My son looked at this tonight. He filled in his name, the person (mom) who he is authorizing to get medical info if necessary, and left the rest blank for now. I would think this form would have to be signed in front of a witness (at least at our doctor's office we always have to do it in front of someone), so he didn't sign yet. He thinks the date not to exceed one year that it terminates will be a year from in-processing, but didn't want to assume so left it blank. It said in the cover letter that it should be hand carried to the AFA and turned in on in-processing day so that's what he'll do. Hopefully they won't give him a hard time for not filling every blank--it should be a quick thing to do that day.