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You should be viewing this form using Adobe Acrobat Reader 2026

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4.9 out of 5

47 votes

The document is a form for employees to complete their health history and physical examination for the Employee Health Clinic. It provides instructions on how to properly fill out and submit the form using Adobe Acrobat Reader, including sections for personal information, current medical conditions, medications, allergies, and occupational health history. Employees must certify the accuracy of their information and authorize the release of past medical records if necessary.

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Click ‘Get Form’ to open it in our platform.
Ensure you have Adobe Acrobat Reader installed. If not, download it for free from the official website.
Save the form to your computer and open it using Adobe Acrobat Reader to avoid any compatibility issues.
Begin filling out the form by entering your personal information in the designated fields, such as Name, Occupation, Birthdate, and Contact Information.
Complete all sections thoroughly, including Current Medical Conditions and Social History. Remember to save your progress frequently.
Review your entries carefully. Close and reopen the form to ensure all data is saved correctly before submission.
Email the completed form to Employee_Health_South@uchealth.org as instructed. If you encounter issues, consider printing and scanning the document.

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Versions	Form popularity	Fillable & printable
2023	4.3 Satisfied (27 Votes)
2023	4.1 Satisfied (45 Votes)
2023	4.1 Satisfied (46 Votes)
2023	4.4 Satisfied (35 Votes)
2022	4.8 Satisfied (52 Votes)
2021	4.8 Satisfied (61 Votes)
2021	4.8 Satisfied (31 Votes)
2021	4.7 Satisfied (124 Votes)
2021	4.8 Satisfied (145 Votes)
2021	4.8 Satisfied (89 Votes)
2021	4.8 Satisfied (49 Votes)
2021	4.5 Satisfied (36 Votes)
2021	4.2 Satisfied (40 Votes)
2020	4.2 Satisfied (46 Votes)
2020	4.5 Satisfied (50 Votes)