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ESTIMATED PHYSICAL CAPABILITIES FORM FOR NEW YORK STATE EMPLOYEES
Name of Physician:Name of Employee:
Note: Important Information on ReverseInstructions: If the employee is found to be 50% or less
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How to fill out estimated physical capabilities form

How to fill out estimated physical capabilities form
01
To fill out the estimated physical capabilities form, follow these steps:
02
Start by entering your personal information, such as your name, date of birth, and contact details.
03
Next, provide detailed information about any medical conditions or disabilities you may have. Be thorough and include any relevant documentation.
04
Proceed to fill out the section regarding your current physical capabilities. This may include questions about your mobility, strength, balance, and any limitations you may have.
05
If necessary, attach any supporting documents or medical evidence that can further support your estimated physical capabilities.
06
Review the form for accuracy and completeness before submitting it.
07
Submit the form to the appropriate authority or organization as instructed.
Who needs estimated physical capabilities form?
01
The estimated physical capabilities form is typically needed by individuals who need to assess and document their physical abilities for various reasons, including:
02
- Applicants for disability benefits or accommodations
03
- Individuals seeking special accommodations for physical activities or events
04
- Participants in research studies or clinical trials
05
- Individuals undergoing medical evaluations or assessments
06
- Individuals applying for certain jobs or licenses that require physical capabilities documentation
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What is estimated physical capabilities form?
The estimated physical capabilities form is a document used to report an individual's physical abilities and limitations.
Who is required to file estimated physical capabilities form?
Individuals who have physical capabilities that may impact their ability to perform certain tasks or duties may be required to file an estimated physical capabilities form.
How to fill out estimated physical capabilities form?
The estimated physical capabilities form can be filled out by providing accurate information about the individual's physical abilities, limitations, and any relevant medical conditions.
What is the purpose of estimated physical capabilities form?
The purpose of the estimated physical capabilities form is to ensure that individuals are placed in roles that are suitable for their physical abilities, and to make any necessary accommodations to meet their needs.
What information must be reported on estimated physical capabilities form?
The estimated physical capabilities form may require information such as medical history, physical exam results, limitations, and recommendations for accommodations.
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