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Click ‘Get Form’ to open the NYS EHS 707 form in our editor.
Begin by filling in the 'PERSON REQUESTING EXAMINATION' section. Enter your name, title, and contact information including phone and fax numbers.
Next, provide details about the agency requesting the examination. Fill in the agency name, address, code, and division.
In the 'INFORMATION CONCERNING' section, input the employee's name, social security number, date of birth, and address details.
Indicate the legal authority for the request by selecting from options such as Involuntary Leave or Workers’ Compensation. Attach any necessary explanations as required.
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