Long-Term Training
All officers wishing to enter into Long Term Training must meet the Basic Readiness Standards
Long-Term Training
All links below lead to PDF documents
Application for Training for PHS Commissioned Personnel (PHS-1122-1)
Program Assessment Form (CDC 0.1116B)
Employee Assessment Form (CDC 0.1116A)
Sample of Training Purposes and Objectives Statement
Extramural Training Agreement (PHS-6373)
Intramural Training Agreement (if required) (PHS-6374)
Preventive Medicine Residents
Application for Training for PHS Commissioned Personnel (PHS-1122-1)
Program Assessment Form (CDC 0.1116B)
Employee Assessment Form (CDC 0.1116A)
Sample of Training Purposes and Objectives Statement
Extramural Training Agreement (PHS-6373)
Intramural Training Agreement (if required) (PHS-6374)
Epidemic Intelligence Service
Application for Appointment (PHS-50)
Appointment affidavit (PHS-5141-1)
Fingerprint chart (SF-87A)
Questionnaire for Non-Sensitive Positions (SF-85)
Continuation Sheet for Questionnaires (SF-86A)
Montgomery GI Bill Election and Statement of Understanding (PHS-6273)
Direct Deposit Sign-Up form (SF-1199A)
Servicemembers’ Group Life Insurance Election and Certificate (SGLV-8286)
Family Coverage Election (SGLV-8286A)
Release of Medical Information
Report of Medical History (DD Form 2807-1)
Report of Medical Examination (DD Form 2808)
Report of Dental Examination (PHS-6355)
Supplemental Medical History Record (PHS-6379)
If prior Uniformed Service – Request for Uniformed Services Medical Records (PHS-6380)