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The physical examination should include a functional assessment of vision and hearing and a systems review looking for conditions that might affect performance
sample form employee cancer - for family and medical leave
This form must be completed by a Health Care Provider when FMLA leave is requested and medical documentation is required pursuant to 512.41, 513.36 and
LIC 503 Health Screening Report - Facility Personnel
A health screening, by or under the direction of a physician must have been performed not more than one year prior to employment or within seven (7) days after
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