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How to use or fill out Fax (919) 779-8210
- Click ‘Get Form’ to open the Medical Examination Report in the editor.
- Begin by entering the date at the top of the form. This is essential for record-keeping.
- Fill in the last four digits of the applicant's Social Security Number, followed by their full name, including first, middle, and last names.
- Input the employing agency's name and the applicant's date of birth.
- Complete the physical examination details such as height, weight, vision acuity with and without glasses, and hearing acuity.
- Document cardiovascular information including blood pressure and resting pulse. Note any abnormal findings in the designated sections.
- Answer all questions regarding tuberculosis risk and symptoms accurately. Ensure that any additional screening requirements are specified.
- Finally, have a qualified medical professional sign and date the form before submission.
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