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Get Medical Clearance Form
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How to fill out the Medical Clearance Form online
Filling out the Medical Clearance Form online is a straightforward process that ensures your safety while engaging in physical activities. This guide will provide you with clear and detailed instructions to complete the form correctly and efficiently.
Follow the steps to complete the Medical Clearance Form online
- Click ‘Get Form’ button to obtain the form and open it in your chosen digital editor.
- Enter the patient’s name in the designated field. Ensure that the name is spelled correctly to avoid any potential issues.
- Fill in the date when you are completing the form. This is important for record-keeping purposes.
- The patient must provide their signature in the space provided. This signifies that they authorize the release of their medical information.
- In the section labeled 'Reason for medical clearance,' briefly specify why medical clearance is required.
- Input the physician’s name in the appropriate field, ensuring correct spelling.
- Provide the physician’s phone number to facilitate communication if needed.
- Enter the physician’s address in the specified area. This should include details such as street, city, state, and zip code.
- In the 'Physician Use Only' section, the physician should check one of the statements that best describes their approval or restrictions regarding the patient’s participation.
- If the physician approves participation with restrictions, they should indicate which program the patient can engage in by circling the appropriate option.
- If participation is not approved, the physician must provide a reason in the space provided.
- For physician referrals, the physician must check the appropriate referral option provided in the form.
- The physician should print their name, sign the form, and date it to validate the clearance.
- Once all sections are completed, you can save any changes made, download a copy for your records, print the form if necessary, or share it with the appropriate office.
Complete your Medical Clearance Form online today to begin your journey towards a safer exercise experience.
To get medically cleared to work, first arrange a visit with your healthcare provider. They will perform a health assessment that includes reviewing any past medical conditions. Following the evaluation, if you meet the health standards, you will receive a Medical Clearance Form to submit to your employer.
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