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USFS Fire Medical Form: Asthma, COPD, Sleep Apnea

When a Forest Service fire employee's medical review flags asthma, reactive airway disease, COPD or obstructive sleep apnea, the employee brings this three-page template to their treating provider. Part B asks about stability and medications, rescue inhaler use, flares and hospitalizations, triggers, and for sleep apnea the device used and daytime sleepiness. Forest Service Medical Officers use it to decide qualification or a waiver.

Who completes it

The employee completes Part A (name, date of birth, home unit and light, moderate or arduous fitness level), which also authorizes release to Forest Service Medical Officers. The treating provider (MD, DO, NP, PA or other) completes Part B as applicable and signs it with an office stamp.

Submitting and payment

How to submit it
Fax the completed form to the Fire Medical Qualifications Program office as printed on the form; the program also receives documents through the employee's eMedical account.
Who pays
When a Medical Officer requests more medical information, the employee must obtain, pay for and supply it under 5 CFR 339.304(c).

Good to know

  • Every provider answers whether there are restrictions on fire duties of 16 hours a day for up to 21 days, in heat over 100°F, smoke and altitude, with care over an hour away.
  • For asthma or COPD, the form asks how often the employee goes through a rescue inhaler and about any flare or hospitalization requiring care in the last five years.
  • For sleep apnea, note whether the employee uses CPAP, an oral appliance or an Inspire device, whether nightly use is required and whether daytime somnolence is controlled.
  • The provider does not make the final qualification decision; only a Forest Service Medical Officer can grant a waiver, and only for a static and stable condition.

Get the official form

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

USDA Forest Service: Fire Medical Qualifications Program - Asthma/ Reactive Airway Disease/ COPD/ Sleep Apnea

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.

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Frequently asked questions

What does the Forest Service asthma and COPD medical form ask?

Part B asks the diagnosis, whether the condition is static and stable with good treatment compliance, a full medication list with indications, the approximate date diagnosed, rescue inhaler use, flares or hospitalizations in the last five years, how often hospitalization is needed, and any specific triggers.

Does the provider decide whether a wildland firefighter with sleep apnea is qualified?

No. The Forest Service says the employee's medical provider does not make the final determination. The provider documents the condition, treatment and any restrictions, and a Forest Service Medical Officer decides medical qualification and whether to grant a waiver, with or without mitigations.

What fitness levels does the Forest Service template refer to?

Part A asks the employee to mark light, moderate or arduous. The last page summarizes each: the arduous work capacity test is a 3-mile hike with a 45-pound pack in 45 minutes, moderate is 2 miles with 25 pounds in 30 minutes, and light is 1 mile with no load in 16 minutes.