Get E2 La County Health Form-only Complete Starred - Keck School Of ... - Keck Usc

Filling out the E2 LA County Health Form is essential for individuals seeking health clearance for work. This guide provides a step-by-step approach to ensure you accurately complete the form online.

Follow the steps to complete the form correctly.

1. Click ‘Get Form’ button to obtain the form and open it in your appropriate software.
2. Begin by entering your first name, middle name, and last name in the corresponding fields. Use your full legal name.
3. Input your birthdate in the specified format. Ensure that the date is accurate to avoid any discrepancies.
4. Complete the work facility field by entering the name of your employer or the institution you are associated with.
5. Fill in your job classification and identification number. These details are necessary for identification purposes.
6. Provide the name of your school or employer if applicable, and fill out the department or division you belong to.
7. Input your work area or unit, followed by your contact number and the name of a contact person, ensuring all details are current.
8. The physician or licensed health care professional (PLHCP) should complete the required health screening section by filling out necessary information as per the guidelines.
9. The workforce member must sign the authorization release section, allowing the sharing of health information as required by the DHS policies.
10. Finally, review all entries for accuracy, then save changes, and consider downloading, printing, or sharing the completed form as needed.

Complete your documents online today to ensure a smooth health clearance process.