fd-967.pdf

FD-967

Revised

06-12-2003

FEDERAL BUREAU OF INVESTIGATION

NEW AGENT PHYSICAL ACTIVITIES

EMPLOYEE INFORMATION

Name: Date:

AGENT PHYSICAL ACTIVITIES

Please indicate if applicant/trainee can perform the following:

1. Control Techniques: Yes No nmlkj nmlkj

Subject takedown requires grappling in both standing and sitting positions. This drill often includes the fugitive crawl with two trainees restraining a third.

2. Personal Weapon Attacks utilizing confrontation drills:

a.) Full contact boxing Yes No nmlkj nmlkj b.) Kicks Yes No nmlkj nmlkj c.) Fist to elbow strikes Yes No nmlkj nmlkj

3. Officer Survival Techniques: Yes No nmlkj nmlkj

This activity stresses live or die drills, weapons disarming and retention.

4. Carotid Restraint: Yes No nmlkj nmlkj

This technique is used against violently resisting subjects and requires a takedown from the standing position.

5. Handcuffing: Yes No nmlkj nmlkj

Actors or students who pose as arrest subjects sometimes resist strenuously.

6. Break Falls and Shoulder Rolls: Yes No nmlkj nmlkj

7. "O" Course to include:

a.) Climbing and Vaulting Yes No nmlkj nmlkj b.) Jumping from High Obstacles Yes No nmlkj nmlkj c.) Net rope climbing Yes No nmlkj nmlkj

8. Yellow Brick Road: Yes No nmlkj nmlkj

A 7.2 run - includes rope climbs and obstacles both natural and man-made.

9. Firearms: Yes No nmlkj nmlkj

This activity includes long periods of firing from a prone position. Students must also qualify on an obstacle course, which requires shooting from standing, kneeling and prone positions.

PHYSICIAN INFORMATION

Physician's Signature: Date:

Print or Type Name: Telephone Number:

Specialty Board Certified: Yes No nmlkj nmlkj List Specialty:

FD-967 (Revised 06-12-2003) Page 1 of 1 FEDERAL BUREAU OF INVESTIGATION