Get Physical Examination Record To Be Completed By Health Care Provider Within The Last 12 Months

Completing the Physical Examination Record is an essential step in ensuring that health information is accurately conveyed to educational institutions. This guide will walk you through the process of filling out this record online, ensuring clarity and ease as you document necessary health information.

Follow the steps to successfully complete the Health Examination Record.

1. Click ‘Get Form’ button to obtain the form and open it in the editor.
2. Fill in the full name of the student in the designated field at the top of the form.
3. Enter the student's height in inches, selecting either 'Normal' or 'Abnormal' for the height assessment.
4. Record the student's weight in pounds, again choosing 'Normal' or 'Abnormal' based on the assessment.
5. Complete the sections regarding various health assessments: 'HEENT', 'Neck', 'Lungs', 'Heart', and 'Abdomen', marking them as 'Normal' or detailing any 'Abnormal' findings.
6. Input blood pressure and pulse readings, and indicate whether they are 'Normal' or note any 'Abnormal' observations.
7. Continue to fill out the sections on 'Genitourinary', 'Musculoskeletal', 'Neurological', and 'Skin', following the same format for health assessments.
8. In the 'Describe any abnormalities OR OTHER HEALTH ISSUES' section, provide a detailed account of any noted health concerns.
9. Enter any other pertinent information related to the student's health as needed.
10. Sign the form as the health care provider, including the date and printing or stamping your name, profession, phone number, and address.
11. If the student is under 18, ensure that a parent or guardian signs the authorization for medical care.
12. For students aged 18 and older, review and sign the approval and consent for treatment section.
13. After completing the form, save your changes, and choose to download or print the document for your records.

Complete your Physical Examination Record online today to ensure timely and accurate health documentation.