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Physical Examination Form Page 1 of 2 Please scan and email this document to campadmin@wa.easterseals.com or Fax to 2535900594. Campers must have a physical exam no more than 12 months prior to the

How to fill out annual physical examination form

How to fill out annual physical examination form

1. Provide accurate personal information such as name, date of birth, address, and contact information.
2. Fill out the medical history section detailing any past illnesses, surgeries, medications, and allergies.
3. Complete the family history section by listing any hereditary conditions or diseases among close relatives.
4. Record information on lifestyle habits such as diet, exercise, smoking, and alcohol consumption.
5. Answer questions regarding current symptoms, pain, or concerns to discuss with your healthcare provider during the exam.
6. Sign and date the form to confirm accuracy and consent for the examination.

Who needs annual physical examination form?

1. Individuals who want to monitor their overall health and wellness on a regular basis.
2. Employers requiring employees to undergo annual physical exams for occupational health and safety reasons.
3. Schools, sports teams, and organizations that mandate physical exams for participation.
4. Individuals with chronic health conditions or specific medical concerns that necessitate routine monitoring.

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What is annual physical examination form?

Annual physical examination form is a document that records the results of a yearly medical checkup.

Who is required to file annual physical examination form?

Employees and individuals in certain professions may be required by their employer or licensing authority to file an annual physical examination form.

How to fill out annual physical examination form?

To fill out an annual physical examination form, one must provide personal information, medical history, and the results of the physical examination conducted by a healthcare provider.

What is the purpose of annual physical examination form?

The purpose of annual physical examination form is to ensure that individuals are medically fit for certain roles or responsibilities, and to monitor their overall health and well-being over time.

What information must be reported on annual physical examination form?

Information such as vital signs, medical history, current medications, and any abnormal findings from the physical examination must be reported on the annual physical examination form.