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Criminal Justice Training CouncilMedical History and Report of Physical Examination CONFIDENTIAL Vermont Police AcademyCONTACT INFORMATION THIS FORM IS TO BE COMPLETED BY APPLICANT Please fill out
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01
Gather all necessary information such as medical history, current medications, and any previous medical reports.
02
Fill out the patient's personal information including name, date of birth, and contact information.
03
Document the reason for the evaluation and any symptoms or concerns the patient may have.
04
Record any physical examinations or tests conducted during the evaluation.
05
Summarize the findings and provide a diagnosis if possible.
06
Include any treatment recommendations or follow-up care that is needed.
07
Review and sign the report before submitting it to the appropriate department.

Who needs medical evaluation reportdepartment of?

01
Individuals who have undergone a medical evaluation and require a formal report for documentation purposes.
02
Healthcare providers or medical professionals who need to assess a patient's health status and provide recommendations for treatment.
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The medical evaluation report department is responsible for ensuring that individuals meet the medical requirements for a specific purpose, such as obtaining a driver's license or participating in athletics.
Individuals who are applying for certain privileges or positions that require a medical evaluation are required to file a medical evaluation report with the department.
To fill out a medical evaluation reportdepartment, individuals must provide accurate and detailed information about their medical history, current health status, and any relevant medical conditions.
The purpose of the medical evaluation report department is to ensure that individuals are medically fit to perform the tasks or duties required for a specific privilege or position.
The medical evaluation reportdepartment must include information about the individual's medical history, current health status, any medications being taken, and any relevant medical conditions.
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