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PrePlacement Physical Exam Authorization Form This form is to be completed by the Trust Member Contact authorized to request PrePlacement Physical (PPP) Exams. Appointments are to be scheduled by

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How to fill out pre-placement physical exam authorization

01

Make sure to obtain the necessary forms from the employer or medical provider.

02

Provide your personal information such as name, date of birth, and contact information.

03

Fill out the medical history section completely and accurately.

04

Sign and date the form to indicate your consent for the physical exam.

Who needs pre-placement physical exam authorization?

01

Individuals who are applying for a new job and are required by their employer to undergo a pre-placement physical exam.

02

Employees who work in certain industries where physical fitness is crucial for job performance.

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What is pre-placement physical exam authorization?

Pre-placement physical exam authorization is a document that grants authorization for a physical examination to be conducted before an individual starts a job.

Who is required to file pre-placement physical exam authorization?

Employees who are required to undergo a physical examination as a condition of employment are required to file pre-placement physical exam authorization.

How to fill out pre-placement physical exam authorization?

Pre-placement physical exam authorization can be filled out by providing personal information, medical history, and signing the authorization form.

What is the purpose of pre-placement physical exam authorization?

The purpose of pre-placement physical exam authorization is to ensure that individuals are medically fit to perform the duties of the job they are applying for.

What information must be reported on pre-placement physical exam authorization?

Information such as medical history, current health status, and any specific health concerns must be reported on pre-placement physical exam authorization.

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