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Form T-1a Physician's Medical Release - docjt ky

Form T-1a Physician's Medical Release - docjt ky 2026

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The document is a Physician's Medical Release Form from the Kentucky Law Enforcement Council, required for applicants undergoing physical ability testing for peace officers. It mandates that a physician, physician assistant, or nurse practitioner assess and confirm whether an applicant can safely participate in essential physical tasks and tests. The form outlines the physical demands of law enforcement duties and specifies the tests to be conducted.

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Click ‘Get Form’ to open it in the editor.
Begin by entering the applicant's name and date of birth in the designated fields. Ensure accuracy as this information is crucial for identification.
Fill in the Social Security Number (SS#) of the applicant. This is necessary for record-keeping and verification purposes.
Review the list of physical tasks that peace officers must perform. This section provides context for why this medical release is necessary.
In the section regarding contraindications, select one of the two options based on your professional assessment of the individual’s ability to participate in physical testing.
Finally, sign and date the form at the bottom, ensuring that your printed name and title are clearly indicated.

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