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Click ‘Get Form’ to open it in the editor.
In SECTION I, enter your PHS serial number in the designated boxes at the upper right corner. Below that, fill in your Officer Name and Professional Category (e.g., Medical, Nurse, Health Services, Pharmacy).
Move to SECTION II and address the three required points in bullet format. Ensure you clearly articulate your support of PHS Commissioned Corps activities, commitment to visibility as an officer, and your vision for a career within the PHS Commissioned Corps.
Finally, navigate to SECTION III where you will provide your signature and date. Make sure this is completed before submitting the form.
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CCMISCommissioned Corps management information systemUnited States public Health Service Commissioned CorpsUSPHS ranks and payCommissioned Corps of the national oceanic and atmospheric administrationCommissioned Corps age limitCCMIS PortalCCMIS promotion
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