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JERICHO UNION FREE SCHOOL DISTRICT PHYSICAL EXAMINATION FORM The form MUST BE COMPLETED by a NEW YORK STATE LICENSED PHYSICIAN! *This is the ONLY form acceptable for Interscholastic Athletic Participation*

How to fill out physical examination form

How to fill out a physical examination form:

1. Begin by carefully reviewing the form and familiarizing yourself with the required information. Make sure you understand what each section of the form is asking for.
2. Start by providing your personal details such as your full name, date of birth, address, and contact information. This information is essential for identification and communication purposes.
3. Proceed to fill out the medical history section. Be honest and thorough when providing information about any past or current medical conditions, allergies, surgeries, or medications you are taking. Include any relevant details that might be important for the examiner to know.
4. The next section usually requires you to provide information about your family's medical history. Include any significant medical conditions that run in your family, such as heart disease, diabetes, or cancer.
5. Move on to the lifestyle and habits section. Here, you may need to disclose information about your smoking or alcohol consumption, exercise routine, and diet. This section helps the examiner assess your overall health habits.
6. If you have recently undergone any medical tests or screenings, indicate the dates and results in the appropriate section. This helps streamline your medical records and aids the examiner in making an accurate assessment.
7. Some physical examination forms may require you to provide additional information specific to certain conditions or activities. Make sure to carefully read and respond to these sections if applicable.
8. Finally, review your completed form to ensure all the necessary information has been accurately provided. Double-check for any errors or missing details.
9. The physical examination form is generally required for a variety of reasons, including pre-employment screenings, sports participation, insurance applications, and general wellness assessments. Different organizations or institutions may have varying requirements, but anyone seeking a comprehensive evaluation of their health may need to fill out this form. It is essential to consult the specific guidelines or regulations of the relevant institution to determine who exactly needs to fill out a physical examination form.

For pdfFiller’s FAQs

What is physical examination form?

A physical examination form is a document used to record the results of a medical evaluation of an individual's overall health.

Who is required to file physical examination form?

Individuals who are applying for certain jobs or programs that require a physical examination as part of the application process are required to file a physical examination form.

How to fill out physical examination form?

To fill out a physical examination form, you will need to provide personal information, medical history, current medications, and undergo a physical examination conducted by a healthcare professional.

What is the purpose of physical examination form?

The purpose of a physical examination form is to assess an individual's health status and determine if they are fit for a specific job or program.

What information must be reported on physical examination form?

The physical examination form typically includes information such as the individual's personal details, medical history, current medications, vital signs, and any medical conditions or concerns.

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