16-02 Annex A - ​Example Training Limitations Assessment Form

Cadet Administrative and Training Orders (CATOs)

Example – Training Limitations Assessment Form

A.   Identification And Medical Status


Cadet Name:

[Insert name]


[Insert corps/squadron]


The CF 51 of this cadet applicant for the Canadian Forces Cadet Summer Training Program mentions the following medical condition: [insert conditions]

B.  Authorization

I authorize the disclosure of information contained in this document to medical authority for the purposes of training programmed selection of this applicant.


[Signature of parents/guardians/
(cadet if over 18)]

[Name (please print)]


C.  Medical Information

Additional medical information is required to determine the applicant’s medical suitability to undertake training. Please identify the following:

1. Past history of illness, surgery or incapacitating conditions:

[Insert conditions]

2. Past/present treatment and/or medications: 

[Insert ast/present treatment and/or medications]

3. Date of last follow-up with his/her physician and current medical status:

[Insert status]

 Use the attached task statement to determine the cadet’s  physical requirements on his/her course and the conditions under which they will have to perform. Please indicate any factors or task the cadet cannot perform for medical reasons:

[Insert reasons]


[Signature of attending physician]

[Name (please print)]


D.   Formation Surgeon Review

Include any restrictions imposed due to medical condition:


[Base Surgeon Signature]


Note: The department of National Defense is not responsible for any FEES incurred, as a result of this request.

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