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The LACCD Annual Physical Form serves as an essential certification tool for employees within the Los Angeles Community College District. This form is crucial for verifying employee absences due to attending annual physical or eye examinations. By facilitating this verification, employees can ensure their absence is recognized for paid time off, in accordance with collective bargaining agreements.
Employees and their physicians are required to complete this form with detailed information, including the dates and times of the examinations. This ensures clarity and uniformity in the submission process. This document aids in upholding the integrity and fairness of absence approvals, providing a clear framework for both verification and compensation.
Obtain the Form: The form can typically be acquired through the HR department of the Los Angeles Community College District or accessed online via the official LACCD portal.
Section for Employee Information: Fill out personal details, including name, position, department, and contact information. Accuracy in this section is vital for subsequent verification processes.
Examination Details: Enter the dates and times of your physical or eye examinations. This information must match any accompanying documentation from the medical provider.
Physician's Information: Provide the physician's name, address, and contact details. The physician is also required to verify the examination by completing and signing their designated section of the form.
Employee Signature: After completing your sections, sign the form to authenticate the information provided. This signature also acknowledges your understanding of the form's purpose and conditions.
Submit for Approval: Once both you and your physician have completed all necessary sections, submit the form to your HR department for approval, following the submission guidelines specified.
The form is primarily used by employees within the Los Angeles Community College District who are seeking verification of absence due to physical or eye examinations. Typical users include faculty, administrative staff, and other employees under the district’s employment. This ensures that the form serves those who require official documentation to account for their health-related absences, facilitating a smooth process for claiming paid absence time.


The LACCD Annual Physical Form is designed to align with legal requirements and collective bargaining agreements within the district. It is imperative that employees use this form in an ethical and legitimate manner to avoid discrepancies and potential legal ramifications. The form ensures compliance with employment and labor laws, providing a standardized method for proving the necessity of absences.
Employees can generally access this form through several methods:
Getting the form promptly is crucial for employees needing timely verification of their examination-related absences.
Each element collectively ensures the form's purpose is effectively fulfilled, aiding in straightforward processing and approval.
Both digital and paper versions of the LACCD Annual Physical Form are available to accommodate different preferences:
Digital Version: Offers convenience for those comfortable with electronic completion and submission. It allows for easier amendments if needed, and can often be submitted via email or an online portal.
Paper Version: Suitable for those who prefer traditional methods or lack access to digital tools. This version requires manual submission, often through physical delivery to the HR department.
Both versions retain the same format and requirements, ensuring consistency in the process.
Employees have multiple options for submitting their completed LACCD Annual Physical Form:
Online Submission: If a digital copy of the form is filled, it can be submitted via email or an online employee portal. This is often the most efficient method.
Mail Submission: For those completing a paper version, mailing the form to the HR department is viable. Ensure that the mail is securely packaged and the address is verified for accuracy.
In-Person Submission: Employees may also choose to deliver the form directly to the HR office. This method can be ideal for ensuring immediate receipt and feedback.
Each method offers unique advantages and can be selected based on personal preference or urgency of submission.
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| Versions | Form popularity | Fillable & printable |
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| 2008 | 4 Satisfied (54 Votes) |
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