Get Ehs 769 Form

The Ehs 769 Form is an essential document used for preplacement physical examinations in the New York State civil service system. This guide provides clear instructions to help users fill out the form accurately and efficiently online.

Follow the steps to complete the Ehs 769 Form online:

1. Click ‘Get Form’ button to obtain the form and open it in the editor.
2. Enter the date of your request at the top of the form. This information is crucial for record-keeping.
3. In the 'Person Requesting Examination' section, print your name and include your title.
4. Fill in your phone number and fax number to allow for easy communication regarding the examination.
5. Provide the name and address of the agency you represent, along with the agency code and cost center code.
6. Specify your division and preferred service location, noting any potential limitations due to physical agility tests.
7. Affirm that the candidate has received a conditional offer of employment by signing in the allocated space.
8. Complete the 'Information Concerning Candidate' section with the candidate’s name, address, city, and other personal details including their date of birth and social security number.
9. Fill in the candidate's preplacement title and any applicable examination or eligible list number.
10. Indicate the contact information for scheduling the appointment, including the name, phone, and email address of the relevant contact person.
11. Review all entered information for accuracy before saving your changes.
12. Finally, you can download, print, or share the completed form as needed.

Start your process by filling out the Ehs 769 Form online today.