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La Grange Area Department of Special Education 1301 W. Consist La Grange, IL 605255358 708/3545730 Fax: 708/3540733 HEALTH EXAMINATION RECORD THIS SECTION TO BE COMPLETED BY EMPLOYEE: Date of Physical
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How to fill out health examibatuon record form

To fill out the health examination record, follow these steps:
01
Start by gathering all the necessary information. This includes personal details such as name, date of birth, gender, and contact information. It is important to ensure that all the information provided is accurate and up to date.
02
Next, move on to the medical history section. Here, you will be required to provide details about any pre-existing medical conditions, allergies, medications currently being taken, and any surgeries or hospitalizations in the past. Be thorough and include as much information as possible.
03
Proceed to the section on family medical history. This will require you to provide information about any medical conditions that run in your family, such as heart disease, diabetes, cancer, or any other hereditary conditions. If you are not aware of your family's medical history, it is recommended to reach out to your relatives and gather this information.
04
Moving on, you will come across a section on lifestyle and habits. Here, you will need to provide details about your dietary habits, exercise routine, smoking or alcohol consumption, and any other pertinent lifestyle choices that may impact your health. Be honest and accurate while filling out this section.
05
The next part of the health examination record will focus on your vital statistics. This includes measurements of your height, weight, blood pressure, and pulse rate. Make sure to have accurate measurements taken at the time of filling out the record.
06
Finally, reach the section on the medical professional's assessment. This part is usually filled out by the healthcare provider conducting the examination. They will assess your overall health based on the information you have provided and may make recommendations or suggestions for further medical intervention if necessary.
Now, who needs a health examination record? The health examination record is typically required by various entities, including employers, educational institutions, and healthcare facilities. Employers may request a health examination record as part of the pre-employment screening process to ensure the candidate is fit for the job. Educational institutions may require the record for admission purposes or to ensure student safety. Healthcare facilities may ask for a health examination record to assess a patient's overall health and assist in diagnosis and treatment. The specific requirements may vary depending on the organization or purpose for which the record is being requested.
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What is health examination record this?
The health examination record is a document that records an individual's health status and medical history.
Who is required to file health examination record this?
Employers are typically required to file health examination records for their employees.
How to fill out health examination record this?
Health examination records should be filled out by including relevant personal and medical information of the individual.
What is the purpose of health examination record this?
The purpose of the health examination record is to ensure that individuals are healthy and fit for certain work or activities.
What information must be reported on health examination record this?
Information such as medical history, current health status, and any relevant medical conditions must be reported on the health examination record.
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