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Request for Replacement Examination UNM Employee Occupational Health Services
2400 Tucker NE, Family Practice Center
p: 5052728043 / f: 5052728044
HSCEOHSForms@salud.unm.eduApplicant Name:MOB:Email:Phone:Job
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How to fill out request for pre-placement examination

How to fill out request for pre-placement examination
01
Obtain the pre-placement examination request form from the employer or human resources department.
02
Fill out all personal information including name, address, contact number, and date of birth.
03
Provide details of any medical conditions or health concerns that may affect the pre-placement examination.
04
Specify the type of examination needed, such as physical, mental, or drug screening.
05
Sign and date the form to acknowledge that the information provided is accurate.
06
Return the completed form to the employer or human resources department for processing.
Who needs request for pre-placement examination?
01
Individuals who have received a job offer contingent on passing a pre-placement examination.
02
Employers who require new employees to undergo a thorough health assessment before starting work.
03
Companies looking to ensure the health and safety of their workforce by screening potential hires.
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What is request for pre-placement examination?
A request for pre-placement examination is a formal application submitted to ensure that an individual is medically qualified for a specific job or role prior to being hired.
Who is required to file request for pre-placement examination?
Typically, employers are required to file a request for pre-placement examination for prospective employees who will be taking on roles that involve specific health requirements or certain levels of physical fitness.
How to fill out request for pre-placement examination?
To fill out the request for pre-placement examination, the employer or authorized personnel should provide necessary details such as applicant's personal information, job position, and any specific medical requirements relevant to the role.
What is the purpose of request for pre-placement examination?
The purpose of the request for pre-placement examination is to assess the health and medical fitness of an applicant to ensure they are suitable for the job and to minimize potential health risks in the workplace.
What information must be reported on request for pre-placement examination?
The request for pre-placement examination must include the applicant's full name, date of birth, job title, specific medical history, and any particular medical requirements or evaluations needed for the position.
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