Get Alliance Beverage Distributing Company Proof Of Annual Physical Exam Form 2012-2025

Filling out the Alliance Beverage Distributing Company Proof Of Annual Physical Exam Form online is a straightforward process. This guide will walk you through each section of the form to ensure you complete it accurately and efficiently.

Follow the steps to successfully complete the form online.

1. Click ‘Get Form’ button to obtain the form and open it in the editor.
2. Locate the section on the form labeled 'This document serves as proof that'. Enter the name of the person receiving the annual physical examination.
3. In the area marked 'was seen for a routine annual physical examination on', provide the date of the examination.
4. In the 'Facility' section, input the name of the medical facility where the examination took place.
5. Fill in 'Doctor’s Name (print)' with the printed name of the physician who performed the examination.
6. Have your doctor sign the document in the 'Doctor’s Signature' section and also indicate the date they signed.
7. On the next line, you will find '*Employee Signature'. Sign your name to confirm your agreement with the terms stated.
8. In 'Employee Name (print)', print your full name clearly for identification.
9. To complete the process, please scan the signed form and email it to your CORE Wellness Team at the provided email address.

Complete your annual physical exam form online today to ensure you meet wellness program requirements.