Pre Employment Physical Form 01-21-11 - Best Choice Home ... 2026

1. Click ‘Get Form’ to open it in the editor.
2. Begin by entering your personal information at the top of the form, including your name, address, and telephone number. Select your gender and provide your date of birth.
3. In the medical practitioner section, input your height, weight, blood pressure (BP), and temperature/pulse/respiratory rate (T.P.R).
4. Complete the immunizations and lab tests section by marking positive or negative for each test. Fill in the dates as required.
5. For past medical history and tuberculosis screening, answer all questions honestly by checking 'YES' or 'NO'.
6. Finally, ensure that a medical practitioner reviews and signs the form. They must include their stamp with contact details.

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