Medical form request 2026

1. Click ‘Get Form’ to open the medical inquiry form in the editor.
2. Begin by answering the initial questions regarding whether the employee has a physical or mental impairment. Select 'Yes' or 'No' as applicable.
3. If you answered 'Yes', specify the impairment and indicate if it is long-term or permanent. If not permanent, provide an estimated duration.
4. Next, assess whether the impairment substantially limits any major life activities. Check 'Yes' or 'No', and if applicable, list affected activities such as breathing, walking, or working.
5. Continue by evaluating if the impairment affects major bodily functions. Again, select 'Yes' or 'No', and detail any impacted functions.
6. Proceed to answer questions about job performance limitations and how they interfere with job functions.
7. Finally, provide any suggestions for accommodations that could enhance job performance and include any additional relevant information before signing.

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