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THE INDUSTRIAL CLINIC
OF RIVERSIDE
NAME
ADDRESSMedical History for PreEmployment Physical
4444 Magnolia Avenue Riverside, CA 92501
(951) 2743419LastFirstHEIGHT
WIGHT
VISION UNCORRECTEDSEXFARRIGHT
VISION
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What is form industrial clinic?
Form industrial clinic is a document used to report on-site injuries or illnesses that occur in the workplace.
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Employers are required to file form industrial clinic when an employee sustains an on-site injury or illness.
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Form industrial clinic can be filled out by providing details about the injured or ill employee, the nature of the injury or illness, and any treatment that was provided.
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The purpose of form industrial clinic is to ensure that workplace injuries and illnesses are properly documented and reported for regulatory purposes.
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Information that must be reported on form industrial clinic includes details about the employee, the injury or illness, and any treatment provided.
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