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# Public Health Service (U.S.)

##

Last modified: 2026-07-18 by rick wyatt
Keywords: public health service | departmental | united states |
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image by Joe McMillan, 31 August 1999

- Public Health Service
- Description
- Officers flags, 2020 series
  - Surgeon General (Vice Admiral)
  - Deputy Surgeon General (Rear Admiral (Upper Half))
  - Assistant Surgeon General (Rear Admiral (Upper Half))
  - Assistant Surgeon General (Rear Admiral (Lower Half))
- Officers flags up to 2020
  - Surgeon General (to 2020)
  - Deputy Surgeon General (to 2020)
  - Assistant Surgeons General (to 2020)
- Assistant Secretary of Health and Human Services - Admiral
- Marine Hospital Service 1870-1902
- Public Health Service 1902-1912
- Cadet Nurse Corps (CNC)

See also:

- Department of Health and Human Services
- Departmental Flags
- United States of America

## Public Health Service

The PHS originates in the bill "An Act for the relief of sick and disabled seamen" passed by Congress on April 12, 1798 (House), July 14 (Senate) and signed into law by the President John Adams on July 16, 1798, effective September 1, 1798 with the USPHS (United States Public Health Service) Commissioned Corps established in 1889 by Congress which is an all-commissioned officer corps, meaning that there are no enlisted or warrant officer personnel, and every service member has at
least a bachelor’s degree. Its purpose is to provide health care mainly to service personnel but also for the general population. In 1902, the Service’s scope expanded, and its name changed to the Public Health and Marine Hospital Service. In 1912, legislation changed the name of the Public Health and Marine Hospital Service to the Public Health Service.
Sources: https://www.usphs.gov/about-us
https://www.usphs.gov/history
https://www.csg.org/2025/08/22/military-101-the-u-s-public-health-service-commissioned-corps
https://www.linkedin.com/company/commissioned-corps-of-the-u-s-public-health-service
Esteban Rivera, 1 June 2026

Warrant officers are authorized for the USPHS and are codified in law. However, none have been appointed to date, although they were planning to do so around 2010.
Dave Fowler, 1 June 2026

## Description

The U.S. Public Health Service wears Navy style uniforms, has a commissioned officer corps and falls within the Department of Health and Human Services.
The Public Health Service flag is yellow with a blue PHS seal centered on the flag. The diameter of the seal is 1/2 the hoist. In 52 x 66 inch size, with a blue fringe, it serves as the Corps color. In 10 x 19, 5 x 9 1/2, or 3.52 x 6.69 foot sizes, it flies over PHS posts that are commanded by other than flag officers (or if a flag officer is not present). In these cases, the PHS flag is the same size as the U.S. flag with which it is flown. On boats, it is either 32 x 48 or 24 x 36 inches, depending on the size of the boat, and flies at the starboard yardarm, unless a flag officer is aboard. In that case, the PHS flag is shifted to the port yardarm.
Joe McMillan, 31 August 1999

The flag adopted in 1912 did not have lettering encircling the anchor and caduceus. I don't know when the lettering was added, but [u9s38] shows the PHS flag without it.
Joe McMillan, 5 June 2002

