Std 610 form 2026

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4.2 out of 5

66 votes

The document is a Health Questionnaire (STD. 610) required by the State of California's State Personnel Board for job applicants. It mandates that applicants provide medical information only after a job offer has been made, ensuring compliance with state law and the Americans with Disabilities Act. The questionnaire includes various health-related questions to assess the applicant's fitness for the position, along with sections for physician evaluation and privacy notices regarding the handling of medical information.

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Click ‘Get Form’ to open the std 610 form in the editor.
Begin by entering your personal information, including your name, address, and social security number (optional). Ensure accuracy as this information is crucial for processing.
In the section regarding health history, carefully review each question. For any 'YES' answers, provide detailed explanations on the back of the form as required.
Complete the certification section at the end of the form by signing and dating it. This confirms that all provided information is true and complete.
If applicable, ensure that a licensed physician completes their section accurately. They should return the completed report to the hiring agency as instructed.

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Versions	Form popularity	Fillable & printable
2019	4.9 Satisfied (54 Votes)
2017	4.8 Satisfied (165 Votes)
2009	4.2 Satisfied (66 Votes)

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