How to use or fill out copy of your Photo ID must accompany this request PLEASE
- Click ‘Get Form’ to open it in the editor.
- Begin by entering the date at the top of the form. This helps in tracking your request.
- Fill in your name and Employee ID/SS# in the designated fields. Ensure accuracy for identification purposes.
- Provide your company name and department, along with a contact number. This information is crucial for communication.
- Indicate who authorized this request by filling in their name and confirming phone authorization if applicable.
- Select the required injury requirements by checking the appropriate boxes. Be specific about tests needed, such as drug screens or physical exams.
- Circle any relevant testing categories like Pre-employment or Post-accident to clarify your needs.
- Review all entered information for accuracy before finalizing your document.
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| Versions | Form popularity | Fillable & printable |
|---|---|---|
| 2018 | 4.8 Satisfied (108 Votes) |
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