Physical form 2025

1. Click ‘Get Form’ to open the Adult Physical Examination Form in the editor.
2. Begin by entering the student's name in the designated fields for Last, First, and Middle Initial. Ensure accuracy as this information is crucial for identification.
3. Fill in the address section with complete details including Street, City, State, and Zip code. This helps in maintaining proper communication.
4. Provide contact information by entering home and work phone numbers along with an emergency contact number and person.
5. In Part 1, document the immunization history by listing each vaccine type along with the corresponding disease and date of immunization. If applicable, indicate any contraindications for medical or religious reasons.
6. Ensure that a qualified individual signs off on the immunization certification section, including their title and date.
7. Part II requires completion by a physician. They will need to provide findings from a physical examination including vital statistics like height, weight, blood pressure, and vision tests.
8. Lastly, ensure that any health conditions requiring emergency action are specified clearly along with any long-term medications being taken.

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