Fire and Aviation Management Medical Qualifications Program
The Fire Medical Qualifications Program of the US Forest Service establishes and maintains a process to decide if a wildland firefighter or wildland fire support staff member meets the health and physical requirements of the fire qualifications, they wish to function in.
The anchor point for the medical qualifications program is the Federal Interagency Wildland Firefighter Medical Standards for arduous positions or the current medical standard of care for light and moderate positions.
The program involves a review of an individual’s medical history, current health status through medical documentation, and sometimes a physical examination. Following these steps, the medical qualifications program issues a medical determination for each responder. The process may help you identify an emerging health issue so that you may seek treatment before it becomes serious.
The medical qualifications program does not actively seek ways to disqualify responders. It reduces the likelihood and severity of medical emergencies occurring during an ongoing incident by supporting a capable workforce.
Follow the steps below to navigate through the 2025/2026 Medical Qualifications Program:
If you have access to ConnectHR, you can initiate the process by logging into eMedical, requesting a packet, and notify your HSQ Coordinator.
If you don’t have access to ConnectHR, a HSQ Coordinator will initiate the eMedical process for you.
Carefully read the eMedical email for instructions.
You may have been cleared to take the WCT (this is the end of the process!)
Your packet may need further review by a Forest Service medical officer.
You may need to go for an OF-178 Exam.
A waiver and mitigations are a medical accommodation for a medical condition that does not meet either the Federal Interagency Wildland Firefighter Medical Standards for arduous or the current medical standard of care for light and moderate.
Essentially, a waiver is your proof for being medically cleared. The waiver will also have the mitigation requirements you need to fulfill in order to keep the waiver valid.
See below for more information on this critical element.
After your Health Screening Questionnaire (HSQ) or OF-178 is sent to the Forest Service Medical Officer, you may get an email for a Request for Information. This request for additional medical information or documentation regarding a medical diagnosis or a potential medical condition as medical signs and/or symptoms noted.
It is your responsibility to obtain, pay for, and supply this information or grant access to this information to the Forest Service medical officer per 5 CFR 339.304(c).
If you are in pay status or have a tentative selection notice, the government will reimburse you for all costs associated with the exam as well as travel using the Request for Reimbursement form FS6500-229 (also found in the Additional Forms and Documents section).
If using Acuity, they will take care of all payments for the exam.
A Forest Service Medical Officer will review the results of your exam and will issue a level of medical clearance.
Your medical provider does not make the final determination if you are medically qualified.
Contact the eMedical Qualifications Program Helpdesk via email: SM.FS.mqp_emedical@usda.gov
Your clearance will provide one of the following qualification determinations:
Medically Qualified: No further action is needed with your medical exam at this time. You are cleared to take the Work Capacity Test (WCT).
Medically Qualified – With Waiver(s): You are cleared to take the WCT. You will need to log into eMedical and review the conditions of your waiver. It may (or may not) require you to submit information about a medical condition to the medical officers annually.
Medically Qualified -- Temporary Restrictions: If you fail to meet the medical qualification standards due to a temporary medical condition you may be allowed to take the WCT or continue performing work but ONLY under certain conditions. Talk to your supervisor.
Not Medically Qualified – Information Needed: You cannot participate in the arduous WCT until you supply the required information requested from the medical officer and they clear you. Log into eMedical to find out what you need to provide.
Not Medically Qualified: A waiver/accommodation would not allow you to perform your duties without endangering the health and safety of yourself and/or others. You can neither participate in the WCT, nor perform duties as a firefighter, unless the determination is reversed.
Update Effective April 2025
Based on our ongoing assessments and feedback from employees and NFFE, the Arduous Medical Process implementation will remain paused, and effective immediately all IQCS cardholders will use the updated Health Screening Questionnaire (HSQ), which closely resembles the pre-2023 version.
Additional details are provided in the Letter to Regional Foresters from Deputy Chief John Crockett about the medical clearance process.
Health Screening Questionnaire (HSQ) and OF-178 Process
Permanent Employees, (PDF, 2.3 MB)
AD / Casual Employees, (PDF, 1.62 MB)
Interim / Temporary / 1039 Employees, (PDF, 1.96 MB)
FS eMedical Guide for Supervisor and Fire Supervisor, How-to Guide, (PDF, 1.28 MB)
Health Screening Questionnaire (HSQ) Guidance Flowchart for Employees and AD's, (PDF, 212 KB)
Links
eMedical for Permanent Employees (Available through ConnectHR)
eMedical Public Site for Temporary, AD, and new employees (Available through ConnectHR) Requires a user name and password to enter.
