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OF 178: Federal Certificate of Medical Examination

Federal agencies use the OF 178 for pre-placement and periodic medical exams in positions with medical standards or physical requirements, such as law enforcement and wildland firefighting, under 5 CFR 339. The examining clinician reviews the job's checked functional requirements and environmental factors, records findings in Part C and states whether any condition would limit performance of the duties.

Who completes it

The applicant or employee completes Part A and the agency's appointing officer completes Part B before the exam. The examining physician, physician assistant or nurse practitioner completes Part C (pages 4 to 6); the agency medical officer completes Part D and HR completes Part E.

Submitting and payment

How to submit it
The examiner returns the form intact to the employing agency in the pre-addressed, pre-paid 'Confidential - Medical' envelope given to the examinee, including certified audiogram results with the package.
Who pays
The employing agency pays for, or reimburses, required examinations.

Good to know

  • Part C covers vision (Snellen acuity, depth perception, peripheral fields, Jaeger near vision, color plates), hearing with a certified audiogram, and system-by-system findings a to l.
  • For law enforcement, air traffic control and firefighting positions, the agency attaches the specific medical standards, and the examiner should have them in hand during the exam.
  • Extra space goes on a continuation page headed 'OF-178 Attachment' with the worker's name and date.
  • The April 2012 edition replaced SF 78, and previous editions are not usable. Final results must be reviewed and certified by the agency medical officer.

Get the official form

Download the current version from the source each time; forms change without notice.

Certificate of Medical Examination

Official pagePDF

How this list is checked

A form is listed only after its name and number were confirmed on the issuing agency’s or insurer’s own website, or in the form itself. Each entry links to that source. The list was last checked in October 2026. Forms and their requirements change without notice, so check the official page for the current version before you complete one.

Vero is not affiliated with, or endorsed by, the agencies and insurers listed here. Read our editorial policy.

Frequently asked questions

Who can complete Part C of the OF 178?

An examining physician, physician assistant or nurse practitioner. Part C is pages 4 to 6 of the 7-page form. The final examination results are then reviewed and certified by the agency medical officer in Part D before HR records the personnel action in Part E.

What goes in the OF 178 conclusions?

Item 5 of Part C asks the examiner to summarize any medical findings that, in their opinion, would limit the person's ability to perform the job duties described in Part B or make them a hazard to themselves or others. If there are none, the examiner checks 'No limiting conditions for this job'.

Who pays for an OF 178 exam?

The employing agency pays for or reimburses required examinations. The agency also supplies the form with Part B completed and a pre-paid 'Confidential - Medical' envelope, which the examiner uses to return the completed form directly to the agency.