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PHYSICAL EXAMINATION (TO BE COMPLETED BY PHYSICIAN)APPLICANT NAME (PLEASE PRINT): DATE: 1. Height Weight Temperature Pulse 2. Vision:R / L / with Glasses / L / Reading / L / 3. Ears R / L / Hearing
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How to fill out physical exam for work

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How to fill out physical exam form for

01
Start by writing your personal information at the top of the form, including your name, date of birth, and contact information.
02
Fill out the medical history section, providing details about any previous illnesses, surgeries, or ongoing medical conditions.
03
Complete the lifestyle section, including information about your exercise routine, diet, and any habits such as smoking or alcohol consumption.
04
Answer the questions related to your family medical history, indicating if any of your close relatives have had significant medical conditions.
05
Provide information about any medications you are currently taking, including the dosage and frequency.
06
Record your vital signs, such as blood pressure, heart rate, and temperature.
07
Include the results of any specific tests or procedures that were part of the physical examination.
08
Finally, sign and date the form, certifying that the information provided is accurate to the best of your knowledge.

Who needs physical exam form for?

01
A physical exam form is typically needed by individuals who are seeking medical evaluation or clearance for various purposes. This may include:
02
- Job applicants who require a pre-employment physical examination as a part of the hiring process.
03
- Athletes who need to undergo a physical examination to ensure they are fit to participate in sports activities.
04
- Students or students-athletes who need a physical exam before starting school or joining a sports team.
05
- Individuals who are applying for life insurance or disability insurance and need to provide a medical evaluation.
06
- People planning to travel to certain countries that require a physical exam as part of the visa application process.
07
- Patients scheduled for certain medical procedures or surgeries, as their healthcare provider may require a physical exam to assess their overall health status.

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The physical exam form is used to document an individual's health status and medical history, often as part of a requirement for participation in school sports, employment, or certain activities.
Individuals such as students participating in school sports, athletes, and new employees in certain occupations typically are required to file a physical exam form.
To fill out a physical exam form, an individual should provide personal information, medical history, any current medications, and have a healthcare provider complete the physical assessment section.
The purpose of the physical exam form is to ensure that individuals are fit for participation in specific activities and to identify any potential health issues that may need to be addressed.
The form typically requires information such as personal details, medical history, allergies, current medications, and results from the physical examination by a healthcare provider.
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