Quoting the USPHS website:
"The Public Health Service seal was originally developed by John Maynard Woodworth, the first Supervising Surgeon (the title was later changed to Surgeon General) of the Marine Hospital Service (forerunner of the PHS). Woodworth, who was appointed in 1871, appears to have designed the seal early in his tenure. It featured a caduceus crossed with a fouled anchor and carried the words "U.S. Marine Hospital Service" and the dates 1798-1871. The 1798 date refers to the year of passage of the act for the relief of sick and disabled seamen, which set up the marine hospital system that evolved into the PHS. The latter date represents the year of Woodworth's appointment and the reorganization of the Service associated with the creation of the Supervising Surgeon position. Today's seal is similar, except that it carries the words "U.S. Public Health Service," and only one date (1798).
The fouled anchor signified a seaman in distress or a sick seamen. The caduceus (a winged wand with two serpents intertwined) is often used today as a symbol of medicine, and it is tempting to think that Woodworth intended it to be interpreted in this way. However, the use of the caduceus to represent medicine was not so common in 1871, and it was more often associated with the god Mercury and used to symbolize trade or commerce. A more historically correct symbol of medicine is the staff of Asklepios (Aesculapius), consisting of a wand or staff with one serpent coiled around it and associated with the Greek god of healing, Asklepios. Ralph Williams, in his history of the PHS (1951), speculates that Woodworth used the caduceus of Mercury in the seal because of the Service's relationship with merchant seamen and the maritime industry.
The PHS flag, consisting of a blue PHS seal on a yellow background, appears to have evolved out of the quarantine flag used by the Service on quarantine vessels and stations. The use of a yellow flag to denote quarantine dates back to the eighteenth century. By the early twentieth century, the PHS had added its seal to the traditional yellow flag. Over the course of the twentieth century, a version of the quarantine flag with the seal came to be used more broadly in connection with various PHS activities and was sometimes referred to as the PHS flag. By the late 1960s, specifications had been formally established for the PHS flag as follows: "The Public Health Service flag shall have a yellow background (gold hue) with a blue seal of the Service centered on the flag." The blue and yellow colors of the PHS of course represent its roots in maritime and quarantine activities.
www.usphs.gov/html/history.html
Ivan Sache, 26 November 2006

Construction sheet: Public Health Service
Construction sheet created 29 August 2013
Base: Golden Yellow (Cable 65001)
Device and Fringe: Ultramarine Blue (Cable 67118)

Dave Fowler, 18 July 2022

The "Purpose of PHS (Public Health Services) Flags and USPHS (United States Public Health Service) Commissioned Corps Official Seal. The flags and official seal serve to enhance the prestige of the PHS and the USPHS Commissioned Corps, provide a symbol of identity, and symbolize the leadership roles of the ASH, PDASH, SG, DSG and ASGs.

All PHS flags shall conform to the specifications contained in this Instruction and set forth by specifications of The Institute of Heraldry (TIOH), Department of the Army."
Since it is the "third issuance of this Instruction within the eCCIS (electronic Commissioned Corps Issuance System)" (p.1 and 11), this issue replaces the previous issues:
- CCI 442.01, “PHS Flags and Official Corps Seal,” dated 2 July 2020.
- CCI 442.01, “PHS Flags and Official Corps Seal,” dated 9 April 2020.
- Commissioned Corps Personnel Manual (CCPM) CC29.9.1, “Public Health
Service Flags and Automobile Plates,” dated 18 May 1978.

Esteban Rivera, 1 June 2026

image located by Esteban Rivera, 1 June 2026
Source: https://dcp.psc.gov/ccmis/ccis/documents/CCI_442.01.pdf
based on photo from https://smucker.house.gov

The Seal on the flag is a little bit bigger, as the image above shows. Notice that although this is the U.S. Public Health Service Flag (Indoor Type with blue fringe), the specimen located does not feature the fringe as per regulation.

Compilation of official seals.
Esteban Rivera, 1 June 2026

## Officers flags, 2020 series

New rank flags for USPHS flag officers were rolled out in the last month or so. Four new flags replace the rank flags that have been in use for decades.

The Commissioned Corps of the US Public Health Service is one of eight federal uniformed services in the United States, and comprises over 6,100 commissioned officers in the ranks of ensign to admiral who staff health agencies in the government (Centers for Disease Control and Prevention, US Food and Drug Administration, Indian Health Services and others.) They also provide medical staff in the Federal Bureau of Prisons, and provide the medical corps of the US Coast Guard and NOAA Commissioned Corps.

