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STATE OF NORTH CAROLINA OFFICE OF STATE PERSONNEL POSITION DESCRIPTION FORM (PD102R89) APPROVED CLASSIFICATION: EFFECTIVE DATE: ANALYST: 1. Present Classification Title of Position: Physician Extender
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Step 1: Obtain the form from the Davidson County Health Department or download it from their website.
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Step 2: Read the instructions and gather all the necessary information and documents required to fill out the form.
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Step 3: Start by entering your personal information such as name, address, phone number, and date of birth.
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Step 4: Proceed to fill out the sections related to your medical history, including any existing medical conditions, allergies, and medications.
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Step 5: If applicable, provide information about your insurance coverage or Medicaid/Medicare eligibility.
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Step 6: Carefully review the completed form for any errors or omissions.
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Step 7: Sign and date the form.
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Step 8: Submit the filled-out form to the Davidson County Health Department either in person or by mail.

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Anyone residing in Davidson County who requires health services provided by the Davidson County Health Department may need to fill out the form.
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Individuals seeking various health programs, services, vaccinations, or assistance from the Davidson County Health Department may also be required to complete the form.
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It is advisable to contact the Davidson County Health Department directly or visit their website for specific details on who needs to fill out the form.
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Form Davidson County Health is a document that must be filled out by individuals or businesses operating in Davidson County to report health-related information.
All individuals or businesses operating in Davidson County are required to file Form Davidson County Health.
Form Davidson County Health can be filled out online on the official Davidson County Health website or submitted in person at the county health department.
The purpose of Form Davidson County Health is to monitor and track health-related information in Davidson County for public health and safety purposes.
Form Davidson County Health requires individuals or businesses to report information such as health practices, sanitation measures, and any health incidents.
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