Get Occupational Health Services Pre-placement Health Assessment - Formrouter

This guide provides detailed instructions on completing the OCCUPATIONAL HEALTH SERVICES Pre-Placement Health Assessment form online. Whether you are filling it out for the first time or you need a refresher, this comprehensive guide will support you through each step.

Follow the steps to successfully complete your health assessment form.

1. Click the ‘Get Form’ button to access and open the health assessment form in the designated editor.
2. Input your personal information, including your last name, first name, middle initial, and the last four digits of your Social Security Number. Select your primary location from the provided options.
3. Indicate whether you have any allergies, are sensitive to latex, have a chronic skin condition, or currently have an open lesion. Provide additional information as required.
4. List any surgeries you have had in the last five years. If you have not had any surgeries, write 'none'.
5. State if you are under any physical or medical restrictions and provide descriptions if applicable.
6. Indicate if you have ever received Workers’ Compensation for a work-related injury by selecting 'Yes' or 'No'.
7. Respond to the series of questions regarding various health conditions by marking 'Yes' or 'No' and providing further descriptions where needed.
8. Fill out the section related to any medications you are currently taking for health conditions, marking 'Yes' or 'No'.
9. Complete the questions regarding symptoms of pulmonary or lung illness by answering 'Yes' or 'No' and providing any additional details if necessary.
10. Read and confirm the statement of understanding regarding the accuracy of your health information. Type your full name to signify your acknowledgment.
11. If the section for office use is relevant, ensure that it is completed by the Occupational Health Nurse. This includes checking types of respirators that will be used.
12. Review your responses for accuracy, then save your changes and submit the form.

Complete your health assessment form online today to ensure your readiness for the position.