Download the form
Treat DD Form 2493-1 as Department-level, which changes how you look for it. Title: DD Form 2493-1, Asbestos Exposure Part I - Initial Medical Questionnaire, January 2000. Function: Asbestos Exposure Part I - Initial Medical Questionnaire. Because the number carries DD rather than a service prefix, the same edition covers all military departments and the defense agencies at once. Nobody issues a Navy copy or an Air Force copy.
Authority: not stated prescribes it, not stated maintains it. Those two names settle most disputes about why the form is being asked for. Local commands add timing on top; the requirement itself comes from above them.
Current edition is not stated, carried as not stated. Check that against any copy you already hold before doing anything else — Department-level revisions land everywhere simultaneously, so a stale file is stale across the whole Department.
Available: PDF, across 2 pages, roughly 188 fields.
Nothing costs anything here. Work in a full desktop pdf application rather than a browser preview; field behaviour in browsers is unreliable.
What the form asks for
- Identification section. 1. Name (last, first, middle initial).
- 2. Social security number. Do not include dashes.
- 3. Clock number. Enter 5 digit number.
- 4. Present occupation.
- 5. Name of plant.
- 6. Street address of plant.
- 7. Plant city, state and zip code.
- 8. Telephone number, include area code.
- 9. Name of interviewer.
- 10. Date of interview (4 digit year, 2 digit month, 2 digit day).
- 11. Date of birth (4 digit year, 2 digit month, 2 digit day).
- 12. Place of birth
- 13. Sex. Press space bar to mark X in first box if male, second box if female.
- 14. Marital status. X first box if single, second box if married, third box if widowed, or fourth box if divorced/separated.
- 15. Race. X first box if white, second box if black, third box if Asian, fourth box if Hispanic, fifth box if Indian, or sixth box if other.
- 16. Highest grade completed in school.
- 17. Occupational history. a. In the past year, did you work full time (30 hours per week or more) for six months or more? X first box if yes, second box if no.
- b. If yeshave you ever worked for a year or more in any dusty job? X first box if yes, second box if no, third box if not applicable.
- (3) Dust exposure: X first box if mild, second box if moderate, third box if severe.
- c. Have you ever been exposed to gas or chemical funes in your work? X first box if yes, second box if no, third box if not applicable.
- If yes: (1) Specify job or industry.
- (2) Total years worked.
- If yes: (1) Specify job or industry.
- (2) Total years worked.
Verify the edition before the first keystroke. The date on the form face should read not stated. If it does not, discard the file. Field numbering shifts between editions, and on a DD form the new layout reaches every receiving office in every service at once — there is no lag during which the old version is still normal somewhere.
Sequence matters. Identification precedes content, content precedes certification, because the lower half of a form is generally conditioned on the upper half.
Mark inapplicable items N/A rather than leaving white space. Use the date format the form specifies. This matters more on Department forms than on service forms: the record may be reviewed by personnel outside your branch who share none of your office conventions.
Read the Privacy Act Statement before entering identifiers, not after. Four facts are in it: authority, purpose, routine uses, consequence of declining. Its placement ahead of the data fields is deliberate.
Certification closes the form. Ink on paper, or a digital signature — normally CAC-applied — in software that supports it. Typed text in the signature box is a name, not an execution. Enter the date beside it before closing the file.
Check before submitting. The recurring failures are edition mismatch, gaps in required boxes, unreadable scanned handwriting, wrong date format, and certification without signature or date. Field-level questions go to the printed instructions, then to not stated, which is authoritative.
Send it as not stated or local guidance specifies. Save a copy. Cross-service and cross-agency routing is normal for Department forms, and a lost original outside your own organization is harder to chase down.
Related forms are found by number alone. The DD sequence is one unified Department-wide series, so a cited number resolves to exactly one document with no branch qualifier needed.
Do not read across from a service number. DA numbering is Army-specific under an Army proponent; DD numbering is Department-wide under not stated or an equivalent Department office. The sequences are unrelated, so identical digits in each identify two different documents. Read the prefix, not the digits.
Three drivers of revision: directive reissue, altered collection requirements, updated statutory notice text. No notification accompanies any of them, so download fresh and confirm not stated rather than reusing an archived file.
What is here is the blank form and a description of it. What is not here is legal guidance or any assurance about a particular filing — this page is not the issuing authority and does not speak for one. Those questions go to not stated, to your servicing administrative office, or to the authority identified in not stated.
Questions and answers
- What is DD Form 2493-1?
- DD Form 2493-1, Asbestos Exposure Part I - Initial Medical Questionnaire, January 2000
- Which edition is current?
- Not stated by the publisher
- Who is responsible for this form?
- Not stated
- In which formats can it be downloaded?