Department of the Air Force

F036 AFPC F

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SYSTEM NAME:

Health Education Records  (March 05, 2013,  78 FR 14292)

SYSTEM LOCATION:

Headquarters, Air Force Personnel Center (AFPC), Chief, Medical Service Officer Utilization Division, 550 C. Street W, Randolph Air Force Base, TX 78150-4703.

CATEGORIES OF INDIVIDUALS COVERED BY THE SYSTEM:

Air Force Active Duty, Reserve, and Air National Guard personnel.

CATEGORIES OF RECORDS IN THE SYSTEM:

Name, Social Security Number (SSN), Department of Defense Identification Number (DoD ID Number) and grade.

Physical Education Branch:

Undergraduate Selection Folders: Application; Medical College Admission Test; Letter of acceptance to approved medical school; Dean's letter of recommendation; DD Form 398, Personal History Statement; Health Professions Scholarship Program (HPSP); Uniformed Services University of the Health Sciences service obligation contracts; Air Reserve Personnel Center order; Privacy Act Statement; Photo; HPSP selection notification letter; Physical exam; Separation order.

Graduate Medical Education Folders: Medical College Admission Test; final medical school transcript; Dean's letter from medical school; hospital agreement form; Privacy Act Statement; photo; application for training; AFMPC Form 131, Education Summary; Program Director's letter; other letters of recommendation; memos for record; Congressional inquiries; general correspondence; legal opinions for correction of military records; essay on career intention and professional goals; residency/fellowship resignation letters; select notification letter; Active Duty Service Commitment statement; redeferred statement of understanding.

Medical Service Corps Utilization and Education Branch

Air Force Institute of Technology Sponsored Graduate Education Folders: Transcripts; chronological listings of work experience (VITAE); letters of recommendation; graduate record examination results; Graduate Management Admission Test results; officer career briefs.

Education With Industry Fellowship Application Folders: Military Facility Fellowship Application Folders; Professional Military Education Application Folders: VITAE; letters of recommendation; officer career briefs.

Dental Utilization and Education Branch

Graduate Dental Education Folders: Application for sponsored training; graduate record examination results; essay on why program is desired; letters of recommendation; general correspondence with applicant; select/non-select/alternate letter; Dean's letter; Active Duty Service Commitment statement.

AUTHORITY FOR MAINTENANCE OF THE SYSTEM:

10 U.S.C. 105, Armed Forces Health Professionals Financial Assistance Programs; 10 U.S.C. 9301, Members of Air Force: detail as students, observers, and investigators at educational institutions, industrial plants, and hospitals; and E.O. 9397 (SSN), as amended.

PURPOSE(S):

Used by the Medical Service Officer Utilization Division/Branches and Medical Education Selection Boards in selecting individuals to attend undergraduate and graduate educational programs. Such programs include medical school, residencies and fellowship programs for physicians, graduate dental education and graduate education for Medical Service Corps officers. Another use of the system is to monitor the individual's progress in an educational program after selection until completion of program.

ROUTINE USES OF RECORDS MAINTAINED IN THE SYSTEM, INCLUDING CATEGORIES OF USERS AND THE PURPOSES OF SUCH USES:

In addition to those disclosures generally permitted under 5 U.S.C. 552a(b) of the Privacy Act of 1974, as amended, these records contained therein may specifically be disclosed outside the DoD as a routine use pursuant to 5 U.S.C. 552a(b)(3) as follows:

The DoD Blanket Routine Uses published at the beginning of the Air Force's compilation of systems of records notices may apply to this system.

NOTE: This system of records contains individually identifiable health information. The DoD Health Information Privacy Regulation (DoD 6025.18-R) issued pursuant to the Health Insurance Portability and Accountability Act of 1996, applies to most such health information. DoD 6025.18-R may place additional procedural requirements on the uses and disclosures of such information beyond those found in the Privacy Act of 1974, as amended or mentioned in this system of records notice.

