U.S. Air Force - 59th Medical Wing Forms

This Form is used for conducting fire watch and ensuring safety measures are in place.

This Form is used for transferring prescriptions to a different pharmacy within the 59th Medical Wing.

This Form is used for reporting and documenting sexual assault incidents involving active duty military personnel. It serves as a checklist to ensure all necessary information is collected.

This Form is used for reporting and documenting sexual assault incidents involving non-active duty personnel within the 59th Medical Wing.

This form is used for documenting and reporting sexual assault incidents involving minors who are 18 years old or younger.

This document is used for conducting monthly inspections at a medical clinic to ensure compliance with regulations and maintain a safe environment for patients and staff.

This document is used for obtaining the commander's authorization for the USAF Corneal Refractive (Crs) Program.

This Form is used to checklist off-duty employment for medical technicians in the 59th Medical Wing.

This document is a managed care agreement for refractive surgery. It outlines the terms and conditions for receiving this type of surgical procedure through a managed care program.

This Form is used for applying for corneal refractive surgery related to aviation duty in the US Air Force.

This form is used for gathering the medical history of patients undergoing refractive surgery.

This Form is used for gathering patient information specifically for refractive surgery at the Wilford Hall Ambulatory Surgical Center.

This Form is used for applying for corneal refractive surgery in the USAF Warfighter program.

This type of document is used for placing restrictions on temporary duty assignments within the 59th Medical Wing.

This document is a checklist used by the 59th Medical Wing for responding to spills or emergencies that are classified as Code Orange.

This form is used for conducting an initial assessment for adult medical nutrition therapy.

This form is used for conducting a clinical exam at the 59th Medical Wing (MDW).

This form is used for conducting an initial assessment for pediatric medical nutrition therapy. It helps healthcare professionals gather relevant information about a child's nutritional needs and create a personalized treatment plan.

This Form is used for conducting an orthodontic screening exam at the 59th Medical Wing.

This form is used for pre-operative/procedure registration and questionnaire at the 59th Medical Wing.