Waiver Guidance for
Employees / AD's to take the Work Capacity Test (WCT), (PDF, 623 KB)
Health Screening Questionnaire (HSQ) Coordinators, (PDF, 698 KB)
Medical Provider Documentation
Asthma - Reactive Airway Disease - COPD - Sleep Apnea, (PDF, 164 KB)
Central Nervous System (CNS) - Seizures - Syncope - Stroke - Headache, (PDF, 186 KB)
Change in Medical Status, (PDF, 107 KB)
Diabetes Mellitus - Pre-Diabetes. (PDF, 317 KB)
Gastrointestinal, PDF, 202 KB)
General Medical Provider Template, (PDF, 250 KB)
Genitourinary, (PDF, 248 KB)
Hearing - Hearing Aids for the years between routine audiograms, (PDF, 204 KB)
Heart Disease - Heart Murmur - Heart Surgery - Cardiac Implantable Devices, (PDF, 267 KB)
Hematopoietic, (PDF, 261 KB)
Hypertension - Aneurysm - Vascular, (PDF, 197 KB)
Immune System - Allergic Disorder, (PDF, 222 KB)
Musculoskeletal - Central Nervous System - Peripheral Nervous System, (PDF, 247 KB)
Prosthetic, (PDF, 260 KB)
Provider Medication Statement, (PDF, 220 KB)
Psychiatric, (PDF, 193 KB)
Thyroid - Other Endocrine, (PDF, 205 KB)
Vision, (PDF, 253 KB)
Health Screening Questionnaire (HSQ) Coordinator Documents
Confidentiality Agreement for Work with Medical Records, (PDF) (297 KB)
Human Resource Information System Access Request form, (PDF) (4.6 MB)
eMedical HSQ User Guide for HSQ Coordinators, (PDF, 1.8 MB)
HFS-5100-31 (v 03/2016) OMB 0596-0164 form Evaluation Instructions, (PDF, 118 KB)
Medical Provider Documents
Essential Functions and Work Conditions of a Wildland Firefighter, (PDF, 141 KB)
Letter to the Medical Provider Templet, (PDF, 52 KB)
Obstetrician, Care Giver, Midwife Letter - Being Pregnant and Fighting Wildland Fire, (PDF), (172 KB)
eMedical Medical Provider User Guide, (PDF, 570 KB)
Work Capacity Test (WCT) Brochure, (PDF, 193 KB)
Complete the Following Steps:
Check-in Patient
At Reception
Patient provides billing and eMedical access information to include all exam templates and forms with instructions. Patient may need to fill-out and complete medical provider documents too.
Initial Nurse Health Check
Nursing staff usually completes vital signs (including height and weight), vision and possibly a hearing test/exam, and/or a Q&A about yourself and family health/medical history.
Medical Provider Completes Exam
Exam Processed
Designated office employee (e.g., reception, billing, nurse, or doctor) logs into the eMedical system, enters in all required information, prints a copy for their office records, and then submits the exam into eMedical for the FS FAM Medical Officer to review.
If assistance is needed, Contact the Help Desk via email at: SM.FS.MQP_emedical@usda.gov or call: 208-387-5635
Physician Documents:
Optional Form 178 (OF-178) for Arduous (PDF, 912 KB); Moderate; (PDF, 912 KB); Light Work Capacity Tests, (PDF, 912 KB)
Medical Provider Guidance Sheet for the OF-178, (PDF, 269 KB)
Additional Forms and Documents
Blood Pressure Documentation, (PDF, 140 KB)
Change in Medical Status, (PDF, 515 KB)
Change in Medical Status Guidance for Employees, (PDF, 515 KB)
eMedical Clearance Process Fax Cover Sheet, (PDF, 78 KB)
Health Screening Questionnaire (HSQ) FS-5100-31, (PDF, 88 KB)
Law Enforcement and Medical Qualifications Program (MQP) Exams, (PDF, 74 KB)
Modified Duty Guidance for Employees, (PDF, 513 KB)
Request for Reimbursement FS-6500-229 Form, (PDF, 206 KB)
Work Capacity Test / Firefighter Preview and Forecasted Risks, (PDF, 109 KB)
Work Capacity Test - Informed Consent FS-5100-30 Form, (PDF, 127 KB)
Policy and Guidance
Federal Interagency Wildland Firefighter Medical Standards, (PDF, 93 KB)
Medical Qualifications Frequently Asked Questions, (PDF, 189 KB)
Historical information
eMedical Program Implementation, (PDF, 169 KB)
Training (User Guides available in AMP and HSQ / OF-178 Sections)
eMedical User Roles Guide (a PowerPoint presentation, download to view)
WCT Administrators
Work Capacity Test Administrator How To User Guide, (PDF, 760 KB)
Questions? Suggestions? Help? Contact the eMedical Qualifications Program Helpdesk via email: