Get Health Form

Filling out the Health Form online is a straightforward process that ensures your medical history and information are recorded accurately. This guide will provide you with step-by-step instructions to complete the form efficiently and correctly.

Follow the steps to complete the Health Form online

1. Click ‘Get Form’ button to obtain the form and open it for editing.
2. Begin by entering your personal information in the Employee Information section. This includes your name, home address, telephone number, date of birth, and gender. Ensure all details are accurate to avoid any issues later.
3. Fill in your position, department, supervisor's name, campus telephone number, and email address in the designated fields. This information helps in processing your form within the university context.
4. In the Emergency Notify section, provide the details of a person to contact in case of an emergency, including their name and telephone number. You should also provide their address for complete information.
5. Indicate your previous employment status at Case Western Reserve University and whether your name has changed. If yes, provide the previous name.
6. Proceed to the Medical History section. List any current physicians or clinics you attend and provide their addresses.
7. Record any allergy history, including allergies to medications and foods, as well as any other relevant medical issues or conditions you may have.
8. Check all applicable medical conditions from the provided list, ensuring you are thorough and honest.
9. Document any past surgeries and immunizations with the appropriate details, including types and dates.
10. Address any issues regarding exercise and smoking in the provided fields, as well as any serious accidents or illnesses you've experienced that have not been covered earlier.
11. In the Prior Work Environment section, answer questions about previous job injuries, hazardous materials, and your understanding of the form.
12. Fill out the Case Work Environment section by detailing your duties and indicating if you will perform any specific tasks such as lifting or working with patients.
13. Finally, review the entire form for completeness and accuracy. Sign and date the form to certify that the information provided is true.
14. After completing the form, you can save changes, download, print, or share the form as needed.

Start filling out the Health Form online today to ensure your health records are up to date.