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DEPARTMENT OF HOMELAND SECURITY. S. Coast Guard OCCUPATIONAL MEDICAL HISTORY AND EXAMINATION FORM Privacy Act Statement The collection and use of this information is authorized by 5 U.S.C. 7901, 5
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Open the cg6010epdf occupational medical history form
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Read the instructions and guidelines provided on the form
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Begin filling out the form by providing your personal information such as name, address, date of birth, etc.
04
Answer the questions related to your occupation, including job title, description, duration, and potential exposure to hazardous substances or physical demands
05
Provide details of any work-related injuries or illnesses you have experienced in the past
06
Answer the medical questionnaire section by indicating any medical conditions, allergies, medication use, and previous surgeries
07
If applicable, attach any relevant medical records or test results supporting your medical history
08
Review the completed form to ensure all required fields are filled accurately
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Submit the filled-out form to the appropriate authority or organization as per the given instructions

Who needs cg6010epdf occupational medical history?

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Any individual who is required to undergo occupational medical assessments or evaluations may need to fill out the cg6010epdf occupational medical history form. This can include employees, job applicants, or individuals seeking specific certifications or permissions related to their occupation.
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cg6010epdf occupational medical history is a form used to document an individual's medical history in relation to their occupation.
Employees who are exposed to occupational hazards are required to file cg6010epdf occupational medical history.
To fill out cg6010epdf occupational medical history, individuals need to provide their personal medical history, details of their current occupation, any exposure to hazards, and any relevant medical conditions.
The purpose of cg6010epdf occupational medical history is to assess and monitor the health of individuals in relation to their occupation, and to identify any occupational health risks.
Information such as personal medical history, current occupation details, exposure to hazards, and any relevant medical conditions must be reported on cg6010epdf occupational medical history.
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