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STATEMENT OF GOOD HEALTH To be completed by the policyholder (PLEASE USE BLOCK LETTERS) 1. POLICYHOLDER INFORMATION Name Last First M.I. Policy number I understand that this Statement of Good Health
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How to fill out statement of good health
How to fill out a statement of good health:
01
Gather necessary information: Before you start filling out the statement of good health form, gather all the required information. This may include details such as your name, date of birth, address, contact information, and any relevant medical history.
02
Read the instructions: Carefully read the instructions provided with the statement of good health form. This will help you understand what information is required and how to accurately fill out the form.
03
Medical history section: In this section, provide details about your medical history. This may include any pre-existing conditions, surgeries, chronic illnesses, or any ongoing treatments. Be thorough and honest when providing this information.
04
Current health status: Describe your current health status in detail. Mention if you have any recent illnesses/injuries or if you are currently under any medical treatment. Provide information about any medications you are currently taking.
05
Doctor's verification: In some cases, the statement of good health may require verification from a medical professional. If this is the case, make an appointment with your doctor, provide them with the form, and ask them to complete the verification section.
06
Review and sign: Once you have filled out all the necessary information, carefully review the form to ensure accuracy. If everything is in order, sign the form as required.
Who needs a statement of good health?
01
Job applicants: Certain job positions, especially those related to healthcare or physically demanding roles, may require applicants to submit a statement of good health. This helps employers ensure that candidates are physically fit for the job.
02
Student athletes: Universities and colleges often require student athletes to provide a statement of good health before participating in sports programs. This ensures their overall fitness and reduces the risk of injuries.
03
Insurance policies: Some insurance policies, especially life insurance or health insurance plans, may require applicants to provide a statement of good health to determine their eligibility and risk factors.
04
Volunteer activities: In certain volunteer programs, such as working with vulnerable populations or in international aid organizations, applicants may be required to submit a statement of good health to ensure they can perform their duties effectively.
Remember, the specific requirements for a statement of good health may vary depending on the entity requesting it. It is important to read and follow the instructions provided by the organization or institution that requires the form.
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