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8/17/2019 Chapter Check List
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Chapter 5, Para 5-8, Involuntary Separation Due to Parenthood
________ DD Form 93 (Emeren!y "oti#i!ation$%
________ S&'I) (Servi!e mem*er+$ 'i#e In$uran!e Poli!y%
_________ Enli$tment Contra!t, eenli$tment Contra!t, andor Eten$ion$ (I#
.ppli!a*le% /e only need the DD Form 0-1, 0-, 0-3
________ 2o$t Current 'ES (3 day$ !urrent%
________ an4 i$tory (et #rom S-1%
________ 6pdated E7 (et #rom S-1%
_________ Duty Statu$ (et #rom S-1%
_________ .CES e!ord (Edu!ation e!ord$%
_________ Pararaph 1-1 Coun$elin
_________ Family Care Plan Che!4li$t or Euivalent Coun$elin
_________ Statement #rom S2 eplainin /hy he$he !annot
:*tain a Family Care Plan
_________ 2edi!al Eamination
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Chapter 5, Para 5-13, Per$onality Di$order
________ DD Form 93 (Emeren!y "oti#i!ation$%
________ S&'I) (Servi!e mem*er+$ 'i#e In$uran!e Poli!y%
_________ Enli$tment Contra!t, eenli$tment Contra!t, andor Eten$ion$ (I#
.ppli!a*le% /e only need the DD Form 0-1, 0-, 0-3
________ 2o$t Current 'ES (3 day$ !urrent%
________ an4 i$tory (et #rom S-1%
________ 6pdated E7 (et #rom S-1%
_________ Duty Statu$ (et #rom S-1%
_________ .CES e!ord (Edu!ation e!ord$%
_________ Pararaph 1-1 Coun$elin
_________ Eviden!e S2 ha$ not re$ponded to Para 1-1 Coun$elin
_________ 2ental Evaluation *y Phy$i!ian trained in P$y!hiatry
and P$y!hiatri! Diano$i$ or a Clini!al P$y!holoi$t
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8/17/2019 Chapter Check List
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Chapter 5, Para 5-1, Early Separation to Further Edu!ation
________ DD Form 93 (Emeren!y "oti#i!ation$%
________ S&'I) (Servi!e mem*er+$ 'i#e In$uran!e Poli!y%
_________ Enli$tment Contra!t, eenli$tment Contra!t, andor Etention$ (I#
.ppli!a*le% /e only need the DD Form 0-1, 0-, 0-3
________ 2o$t Current 'ES (3 day$ !urrent%
________ an4 i$tory (et #rom S-1%
________ 6pdated E7 (et #rom S-1%
_________ Duty Statu$ (et #rom S-1%
_________ .CES e!ord (Edu!ation e!ord$%
_________ 'etter o# .dmi$$ion (Must include Date Classes will begin)
_________ Statement provin $oldier !an pay tuition #ee$
_________ Eviden!e that $!hool i$ ). approved(Statement from School or Education Center will suffice)
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Chapter 5, Para 5-1?, :ther De$inated Phy$i!al or 2ental Condition$
________ DD Form 93 (Emeren!y "oti#i!ation$%
________ S&'I) (Servi!e mem*er+$ 'i#e In$uran!e Poli!y%
_________ Enli$tment Contra!t, eenli$tment Contra!t, andor Etention$ (I#
.ppli!a*le% /e only need the DD Form 0-1, 0-, 0-3
________ 2o$t Current 'ES (3 day$ !urrent%
________ an4 i$tory (et #rom S-1%
________ 6pdated E7 (et #rom S-1%
_________ Duty Statu$ (et #rom S-1%
_________ .CES e!ord (Edu!ation e!ord$%
_________ Pararaph 1-1 Coun$elin
_________ Eviden!e S2 ha$ not re$ponded to Para 1-1 Coun$elin
_________ Eviden!e #rom 2edi!al or 2ental ealth Per$onnel
do!umentin !ondition
_________ 2edi!al Eamination
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8/17/2019 Chapter Check List
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Chapter , Para -3(a% or -3(*%, Dependen!y or ard$hip
________ DD Form 93 (Emeren!y "oti#i!ation$%
________ S&'I) (Servi!e mem*er+$ 'i#e In$uran!e Poli!y%
_________ Enli$tment Contra!t, eenli$tment Contra!t, andor Etention$ (I#
.ppli!a*le% /e only need the DD Form 0-1, 0-, 0-3
________ 2o$t Current 'ES (3 day$ !urrent%
________ an4 i$tory (et #rom S-1%
________ 6pdated E7 (et #rom S-1%
_________ Duty Statu$ (et #rom S-1%
_________ .CES e!ord (Edu!ation e!ord$%
_________ Eviden!e $upportin dependen!y or hard$hip
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Chapter 8, Prenan!y o# Enli$ted @omen
________ DD Form 93 (Emeren!y "oti#i!ation$%
________ S&'I) (Servi!e mem*er+$ 'i#e In$uran!e Poli!y%
_________ Enli$tment Contra!t, eenli$tment Contra!t, andor Eten$ion$ (I#
.ppli!a*le% /e only need the DD Form 0-1, 0-, 0-3
