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How to use or fill out Employment Post Job Offer Medical History Questionnaire This is a rebuild of 1218
- Click ‘Get Form’ to open it in the editor.
- Begin by entering your Employee ID, First Name, Middle Initial, and Last Name at the top of the form.
- Carefully read each question regarding your medical history. For each condition listed, select 'Yes' or 'No' as applicable.
- If you answer 'Yes' to any question, use the space provided on the third page to explain fully, including diagnosis, treatment details, and healthcare provider information.
- Complete additional sections regarding hospitalization history, mental health treatment, and any medications you are currently taking.
- Ensure all questions are answered completely. If a question does not apply to you, state 'none' as instructed.
- Review your responses for accuracy before signing and dating the form at the bottom.
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