance for Administration of the Fleet and Marine Corps Health Risk Assessment (HRA)
- Health and Readiness Tool (HART)
- PHA Coding
- AHLTA Template Screen Shots
Patient-Centered Prevention Counseling Guidelines:
Clinical References
- MANMED, Chapter 15 Revision. Article 15-9, Periodic Examinations for Active Duty Personnel on page 15-10 states “Routine periodic physical examinations are no longer required for officers. Please see OPNAVINST 6120.3 series for guidance on the Preventive Health Assessment.”
- Guide to Clinical Preventive Services, Pocket Edition 2009
- Guide to Clinical Preventive Services, 3rd edition, updated recommendations from the 2nd Edition and additional new topics.
- National Immunization Program, CDC recommendations for the routine administration of vaccines to the pediatric and adult populations
- 2008 DoD Survey of Health Related Behaviors
- Healthy People 2010: Healthy People 2010 provides a framework for prevention for the Nation. It is a statement of national health objectives designed to identify the most significant preventable threats to health and to establish national goals to reduce these threats.
Patient Education
- Framingham Cardiovascular Risk Assessment Tool: This risk assessment tool uses data from the Framingham Heart Study to estimate 10-year risk for “hard” coronary heart disease outcomes (myocardial infarction and coronary death). This tool is designed to estimate risk in adults aged 20 and older who do not have heart disease or diabetes.
- Assess Your Body Mass Index (BMI): Body Mass Index or BMI is a tool for indicating weight status in adults. BMI ranges are based on the effect body weight has on disease and death. As BMI increases, the risk for some disease increases.
- MEDLINE Plus This site provides information on management ofmedical conditions and many health and wellness topics
- AHRQ The vision of the Agency for Health Care Policy and Research is to foster health care research that helps the American health care system provide access to high-quality, cost-effective services; be accountable and responsive to consumers and purchasers; and improve health status and quality of life. The Consumer and Patients page provides guidance on health care topics and assists consumers in making decisions about health care.
- Men: Checklist for your PHA
- Women:Checklist for your PHA
This page last updated on April 25, 2012.
Content last reviewed on April 25, 2012.
Content last reviewed on April 25, 2012.





