Get Health Screening Report

The Health Screening Report is a crucial document required for personnel working in alcoholism or drug abuse recovery or treatment facilities. This guide provides detailed instructions on how to fill out this report online, ensuring all necessary information is accurately captured.

Follow the steps to complete the Health Screening Report online

1. Click ‘Get Form’ button to obtain the form and open it in the editor.
2. Begin by filling out the employee's name in the designated field. Ensure that the name is entered accurately as it will be used for identification purposes.
3. Next, indicate the job title of the employee in the appropriate section. This information is essential for verifying their role within the facility.
4. Specify the number of workdays per week by choosing the appropriate number from the dropdown menu or entering it directly.
5. Enter the number of work hours per day. This helps in assessing the workload and ensuring the employee's health aligns with their duties.
6. In the Authorization for Release of Medical Information section, the employee must provide their signature along with the date. This should be done electronically in the document if possible.
7. Following the employee's details, the licensed medical professional will need to evaluate the employee's general health. They will mark 'NO' or 'YES' regarding any limitations or health hazards in the designated area.
8. If 'YES' is selected, the medical professional must provide an explanation in the provided space. This commentary should clearly explain any limitations or concerns.
9. The licensed medical professional must then complete their signature, include the date of the evaluation, and provide their title. This section verifies the legitimacy of the health screening.
10. Once all fields are completed, users can save changes, download, print, or share the Health Screening Report as needed.

Complete your Health Screening Report online today for efficient processing.