Get the free DSS-1811 Medical Examination - info dhhs state nc

STATE OF NORTH CAROLINA IN THE GENERAL COURT OF JUSTICE DISTRICT COURT DIVISION BEFORE THE CLERK COUNTY SP (Full name of petitioning parent 1) MEDICAL EXAMINATION (Full name of petitioning parent

How to fill out dss-1811 medical examination

Who needs dss-1811 medical examination?

1. Individuals applying for a job position in federal agencies, specifically those requiring a security clearance.
2. Current federal employees who may need to undergo periodic medical exams as part of their security clearance maintenance.

How to fill out dss-1811 medical examination:

1. Obtain the form: The dss-1811 medical examination form can usually be obtained from the agency or employer requesting it. It may also be available online on the agency's official website.
2. Read the instructions: Start by thoroughly reading the instructions provided along with the form. This will give you a clear understanding of what information and documentation is required.
3. Personal information: Begin by filling out your personal information section, including your full name, date of birth, social security number, contact information, and any other relevant identification details as requested.
4. Medical history: Provide detailed information about your medical history, including any previous or current medical conditions, surgeries, illnesses, medications taken, allergies, and other relevant medical information. Be honest and accurate in your responses, as any discrepancies could affect your security clearance approval.
5. Family medical history: If required, provide details about your family's medical history, particularly if it is relevant to inherited conditions or potential medical issues.
6. Physical exam: If your employer or agency requires a physical examination, schedule an appointment with a licensed physician or healthcare provider. Make sure to bring the dss-1811 form with you to the appointment. The physician will conduct a thorough examination and fill out the necessary sections of the form, including documenting your vital signs, height, weight, and overall physical health.
7. Additional tests or evaluations: Depending on specific agency requirements, you may need to undergo additional tests or evaluations. These could include laboratory tests, psychological evaluations, vision and hearing tests, or any other assessments deemed necessary.
8. Certification: Once you have completed all the necessary sections, review the form for accuracy and completeness. Sign and date the form as required, certifying that the information provided is true and accurate to the best of your knowledge.
9. Submission: Submit the completed dss-1811 medical examination form to the appropriate agency or employer as instructed. Ensure that you keep a copy for your records.
10. Follow-up: If required, follow-up with the agency or employer to verify that your form has been received and if any further steps are necessary.

Remember, the process and requirements for filling out the dss-1811 medical examination form may vary slightly depending on the agency or employer. It is essential to carefully read and follow the specific instructions provided along with the form for the most accurate and up-to-date information.

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What is dss-1811 medical examination?

The dss-1811 medical examination is a medical assessment required by the Department of Social Services (DSS) for certain individuals.

Who is required to file dss-1811 medical examination?

Individuals who are applying for or receiving assistance from DSS may be required to file the dss-1811 medical examination.

How to fill out dss-1811 medical examination?

To fill out the dss-1811 medical examination, you can obtain the form from the DSS office or website and follow the instructions provided. It usually involves providing personal and medical information.

What is the purpose of dss-1811 medical examination?

The purpose of the dss-1811 medical examination is to determine the applicant's or recipient's medical condition and its impact on their eligibility for assistance.

What information must be reported on dss-1811 medical examination?

The dss-1811 medical examination generally requires reporting of personal information, medical history, current medical conditions, treatments, and any disability or limitations.