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Employee Medical Statement - Ohio Department of Education - doyocs 2026
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- Click ‘Get Form’ to open the Employee Medical Statement in the editor.
- Begin by entering the employee's name in the designated field. Ensure that you print the name clearly for accurate identification.
- Indicate whether the employee is free of communicable diseases and physically fit to work with children aged birth to 15 by checking the appropriate boxes.
- If there are any limitations, specify them in the provided space. This section is crucial for understanding any health-related constraints.
- The examining physician or authorized personnel must sign in the designated area, circling their title (Physician, Physician’s Assistant, or Advanced Practice Nurse).
- Fill in the date of examination and provide the name of the physician or clinic along with their address and phone number.
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jfs 01296 form
Apr 8, 2026 Ohio Department of Education and Workforce. Stephen D. Dackin, Director; 25 South Front Street, Columbus, Ohio 43215. 1-877-644-6338; contactRead more
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