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*** PICTURE ID REQUIRED FOR FOB PICK UP *** SIMON FAMILY JCC SANDLER FAMILY CAMPUS of the TIDEWATER JEWISH COMMUNITY DOOR ACCESS CARD REQUEST PLEASE PRINT CLEARLY___PLEASE ISSUE TO:Last NameFirst
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01
Obtain a copy of the health screening form.
02
Read the instructions carefully before filling out the form.
03
Provide accurate and truthful information about your health history.
04
Fill out all the required fields on the form.
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Double check your answers to ensure all information is complete and correct.
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Submit the form to the appropriate healthcare provider or organization.

Who needs health screening form for?

01
Anyone who is required to undergo a health screening as part of a job application process.
02
Individuals participating in certain activities such as sports competitions or travel to certain countries.
03
Patients seeking medical treatment or surgery may also need to fill out a health screening form.
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The health screening form is used to assess an individual's health status and identify potential health risks.
All employees are typically required to file a health screening form.
To fill out a health screening form, individuals must provide accurate information about their health history, current health status, and any symptoms or conditions they may be experiencing.
The purpose of the health screening form is to promote workplace safety, identify any health issues that may impact job performance, and prevent the spread of contagious diseases.
Information such as personal health history, current symptoms, recent travel history, and contact with individuals who have tested positive for illnesses must be reported on a health screening form.
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