________ 2o$t Current 'ES (3 day$ !urrent%
________ an4 i$tory (et #rom S-1%
________ 6pdated E7 (et #rom S-1%
_________ Duty Statu$ (et #rom S-1%
_________ .CES e!ord (Edu!ation e!ord$%
_________ Prenan!y Coun$elin
_________ Prenan!y Pro#ile or Statement o# Prenan!y
_________ 2edi!al Eamination
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Chapter 9, .l!ohol or :ther Dru .*u$e eha*ilitation Failure
________ DD Form 93 (Emeren!y "oti#i!ation$%
________ S&'I) (Servi!e mem*er+$ 'i#e In$uran!e Poli!y%
_________ Enli$tment Contra!t, eenli$tment Contra!t, andor Eten$ion$ (I#
.ppli!a*le% /e only need the DD Form 0-1, 0-, 0-3
________ 2o$t Current 'ES (3 day$ !urrent%
________ an4 i$tory (et #rom S-1%
________ 6pdated E7 (et #rom S-1%
_________ Duty Statu$ (et #rom S-1%
_________ .CES e!ord (Edu!ation e!ord$%
_________ .D.PCP Summary o# eha*ilitation
_________ Statement De!larin S2 a eha*ilitation Failure
_________ 2edi!al Eamination
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Chapter 1, In 'ieu o# a Court-2artial
________ DD Form 93 (Emeren!y "oti#i!ation$%
________ S&'I) (Servi!e mem*er+$ 'i#e In$uran!e Poli!y%
_________ Enli$tment Contra!t, eenli$tment Contra!t, andor Eten$ion$ (I#
.ppli!a*le% /e only need the DD Form 0-1, 0-, 0-3
________ 2o$t Current 'ES (3 day$ !urrent%
________ an4 i$tory (et #rom S-1%
________ 6pdated E7 (et #rom S-1%
_________ Duty Statu$ (et #rom S-1%
_________ .CES e!ord (Edu!ation e!ord$%
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Chapter 11, Entry 'evel Separation
________ DD Form 93 (Emeren!y "oti#i!ation$%
________ S&'I) (Servi!e mem*er+$ 'i#e In$uran!e Poli!y%
_________ Enli$tment Contra!t, eenli$tment Contra!t, andor Etention$ (I#
.ppli!a*le% /e only need the DD Form 0-1, 0-, 0-3
________ 2o$t Current 'ES (3 day$ !urrent%
________ an4 i$tory (et #rom S-1%
________ 6pdated E7 (et #rom S-1%
_________ Duty Statu$ (et #rom S-1%
_________ .CES e!ord (Edu!ation e!ord$%
_________ Pararaph 1-1 Coun$elin
_________ Eviden!e S2 ha$ not re$ponded to Para 1-1 Coun$elin
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8/17/2019 Chapter Check List
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Chapter 13, 6n$ati$#a!tory Per#orman!e
________ DD Form 93 (Emeren!y "oti#i!ation$%
________ S&'I) (Servi!e mem*er+$ 'i#e In$uran!e Poli!y%
_________ Enli$tment Contra!t, eenli$tment Contra!t, andor Etention$ (I#
.ppli!a*le% /e only need the DD Form 0-1, 0-, 0-3
________ 2o$t Current 'ES (3 day$ !urrent%
________ an4 i$tory (et #rom S-1%
________ 6pdated E7 (et #rom S-1%
_________ Duty Statu$ (et #rom S-1%
_________ .CES e!ord (Edu!ation e!ord$%
_________Pararaph 1-1 Coun$elin
_________ Eviden!e S2 ha$ not re$ponded to Para 1-1 Coun$elin
_________ 2ental Evaluation
_________ 2edi!al Eamination In APFT cases, the two APFTs must be no more than 90 days apart. If the APFTs are more than
90 days apart because the soldier was on profile, the packet should include a copy of the profile.
It is recommended that units counsel soldiers on profile that they will be administered the APFT
immediately after the recovery period.
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Chapter 10, Para 10-1a, 2inor Di$!iplinary In#ra!tion$ orChapter 10, Para 10-1*, Pattern o# 2i$!ondu!t
________ DD Form 93 (Emeren!y "oti#i!ation$%
________ S&'I) (Servi!e mem*er+$ 'i#e In$uran!e Poli!y%
_________ Enli$tment Contra!t, eenli$tment Contra!t, andor Eten$ion$ (I#
.ppli!a*le% /e only need the DD Form 0-1, 0-, 0-3
________ 2o$t Current 'ES (3 day$ !urrent%
________ Current 6nit o# .$$inment :rder$
________ an4 i$tory (et #rom S-1%
________ 6pdated E7 (et #rom S-1%
_________ Duty Statu$ (et #rom S-1%
_________ Pararaph 1-1 . 35- Coun$elin
_________ Eviden!e S2 ha$ not re$ponded to Para 1-1 Coun$elin
_________ 2ental Evaluation
_________ 2edi!al Eamination
_________ .CES e!ord (Edu!ation e!ord$%
Examples of evidence include counseling’s, Article 15s, records of trial by court-
martial, ect.
