Get Lcopat Physician's Health Screening Form - Michigan Sheriffs ... - Delta

The LCOPAT Physician's Health Screening Form is an essential document that verifies a candidate's physical capability to participate in the Local Corrections Officer Physical Abilities Test. This guide provides clear and user-friendly instructions on how to accurately complete this form online.

Follow the steps to fill out the LCOPAT Physician's Health Screening Form online

1. Click ‘Get Form’ button to obtain the form and open it in the editor.
2. Enter the examinee's full name in the fields provided, including last, first, and middle name.
3. Provide the date of birth in the format M/D/YYYY, ensuring accuracy for identification purposes.
4. Input the driver’s license number of the examinee. This information is important for verification.
5. Complete the address section with street, city, state, and zip code to ensure proper documentation.
6. Physicians or physician’s assistants should carefully read the six physical evolutions listed and confirm the examinee's capability to perform them.
7. The examining physician or physician's assistant must print their name, provide their phone number, medical license number, and address.
8. Sign and date the form at the designated spaces to validate the health screening.
9. The examinee should sign the form, verified by their valid driver’s license, and date it appropriately.
10. Once completed, ensure the original form is saved, downloaded, printed, or shared as needed for the test.

Complete your LCOPAT Physician's Health Screening Form online today.