Get Physical Examination - Axiom Medical Consulting

Completing the PHYSICAL EXAMINATION form from Axiom Medical Consulting online is a straightforward process. This guide will provide you with a step-by-step approach to ensure you fill out each section accurately and efficiently.

Follow the steps to successfully complete the form.

1. Click the ‘Get Form’ button to obtain the form and access it in the online editor.
2. Begin by entering your personal information in the designated fields. This includes your full name (last name first), today's date, social security number, birthdate, age, and sex. Make sure the information is accurate as this is crucial for your examination.
3. Provide your contact information. Fill in your home phone number, race, work location, work phone number, job title or assignment, and home address (street, city, state, and zip code). This information helps in identifying your current work environment.
4. Indicate the type of examination you are undergoing by checking the appropriate box. Options include pre-placement, DOT, audiogram, HAZWOPER, respirator, or other. If selecting 'other', provide specific details in the comments section.
5. Record your vital signs by entering your weight (in pounds), height (in feet and inches), temperature, blood pressure, and pulse. Ensure measurements are accurate for effective evaluation.
6. Complete the pulmonary functions section. Provide the observed FVC and the FVC percentage predicted. Fill in your vision details, including right eye (OD) and left eye (OS) measurements.
7. In the hearing section, indicate if hearing protection was used, and specify the type. Fill in the necessary results regarding visual tests and any additional health indicators, such as fecal occult blood and PPD results.
8. Check the boxes for each examination category, including skin, eyes, ears, and others as listed. If there are any abnormalities, explain them in the comments section.
9. Assess your general state of health and provide a diagnosis if applicable. List any physical limitations or impairments you may have.
10. Finally, enter the examiner's name (type or print) and their signature along with the date. Remember to attach any necessary copies of reports, but do not send chest films.
11. After reviewing all the completed information for accuracy, you can save your changes, download the document, print it, or share it as needed.

Complete your PHYSICAL EXAMINATION form online today to ensure your health assessment is accurately recorded.