There are two additional rank flags:
5) Assistant Secretary for Health (Admiral) 4 stars on a blue background
6) Principal Deputy Assistant Secretary for Health (Rear Admiral (Upper Half)) 2 stars on a blue and white background, sent to the list on April 23, 2020.
Dave Fowler, 19 June 2020

### Surgeon General (Vice Admiral)

image by Dave Fowler, 19 June 2020

Three stars on a blue background.
Dave Fowler, 19 June 2020

Construction sheet: Surgeon General
Construction sheet created 30 August 2013. Supersedes original drawing created on 4 June 1986.

Base: Ultramarine Blue (Cable 65010)
Device and Fringe: White (Cable 67101)

Dave Fowler, 19 July 2022

### Deputy Surgeon General (Rear Admiral (Upper Half))

image by Dave Fowler, 19 June 2020

Two stars on a blue background.
Dave Fowler, 19 June 2020

Construction sheet: Deputy Surgeon General/Assistant Surgeons General
Construction sheet created 30 August 2013. Supersedes original drawing created on 4 June 1986.

Base: White (Cable 67101)
Device and Fringe: Ultramarine Blue (Cable 65010)

Dave Fowler, 19 July 2022

### Assistant Surgeon General (Rear Admiral (Upper Half))

image by Dave Fowler, 19 June 2020

Two stars on a white background.
Dave Fowler, 19 June 2020

### Assistant Surgeon General (Rear Admiral (Lower Half))

image by Dave Fowler, 19 June 2020

One star on a white background.
Dave Fowler, 19 June 2020

## Officers flags up to 2020

PHS flag officers hold one of four grades. Their flags are flown in lieu of the PHS flag at PHS posts under their command or to which they are paying official visits, as well as at the starboard yardarm of PHS vessels on which they are present. You might see them afloat in port areas, etc, since the PHS is the organization charged with enforcing health regulations for entry into the United States.
Sources: Personnel Instruction 1, "Public Health Service Flags and Automobile Plates," Subchapter CC29.9, Commissioned Corps Personnel Manual; Public Health Service insignia scanned and redrawn from Government Printing Office sheet of official seals and emblems.
Joe McMillan, 31 August 1999

### Surgeon General (to 2020)

image by Joe McMillan, 31 August 1999

The Surgeon General is normally equivalent to a vice admiral, but, if serving concurrently as Assistant Secretary for Health, holds four-star rank. Either way, the SG's flag is blue with a white PHS corps device centered on it. It comes in the same sizes as the PHS flag as well as in an 18x26 inch size for automobiles. For indoor/ceremonial use, the SG's flag has white fringe, cord, and tassels. The auto flag also has a white fringe.
Joe McMillan, 31 August 1999

The Surgeon General is the chief of the Public Health Service. By law, his rank is the equal to that of the Surgeon General of the Army (currently a lieutenant general), but he is accorded four-star rank when he is concurrently appointed as an assistant secretary of health and human services. The Surgeon General's flag is blue with the central device of the PHS seal in white. It comes in the same sizes as the PHS flag and displaces the service flag when the Surgeon General officially visits a PHS installation or vessel. For indoor and ceremonial use, the Surgeon General's flag has a white fringe, cord, and tassels.
Joe McMillan, 1 December 2002

### Deputy Surgeon General (to 2020)

image by Joe McMillan, 31 August 1999

The Deputy Surgeon General ranks as a rear admiral and flies a flag (us_dsg) identical to the SG's but with the colors reversed. The fringe for indoor/ceremonial flags is white and blue, the cord and tassels of intertwined blue and white cords. The fringe on the DSG's auto flag is plain blue.
Joe McMillan, 31 August 1999

The Deputy Surgeon General and Assistant Surgeons General rank with rear admirals and rear admirals (lower half). They use the same flag as the Surgeon General--and according to the same procedures-- but with the colors reversed. The only difference between the Deputy SG and Assistant SG flags is that the fringe, cord, and tassels on ceremonial flags is intertwined blue and white cord for the Deputy and solid blue for the Assistants.
Joe McMillan, 1 December 2002

