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Health examination certificate 2026

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The document is a Health Examination Certificate required for employment in North Carolina public schools. It mandates a health assessment for individuals upon initial hiring, extended absences due to communicable diseases, or as deemed necessary by school authorities. The certificate includes sections for reporting communicable diseases, physical and mental health limitations, and immunization status, requiring certification from a licensed healthcare provider.

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Click ‘Get Form’ to open the health examination certificate in the editor.
Begin by entering your name and Social Security Number in the designated fields at the top of the form.
Fill in your address accurately to ensure proper identification.
In the section regarding employment recommendation, specify the local school board and position you are applying for.
For the communicable disease section, certify that you do not have any diseases that could pose a risk. If there are any concerns, provide comments in the space provided.
Complete the 'Other Health Areas' section by indicating any limitations for each area listed (Vision, Hearing, etc.) and provide details as necessary.
Finally, have your physician or authorized health professional complete their information and sign where indicated.

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