Home
Forms Library
State of health answer

Health status in application form 2025

state of health answer Preview on Page 1

See details

4.7 out of 5

62 votes

The document is a Health Status Statement Form required by Maxim Staffing Solutions for applicants before employment. It includes sections for personal information, tuberculosis testing, immunization records, height and weight, and a physician's certification of the applicant's health status. The form emphasizes the necessity of current test results and medical evaluations to ensure the applicant is fit for employment.

Here's how it works

01. Edit your state of health answer online

Type text, add images, blackout confidential details, add comments, highlights and more.

02. Sign it in a few clicks

Draw your signature, type it, upload its image, or use your mobile device as a signature pad.

03. Share your form with others

Send health status answer in form via email, link, or fax. You can also download it, export it or print it out.

How to use or fill out health status in application form with our platform

Ease of Setup

DocHub User Ratings on G2

Ease of Use

DocHub User Ratings on G2

Click ‘Get Form’ to open the health status statement form in the editor.
Begin by filling out the 'APPLICANT INFORMATION' section. Enter your name, home address, city, state, and zip code clearly.
Proceed to the 'TESTS PERFORMED' section. Document the dates for your TB skin test and any subsequent tests. Ensure you indicate if a chest x-ray is required based on your TB test results.
In the 'IMMUNIZATION RECORDS' section, provide details for each vaccine or titer. Include dates performed and results for mumps, rubella, rubeola, varicella, and hepatitis vaccines.
Complete the 'HEIGHT/WEIGHT' section as per state licensing requirements. If not applicable, mark N/A.
Finally, have your physician complete their statement by certifying your health status. Ensure they sign and date the form before submission.

Start using our platform today to easily fill out your health status statement form for free!

be ready to get more

Complete this form in 5 minutes or less

Get form

Got questions?

We have answers to the most popular questions from our customers. If you can't find an answer to your question, please contact us.

What are examples of health status?

The health status of a population can be measured by a wide range of factors: birth and death rates, life expectancy, quality of life, morbidity from specific diseases and conditions, environmental risk factors, use of ambulatory care and inpatient care, financial and geographical accessibility of health personnel and

How do you describe your health status?

Refers to your medical conditions (both physical and mental health), claims experience, receipt of health care, medical history, genetic information, evidence of insurability, and disability.

What is a health status form?

A health status report form is a form used by healthcare providers to collect information about a patients health and well-being. Whether you own or manage a clinic, hospital, or private practice, use this free Health Status Report Form to collect information about your patients!

How do you describe health status?

Health status is a measure of how people perceive their healthrating it as excellent, very good, good, fair, or poor. Reported health status is a predictor of important health outcomes including mortality, morbidity, and functional status (14). It is considered a good global assessment of a persons well-being (4).

What to write on health status?

You are not required to disclose specific medical diagnoses unless it directly affects your job performance. Use general terms if possible, such as excellent health, good physical condition, or managing a chronic condition.

state of health answer in application form

Health status in application form template Health status in application form sample Health status in application form pdf Health status in application form example Health status examples Health status answer Health Status form My health status

What does health mean on a form?

Health is a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity.

How do you describe physical health status?

Physical health is how well your organs and body systems function. Each persons version of physical health is different. Someone can achieve their own definition of physical health, despite a disease, a disability, or their age.

How would you describe your health?

The WHO constitution states: Health is a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity. An important implication of this definition is that mental health is more than just the absence of mental disorders or disabilities.