Ability form 2026

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The document is a Physical Ability Form from the University of West Georgia's School of Nursing, used by healthcare providers to conduct a complete health examination of nursing students. It includes sections for recording vital signs, overall physical examination results, and comments regarding the student's ability to participate in clinical activities. The form requires the signature of a qualified healthcare provider and indicates whether the student has passed the examination with or without limitations.

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Click ‘Get Form’ to open the ability form in the editor.
Begin by entering the student's name in the designated field under 'HEALTHCARE PROVIDER'. This ensures that the examination is accurately attributed.
Fill out the 'General Medical' section, providing details such as blood pressure and pulse. Use the checkboxes to indicate whether each assessment is normal or abnormal.
In the 'Physicians Comments' area, add any relevant notes regarding the student's health status that may impact their clinical participation.
Select one of the options under 'OVERALL PHYSICAL EXAMINATION RESULTS' by checking either 'PASSED WITHOUT LIMITATIONS', 'PASSED PENDING THE FOLLOWING', or 'FAILED DUE TO THE FOLLOWING'.
Ensure that a qualified healthcare provider signs and dates the form at the bottom, along with providing their facility address and telephone number for verification.

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