### Assistant Surgeons General (to 2020)

Assistant Surgeons General, who equate to either rear admirals or rear admirals (lower half), have the same flag as the DSG, but with blue fringe, cord and tassels. The ASG's auto flag has no fringe.
Joe McMillan, 31 August 1999

## Assistant Secretary of Health and Human Services - Admiral

image by Joe McMillan, 23 January 2015

This is the positional flag for the Assistant Secretary (of Health and Human Services) for Health, when the office-holder is a US Public Health Service commissioned officer with the rank of Admiral. It was adopted in approximately March 2008, and this far has only been used by one ASH, Dr. (Admiral) Joxel Garcia from 2008 to 2009. The last office-holder was a civilian, Dr. Howard Koh, from 2009-2014. As a civilian, he used the standard Assistant Secretary for Health flag. From The Office of the ASH:

> "This flag was designed by Dr. (Admiral) John Agwunobi, the ASH from 2005-2007, but he did not authorize having it made during his tenure. The flag was manufactured for the commissioning ceremony of Dr. Garcia, and he is the only ASH for whom the flag has been displayed. This flag can only be displayed and/or used by the ASH when the official in the position is also commissioned as a 4 star Admiral in the USPHS Commissioned Corps. Distinguishing/positional flags can only be displayed when the official who has been appointed to occupy the position is present and/or actively participating in an event."

Dave Fowler, 16 January 2015

## Principal Deputy Assistant Secretary for Health (Rear Admiral (Upper Half))

image by Dave Fowler, 23 April 2020

This is a new US Public Health Service officer positional flag.
The Principal Deputy Assistant Secretary for Health is a 2-star rear admiral billet. The officer works directly under the 4-star admiral who is the Assistant Secretary for Health, and is not in the Surgeon General's chain of command. Flag drawing is dated 23 August 2019.
The Commissioned Corps of the US Public Health Services is one of eight statutory federal uniformed services in the United States (Army, Marine Corps, Navy, Air Force, Space Force, Coast Guard. USPHS Corps, NOAA Corps).
Dave Fowler, 23 April 2020

## Marine Hospital Service 1870-1902

image by Rob Raeside, 12 September 2011

Based on an image provided by Ben Cahoon from www.nlm.nih.gov/exhibition/nih_origins/images/marine.jpg

## Public Health Service 1902-1912

image by Rob Raeside, 12 September 2011

Based on an image provided by Ben Cahoon from www.nlm.nih.gov/exhibition/nih_origins/images/marine.jpg

## Cadet Nurse Corps (CNC)

The (U.S.) Cadet Nurse Corps (CNC) was established by the Bill passed by both houses of Congress by unanimous vote on June 15, 1943 signed by the President and became Public Law 74 effective on July 1, 1943 with the title of "Nurse Training Act of 1943" but commonly referred to as the "Bolton Act" to alleviate the nursing shortage that existed before and during World War II. It was dissolved on December 31, 1948. Its supervisory agency was the United States Public Health Service (USPHS).
Sources: https://uscadetnurse.org/sites/default/files/USCNC_OpPlan.pdf
https://www.usphs.gov/history
https://uscadetnurse.org/node/3 and
https://en.wikipedia.org/wiki/Cadet_Nurse_Corps

image located by Esteban Rivera, 1 June 2026
Source: https://uscadetnurse.org/uscnc2018
The flag is a white horizontal background with the logo in the middle and below the Corps' name (possibly in red), the logo being the sleeve marking insignia as follows: "a silver maltese Cross on a red oval" (source: "Regulations for Uniforms for U. S. Cadet Nurse Corps",
https://uscadetnurse.org/sites/default/files/UniformRegs.pdf).

For additional information go to U.S. Cadet Nurse (semi official website): https://uscadetnurse.org
Esteban Rivera, 1 June 2026

### Logo

image located by Esteban Rivera, 1 June 2026
Source: https://www.facebook.com/cadetnurses