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BCP EVALUATION FORM

FOR OFFICIAL USE ONLY Privacy sensitive when filled in. Any misuse or unauthorized disclosure may result in both civil and criminal 11621 (Rev. 11-16)MCO EVALUATION FORMAUTHORITY: 10 5013, Secretary of the Navy; 10 5041, Headquarters, Marine Corps; 10 1074f, Medical Tracking System for Members Deployed Overseas; 32 CFR , Management and Mobilization; DoD Dir , Reserve Component Member Participation Policy; DoD Instruction , Personnel Accountability in Conjunction with Natural and Manmade Disasters; CJCSM , Joint Reporting Structure Personnel Manual; DoD Instruction , Deployment Health; MCMEDS: SECNAVINST , Management and Disposition of Incapacitation Benefits for Members of the Navy and Marine Corps Reserve Components (Renamed Line of Duty(LOD)).

PRINCIPAL PURPOSE: Information collected by this form will be used to record body composition data for compliance with the ... disease and that I am being assigned to the Body Composition/Remedial Physical Conditioning Program. MEDICAL DOCTOR'S INITIAL EVALUATION AND FINDINGS.

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