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Revised 04/12/2019ORANGE COAST COLLEGESchool of Allied Health ProfessionsProgramMEDICAL HISTORY AND PHYSICAL EXAMINATION FORMStudent NameStudent ID#Directions to Student: Fill out Part I entirely
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What is have form physician complete?
The form that must be completed by a physician.
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The individuals who need medical evaluation or certification.
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By providing all necessary information and having a physician complete and sign the form.
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To ensure that individuals meet medical requirements or have necessary certifications.
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Medical history, current health status, and physician's evaluation.
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