Standard pre employment physical form
[PDF File]Pre-Employment History and Physical Form
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Have you ever had: a car accident loss of consciousness heart attack loss of vision abnormal heart rhythm seizure panic attacks head injury stroke paralysis back injury psychiatric disorder Current Medical Conditions Those that you are currently experiencing and/or receiving tr eatment for (such as diabetes, high blood pressure, migraine)
[PDF File]CBP Officer Candidate
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CBP Officer Candidate . Pre-Employment Fitness Test-1 . ... This Pre-employment Fitness Test-1 Physical Readiness Program provides you with a six-week ... Document your level of readiness using the form found on the Day 1 sheet of the Training Program (page 6). Remember to sign and date the form.
[PDF File]MedExpress Employer Authorization Form
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Physical Examinations: DOT New certification Re-certification Interstate Intrastate School bus driver physical (if applicable) Standard Pre-Employment (non-DOT) eScreen ePhysical non-DOT look-alike Special Company Form (Requires approval- contact your Account Executive) Other ...
[PDF File]Certificate of Medical Examination (2012 Version)
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CERTIFICATE OF MEDICAL EXAMINATION. U.S. OFFICE OF PERSONNEL MANAGEMENT . Form Approved OMB No. 3206 - 0250 ... to age, health, character, knowledge and ability; and Section 3312 of Title 5 United States Code, regarding waiver of physical ... in processing the form for employment, termination of employment, or criminal sanction.
[PDF File]Manual for The Medical and Physical Examination Program
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Manual for Medical and Physical Examination Program Revised May 1, 2017 3 Proponent Authority Medical and Physical Examination Program Standards of Pre-employment Medical and Physical Fitness History: This publication is a revision of the MAPEP Guidelines. The portions affected by this revision are listed in the Summary of Change.
[PDF File]Pre-Enrollment Physical Fitness Examination
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Pre-Enrollment Physical Fitness Examination PHYSICIAN’S HEALTH SCREENING FORM Examinee’s Name (Last, First, Middle) Date of Birth (M/D/YYYY) Social Security Number* Address (Street, City, State, Zip) Driver License Number Note to Examining Physician/Physician Assistant/Nurse Practitioner: Your medical exam will attest that the examinee is ...
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