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Org Lancaster General Health Wellness Center 2100 Harrisburg Pike Lancaster PA 17604 Phone 717 544-3286 Fax 717 544-3139 Page 1 of 2. Annual Physical Exam Form- SDOL Employee completes the following information Please Print to ensure accuracy. By authorizing releases of this information I hereby release Lancaster General Health and any other organizations associated with this wellness program their affiliates directors officers employees successors and assigns from any and all liability...
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Review the annual physical exam form to understand the information that is required.
02
Ensure that you have all the necessary personal information such as your name, date of birth, address, and contact details.
03
Fill in your medical history accurately, including any past illnesses, surgeries, medications, and allergies.
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Answer the questions regarding your lifestyle habits honestly, such as smoking, alcohol consumption, exercise routine, and diet.
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Provide information about any ongoing medical conditions or concerns you may have.
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Include details about any medications or supplements you are currently taking.
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If available, attach any relevant medical reports or test results.
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Ensure that all sections of the form are completed, including signing and dating it if required.
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Who needs annual physical exam form?

01
Anyone who wants to undergo a comprehensive medical evaluation should fill out an annual physical exam form.
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Individuals seeking preventive healthcare and early detection of potential health issues can benefit from completing this form.
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Employers or organizations may require individuals to fill out an annual physical exam form as part of employment or insurance policies.
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People with chronic illnesses or specific health concerns may need to fill out this form to provide necessary information to healthcare professionals.
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Certain government agencies or educational institutions may require individuals to fill out this form for administrative purposes.
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Annual physical exam form is a document that records the results of a person's yearly medical check-up.
Employees of certain organizations or industries may be required to file annual physical exam forms as part of their job requirements.
The annual physical exam form typically requires personal information, medical history, and the results of the medical examination to be filled out by a healthcare provider.
The purpose of the annual physical exam form is to ensure that individuals are in good health and able to perform their job duties safely.
Information such as vital signs, medical history, current medications, and any abnormalities found during the examination must be reported on the form.
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