Follow the steps to fill out the form correctly.

1. Click ‘Get Form’ button to obtain the form and open it for editing.
2. In Part A, complete all fields: start with your name, social security account number, sex, and date of birth. Clearly indicate your answers to the medical condition questions, ensuring you provide full details if applicable.
3. For Part B, the appointing officer must fill in the purpose of examination, position title, and a brief description of job duties. Make sure to circle each functional requirement and environmental factor that is essential to the position.
4. In Part C, the examining physician will fill in their information after the examination and provide their signature and date.
5. If applicable, the agency medical officer should complete Part D by providing a recommendation based on the examination findings.
6. In Part E, the agency personnel officer marks the action taken regarding the applicant’s status. They will enter their name, signature, and date.
7. Finally, for Part F, circle the appropriate handicap code only if applicable. Once all sections are complete, review the form for accuracy.
8. Save your changes, then download, print, or share the form as needed. Ensure to send it back in the preaddressed 'Confidential-Medical' envelope.

Complete your documents online today to ensure a smooth and efficient process.