Health Statement - UCSF Fresno - University of California, San - fresno ucsf 2025

1. Click ‘Get Form’ to open the Health Statement in the editor.
2. Begin by entering your personal information, including your first name, middle name, last name, work status, and last four digits of your Social Security number.
3. Fill in your date of birth, gender, personal email address, phone number, and cell number. Ensure all details are accurate for processing.
4. Complete the sections regarding immunizations and health history. Attach any required supporting documentation such as vaccination records or lab test results.
5. Have your Licensed Health Care Provider complete the Pre-Placement Health Statement and TB Skin Test Reporting Form as necessary.
6. Review all entered information for completeness before submitting. Incomplete forms may delay your start date.

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