DA Form 5551-R Spirometry Flow Sheet – Download PDF – The DA Form 5551-R, officially titled the Spirometry Flow Sheet, is a standardized U.S. Army medical form used to document pulmonary function tests (PFTs), specifically spirometry results. It supports occupational health surveillance, respirator medical clearance, and respiratory health monitoring for service members, DA civilians, and others in roles with potential airborne hazards.
What Is DA Form 5551-R Used For?
Spirometry measures lung function through key parameters:
- FEV1 (Forced Expiratory Volume in 1 second)
- FVC (Forced Vital Capacity)
- FEV1/FVC ratio
- Percent predicted values and changes over shifts or time
The form records observed values (BTPS-corrected), predicted values based on age, height, sex, and ethnicity, percent of predicted, and any pre/post-shift or pre/post-bronchodilator changes.
Primary uses include:
- Respiratory Protection Program evaluations (per AR 11-34 and related guidance)
- Occupational health surveillance for exposures to dust, fumes, chemicals, or particulates (e.g., hexavalent chromium, silica, asbestos)
- Baseline, annual, or periodic monitoring for at-risk personnel
- Documenting fitness for duty involving respirators or physically demanding tasks
It is referenced in TB MED 509 (Spirometry in Occupational Health Surveillance), the key technical bulletin governing procedures, technician training, equipment calibration, and interpretation in Army settings.
Related form: DA Form 5550-R (Spirometer Calibration Log) ensures equipment accuracy.
Who Needs Spirometry Testing?
Testing applies to:
- Soldiers and civilians required to wear tight-fitting respirators
- Personnel in industrial, maintenance, construction, or hazardous material handling roles
- Those in programs involving respiratory hazards under OSHA-aligned Army standards (e.g., respiratory protection, silica)
Medical providers determine frequency (often annual or as indicated). A licensed health care professional reviews results for respirator clearance.
How to Complete and Use DA Form 5551-R?
- Patient Information — Enter name, location, job title, age, height, sex, race/ethnicity, and test date.
- Spirometer Details — Record equipment type and technician information.
- Test Results — Document multiple efforts for reproducibility (per ATS standards referenced in TB MED 509).
- Calculations — Include observed, predicted, % predicted, and any shift changes.
- Interpretation — Note technician observations and provider review.
Best practices:
- Use properly calibrated spirometers (daily/weekly checks via DA 5550-R)
- Follow NIOSH-approved technician training
- Ensure reproducible efforts (typically 3 acceptable maneuvers)
- Maintain records in medical files per AR 40-66
The current version is DA FORM 5551-R, MAY 2009 (previous editions obsolete).
Download Official DA Form 5551-R (PDF)
Direct official link: Download DA Form 5551-R PDF
Always download from Army Publishing Directorate (armypubs.army.mil) for the most current version. Fillable versions are available on authorized Army sites.
Importance in Army Occupational Health
Accurate spirometry helps:
- Detect early changes in lung function
- Ensure safe respirator use
- Comply with federal and Army standards (29 CFR 1910.134 alignment)
- Support medical surveillance programs
Longitudinal tracking on the flow sheet identifies declines warranting further evaluation.
Additional Resources
- TB MED 509 — Primary guidance on spirometry procedures
- Army Public Health Center / Defense Centers for Public Health resources
- Local Occupational Health or Preventive Medicine offices for program-specific requirements
- AR 40-66 (Medical Record Administration) for filing
For questions about your unit’s Respiratory Protection Program or medical surveillance, contact your installation’s Occupational Health Clinic or Industrial Hygiene office.