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FORM NUMBER: DD294

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TITLE: APPLICATION FOR A REVIEW BY THE PHYSICAL DISABILITY BOARD OF REVIEW (PDBR) OF THE RATING

AWARDED ACCOMPANYING A MEDICAL SEPARATION FROM THE ARMED FORCES OF THE U.S.

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EDITION DATE: 20090101 CANCELLATION DATE:

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AVAILABLE FILE FORMATS: PLEASE NOTE:
Fillable Adobe: PDF-Ext If no hyperlink appears next to a format, the form is not available electronically.
Perform Pro: To obtain hard copies of current forms not available in electronic format, please
Form Flow 2.0: contact your own Military Service or DoD Component Forms Management
Form Flow 99: Officer. Cancelled forms are not available in electronic formats. Click on link for
Other: a list of Forms Management POCs.

Forms Management POCs

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REMARKS:
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ISSUANCES: DODI 6040.44
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SPONSOR / POC: P&R SUB-SPONSOR: MPP
NUMBER OF PAGES: 3
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USERS*: A N AF MC
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PRESCRIBED OR ADOPTED?: P

DISPOSITION:

FUNCTION CODE: 6040

FORM CONTROLLED: N

MANDATORY PRINT SPECIFICATIONS: N

RCS:

IRCN:

OMB: 0704-0453

PRIVACY ACT IMPLICATIONS: Y
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* All revisions and/or cancellations must be coordinated through these USERS.

DISPOSITION: S = Do NOT use previous edition. U = Use previous edition until supply is depleted.