SAR-40A.docx 2025

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The document is a Physical Examination Form required for students in health occupations programs. It mandates that students complete personal information, undergo a physical examination by a licensed practitioner, and provide immunization records. The form emphasizes the importance of maintaining copies for personal records and includes sections for medical history, current medications, and any conditions affecting attendance. Additionally, it outlines the necessity of vaccinations, particularly against Hepatitis B, and includes a release statement for students opting out of immunizations.

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Click ‘Get Form’ to open the SAR-40A.docx in the editor.
Begin by selecting your Program of Study from the provided options. Ensure you check the appropriate box for your chosen field.
Complete all personal information fields, including your name, student ID number, address, and emergency contact details. Make sure to type or print legibly.
The licensed practitioner section requires specific health metrics. Fill in height, weight, visual acuity, blood pressure, pulse, and hearing status as assessed by a healthcare professional.
List any current medications and specify any emotional or physical conditions that may affect your studies.
Document required immunizations and laboratory tests. Attach results as necessary and ensure all dates are filled accurately.
Finally, have both the student and practitioner sign and date the form before submission.

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Versions	Form popularity	Fillable & printable
2015	4.8 Satisfied (85 Votes)

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