NOE! "E#$ "N %O&' A(E (E)*"(E' "N E+E( A$E
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Chapter 10, Para 10-1!, Commi$$ion o# a Seriou$ :##en$e
________ DD Form 93 (Emeren!y "oti#i!ation$%
________ S&'I) (Servi!e mem*er+$ 'i#e In$uran!e Poli!y%
_________ Enli$tment Contra!t, eenli$tment Contra!t, andor Eten$ion$ (I#
.ppli!a*le% /e only need the DD Form 0-1, 0-, 0-3
________ 2o$t Current 'ES (3 day$ !urrent%
________ Current 6nit o# .$$inment :rder$
________ an4 i$tory (et #rom S-1%
________ 6pdated E7 (et #rom S-1%
_________ Duty Statu$ (et #rom S-1%
_________Pararaph 1-1 . 35- Coun$elin
_________ Eviden!e o# Seriou$ :##en$e
_________ 2ental Evaluation
_________ 2edi!al Eamination
_________ .CES e!ord (Edu!ation e!ord$%
Examples of evidence include counseling’s, Article 15s, records of trial by court-martial, ect.
NOE! "E#$ "N %O&' A(E (E)*"(E' "N E+E( A$E
A!
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Chapter 10, Para 10-5, Convi!tion *y Civil Court
________ DD Form 93 (Emeren!y "oti#i!ation$%
________ S&'I) (Servi!e mem*er+$ 'i#e In$uran!e Poli!y%
_________ Enli$tment Contra!t, eenli$tment Contra!t, andor Eten$ion$ (I#
.ppli!a*le% /e only need the DD Form 0-1, 0-, 0-3
________ 2o$t Current 'ES (3 day$ !urrent%
________ an4 i$tory (et #rom S-1%
________ 6pdated E7 (et #rom S-1%
_________ Duty Statu$ (et #rom S-1%
_________ .CES e!ord (Edu!ation e!ord$%
_________ 2emorandum #or 2edi!al and Dental e!ord$ i# no loner
hereA
_________ e$ult$ o# the ;rial and !onvi!tion
"#T!$ IT!% I" '( A)! )!*+I)!( I" !!)- A!
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Chapter 15, Di$!hare #or omo$eual Condu!t
________ DD Form 93 (Emeren!y "oti#i!ation$%
________ S&'I) (Servi!e mem*er+$ 'i#e In$uran!e Poli!y%
_________ Enli$tment Contra!t, eenli$tment Contra!t, andor Eten$ion$ (I#
.ppli!a*le% /e only need the DD Form 0-1, 0-, 0-3
________ 2o$t Current 'ES (3 day$ !urrent%
________ Current 6nit o# .$$inment :rder$
________ an4 i$tory (et #rom S-1%
________ 6pdated E7 (et #rom S-1%
_________ Duty Statu$ (et #rom S-1%
_________ .CES e!ord (Edu!ation e!ord$%
_________ Eviden!e o# omo$eual Condu!t
_________ 2ental Evaluation
_________ 2edi!al Eamination
ommanders must consult it/ t/e %rigade rial ounsel on any case involving
allegations of /omosexual conduct prior to initiating any action.
"#T!$ IT!% I" '( A)! )!*+I)!( I" !!)- A!
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Chapter 18, Failure to 2eet 7ody Fat Standard$
________ DD Form 93 (Emeren!y "oti#i!ation$%
________ S&'I) (Servi!e mem*er+$ 'i#e In$uran!e Poli!y%
_________ Enli$tment Contra!t, eenli$tment Contra!t, andor Eten$ion$(I# .ppli!a*le% @e only need the DD Form 0-1, 0-, 0-3
________ 2o$t Current 'ES (3 day$ !urrent%
________ an4 i$tory (et #rom S-1%
________ 6pdated E7 (et #rom S-1%
_________ Duty Statu$ (et #rom S-1%
_________ .CES e!ord (Edu!ation e!ord$%
_________ 7ody Fat Content @or4$heet$
_________ "utrition Coun$elin
_________ Enrollment into @eiht Control Proram
_________ Statement that /eiht i$ not due to a medi!al !ondition
_________ 2edi!al Eamination
"#T!$ IT!% I" '( A)! )!*+I)!( I" !!)- A!
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Chapter 1, Para 1-0, "on-etention on .!tive Duty
________ DD Form 93 (Emeren!y "oti#i!ation$%
________ S&'I) (Servi!e mem*er+$ 'i#e In$uran!e Poli!y%
_________ Enli$tment Contra!t, eenli$tment Contra!t, andor Eten$ion$ (I#
.ppli!a*le% @e only need the DD Form 0-1, 0-, 0-3
________ 2o$t Current 'ES (3 day$ !urrent%
________ Current 6nit o# .$$inment :rder$
________ an4 i$tory (et #rom S-1%
________ 6pdated E7 (et #rom S-1%
_________ Duty Statu$ (et #rom S-1%
_________ .CES e!ord (Edu!ation e!ord$%
_________ De!lination Statement
BBBBBBBB D. 018? reue$tin $eparation $ined *y C: CD
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