Get Uab Sh&w Physical Examination (please Print In Black Ink) To Be Completed And Signed By

This guide provides clear, step-by-step instructions for filling out the UAB SH&W Physical Examination form online. Completing this form is essential for all clinical students prior to matriculation.

Follow the steps to complete the form online accurately.

1. Press the ‘Get Form’ button to access the document and open it for editing.
2. Fill in your last name, first name, and middle name in the designated fields. Ensure all information is printed clearly.
3. Enter your permanent address, city, state, and zip code accurately to ensure proper identification.
4. Input your height and weight in the respective fields. These measurements are necessary for the physical evaluation.
5. Record your date of birth in the format mm/dd/yyyy to verify your identity.
6. Provide your area code and phone number for communication purposes.
7. Complete the vision assessment fields, detailing your vision in corrected and uncorrected states.
8. Fill out the vital signs including temperature, pulse, respiration, and blood pressure in the specified fields.
9. Document any abnormalities in the provided sections as well as any areas of concern you may have. Ensure to explain if necessary.
10. Indicate whether there is any loss or serious impairment of organ function, and provide explanations in the designated area.
11. State any recommendations for physical activity, marking whether activity is unlimited or limited. Provide your reasoning in the explanation area.
12. Ensure all sections are signed and dated by a physician, physician assistant, or nurse practitioner as required.
13. After completion, save the document, download it for your records, and print a hard copy if necessary. You may also share it with the appropriate office.

Complete your documents online today for a smooth submission process.