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01. Edit your pedia clearance online
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Send bcal 3704 cc via email, link, or fax. You can also download it, export it or print it out.
How to use or fill out medical clearance request with our platform
- Click ‘Get Form’ to open the medical clearance request in the editor.
- Begin by filling out the 'Applicant/Licensee Information' section. Enter the facility or home name, license number, and address details accurately.
- In the 'Patient Information' section, provide your full name, date of birth, telephone number, and address. Ensure all information is printed clearly.
- Complete the 'Release of Information' section by signing and dating it. This authorizes the release of your medical information for licensing purposes.
- The physician will fill out the 'Medical Information' section. They need to answer questions regarding TB testing and provide comments on your physical and mental health condition.
- Finally, ensure that both you and your physician sign and date where required before submitting the form as instructed.
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