Get Ny Ehs-707 2006

This guide provides clear instructions for completing the NY EHS-707 form, also known as the agency request for medical examination. Whether you are new to filling out forms or have prior experience, this comprehensive approach will help ensure you complete the application properly.

Follow the steps to successfully complete the form online.

1. Press the ‘Get Form’ button to acquire the form and open it for editing.
2. Begin by filling in the section for the person requesting the examination. Enter your printed name, signature, title, and the date of the request. Provide your phone number and fax number if applicable.
3. Next, input the agency name and address, along with the agency code and division. Specify your preferred service location, along with the name, address, and phone number of the agency payment coordinator.
4. Identify the contact person to schedule the appointment by filling out their name and phone number.
5. Provide the information concerning the employee. This includes the employee’s name, social security number, date of birth, street address, city, state, and zip code. Include the employee's agency and title.
6. Indicate the legal authority for the request by selecting from the given options. Attach any necessary explanations and relevant documentation, such as the official job description and task assignments.
7. Ensure you have not written anything on the reverse side of the form, as instructed.
8. Once all fields are completed, save your changes. You can then download, print, or share the form as needed.

Begin completing your NY EHS-707 online today to ensure proper submission.