Physical Form - Alvernia University - alvernia 2026

1. Click ‘Get Form’ to open the Physical Form in the editor.
2. Begin by entering your Last Name, First Name, and Date of Birth in the designated fields. Ensure accuracy for proper identification.
3. Fill in your contact information, including Cell Phone Number and Home Phone Number, followed by your Address.
4. Provide your Height and Weight. If applicable, indicate Corrected Vision details.
5. Complete the Medical Appearance section by checking the appropriate boxes for each health category such as Cardiovascular and Lungs.
6. Record your Blood Pressure and Pulse readings in the specified fields.
7. Indicate the Date of Last Dental Exam and describe any Abnormal findings if necessary.
8. If there are any health issues that may limit activity, please detail them in the provided space.
9. The Authorized Medical Examiner must print their name, sign, and provide their address along with their contact information before submitting the form.

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