POLICIES AND PRACTICES FOR STORING, RETRIEVING, ACCESSING, RETAINING, AND DISPOSING OF RECORDS IN THE SYSTEM:


STORAGE:

Paper records and electronic storage media.

RETRIEVABILITY:

Retrieved by name, SSN and/or DoD ID Number.

SAFEGUARDS:

Records are maintained in file cabinets in the building that is locked and have controlled access entry requirements. Electronic files are only accessed by authorized personnel with secure Common Access Card (CAC) in combination with a Personal Identification Number (PIN) and need-to-know. Environment consists of magnetic keyed cipher locked room within AFPC complex.

RETENTION AND DISPOSAL:

Undergraduate and graduate medical education records are retained until the individual separates or retires from the Air Force. Air Force Institute of Technology (AFIT) selection folders are maintained until the end of the calendar year with the exception of transcripts which are returned to AFIT within 60 days of board completion. Dental graduate education folders are maintained while member is in program. Upon graduation, only transcripts, letters of recommendation, Graduate Record Examination results and Active Duty Service Commitment statements are maintained until member separates, retires or is promoted to colonel. When promoted to colonel, records are transferred to the Colonel's Group.

SYSTEM MANAGER(S) AND ADDRESS:

Chief, Medical Service Officer Utilization Division, Headquarters, Air Force Military Personnel Center, 550 C Street W, Randolph Air Force Base, TX 78150-4703.

NOTIFICATION PROCEDURE:

IIndividuals seeking to determine whether this system of records contains information on themselves should address written inquiries to the Chief, Medical Service Officer Utilization Division, Headquarters, Air Force Military Personnel Center, 550 C Street W, Randolph Air Force Base, TX 78150-4703.

For verification purposes, individuals should provide their full name, SSN and/or DoD ID Number, any details which may assist in locating records, and their signature.

In addition, the requester must provide a notarized statement or an unsworn declaration made in accordance with 28 U.S.C. 1746, in the following format:

If executed outside the United States:

‘I declare (or certify, verify, or state) under penalty of perjury under the laws of the United States of America that the foregoing is true and correct. Executed on (date). (Signature)’.

If executed within the United States, its territories, possessions, or commonwealths: ‘I declare (or certify, verify, or state) under penalty of perjury that the foregoing is true and correct. Executed on (date). (Signature)’.

RECORD ACCESS PROCEDURES:

Individuals seeking to access records about themselves contained in this system should address written requests to the Chief, Medical Service Officer Utilization Division, Headquarters, Air Force Military Personnel Center, 550 C Street W, Randolph Air Force Base, TX 78150-4703.

For verification purposes, individuals should provide their full name, SSN and/or DoD ID Numbers, any details which may assist in locating records, and their signature.

In addition, the requester must provide a notarized statement or an unsworn declaration made in accordance with 28 U.S.C. 1746, in the following format:

If executed outside the United States:

‘I declare (or certify, verify, or state) under penalty of perjury under the laws of the United States of America that the foregoing is true and correct. Executed on (date). (Signature)’.

If executed within the United States, its territories, possessions, or commonwealths: ‘I declare (or certify, verify, or state) under penalty of perjury that the foregoing is true and correct. Executed on (date). (Signature)’.

CONTESTING RECORD PROCEDURES:

The Air Force rules for accessing records, and for contesting contents and appealing initial agency determinations are published in Air Force Instruction 33-332; Air Force Privacy Program; 32 CFR part 806b; or may be obtained from the system manager.

RECORD SOURCE CATEGORIES:

Member’s Air Force Form 63, Active Duty Service Commitment (ADSC) Acknowledgement Statement; Member's application; supervisor's evaluation; master personnel records (board use only); Career Brief (board use only); transcripts; test scores; Deans' letters of recommendation; Standard Form (SF) 88, Report of Medical Examination; and SF 93, Report of Medical History.

EXEMPTIONS CLAIMED FOR THE SYSTEM:

None.

FEDERAL REGISTER HISTORY:

June 11, 1997, 62 FR 31793; March 5, 2013, 78 FR 14292.