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Employee Incident ReportSTAFFCONFIDENTIAL
Instructions: Have the employee complete pages
25 and email to Dawn Fox and copy Rick Powell.
A supervisor will complete pages 611 and return
to the Risk
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How to fill out appendix i - washington
How to fill out appendix i - washington
01
Obtain a copy of the Washington State Appendix I form.
02
Fill out the personal information section including your name, address, and contact information.
03
Provide information about your medical history including any medications you are currently taking.
04
Have a healthcare provider complete the medical examination section certifying your fitness to perform the job.
05
Review the completed form for accuracy and sign where indicated.
06
Submit the completed Appendix I form to the appropriate agency or employer.
Who needs appendix i - washington?
01
Individuals applying for certain jobs or licenses in the state of Washington may need to fill out Appendix I as part of the application process.
02
Employers in Washington may require applicants to complete Appendix I as part of the pre-employment screening process.
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What is appendix i - washington?
Appendix I - Washington is a form used to report certain information to the Washington State government.
Who is required to file appendix i - washington?
All individuals and businesses operating in Washington State may be required to file Appendix I - Washington.
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Appendix I - Washington can be filled out online through the Washington State government's website or by submitting a physical form.
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The purpose of Appendix I - Washington is to collect specific information from individuals and businesses to ensure compliance with state regulations.
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Information such as income, expenses, and any relevant financial data may need to be reported on Appendix I - Washington.
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