How to apply: **NOTE UPDATED APPLICATION INFORMATION**
To apply for the Purple Heart Medal you will need the following:
1. 2 Eye witness statements
(on DA 2823 or Word document. Needs to be dated and signed.)
2. Situation/Casualty Report (if you can get it)...if not, it is okay.
3. Medical documentation showing combat injury:
-need documentation showing you were evaluated after the blast (in theatre, preferably).
-include Pre & Post-deployment Health Assessment (PDHA).
-TBI clinic referrals, neuropsych evaluations, and any other medical documents that
state you have a TBI or concussion.
--important to make sure that you can connect your injury with a combat event, even if you do not have a medic report from being evaluated in theatre.
4. Deployment Orders
5. CAB (optional if you were awarded one)
6. ERB or ORB
7. Personal Narrative:
-Can be on a Microsoft Word doc or Sworn Statement form. Needs to include:
1. Top of Document= Name, Rank, "Purple Heart Request"
2. Complete narrative with dates, approx times, location, etc... of how and when
the incident occurred. State the following: what happened, how you felt (saw stars,
blacked out, etc...), approx date you were evaluated by a medic/PA and what they did to
help you (if you were not evaluated immediately, explain why. For example:
"I was in a COP and could not access medical care", "I did not know the
signs/symptoms of a TBI, I thought I was okay, but my headaches wouldn't
stop", etc..). If you do not have documentation of the actual medical evaluation in
theatre, then this is the place to explain when you sought medical care for your
concussion. It is okay if the medic did not formally diagnose your concussion and just
gave you Motrin, it just needs to be explained here.
8. FOR ACTIVE DUTY ONLY:
-Need DA 4189 (Personal Action Request) signed by CoC.
Send all documentation and personal contact information to:
1600 Spearhead Div Ave
Fort Knox, KY 40122
**allow 3-6 months for review.**
Potential information sources:
2. DIRECTOR, NATIONAL PERSONNEL RECORDS & ADMINISTRATION CENTER, ATTN: NCP-MA, 9700 PAGE AVENUE, ST. LOUIS, MO 63132-5200
3. WASHINGTON NATIONAL RECORDS CENTER, 8601 ADELPHI ROAD, COLLEGE PARK, MD 20740-6001
4. NATIONAL ARCHIVES & RECORDS ADMINISTRATION (NARA), LIBRARY AND PRINTED ARCHIVES BRANCH, 8TH AND PENNSYLVANIA AVENUE, NORHTWEST, WASHINGTON, DC 20408
5. **NARA WORLD WIDE WEB HOMEPAGE - (http://www.nara.gov) Search National Archives Database for records
Standard Form 180 to Request Medical/Incident Records
http://www.archives.gov/research/order/standard-form-180.pdf fill out this request form and mail it in. Be sure to request ALL medical and non-medical documentation related to any blasts you were involved in downrange. Hopefully, the archives will have records of the event.