Agriculture 4339 form-2026

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4.8 out of 5

72 votes

The document outlines the requirements and procedures for the Certificate of Medical Examination used by the United States Department of Agriculture's Food Safety and Inspection Service (FSIS). It details the collection of medical information from current and prospective employees to assess their fitness for federal employment, in compliance with various legal regulations. The form includes sections for personal information, medical history, examination results, and specific job-related health requirements. It emphasizes confidentiality, voluntary disclosure, and non-discrimination policies.

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Click ‘Get Form’ to open the agriculture 4339 form in the editor.
Begin by filling out Part A, which includes your personal information such as name, social security number, and contact details. Ensure accuracy as this information is crucial for processing.
Proceed to list any current medications and allergies in the designated fields. This section is vital for your medical examination and should be completed thoroughly.
In the Review of Systems section, mark 'YES' or 'NO' for each health condition listed. If you answer 'YES', provide detailed explanations including dates and treatments.
Complete Parts B through D with your physician during your medical examination. Ensure they sign and date each part to certify completion before submission.

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Versions	Form popularity	Fillable & printable
2020	4.8 Satisfied (72 Votes)
2015	4.4 Satisfied (227 Votes)

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