Physical exam form is known as a blank form that comes in a format that is used to inform about someone’s physical result or upgrade. This form comes with guided lines that will help you to fill out the space that leave as blank in the form.

There are various formats that you can follow easily. This format will help you to create a formal letter written in a professional way. You can make the form with template that is suitable with your preference. Below there is samples that can help you to create a good order of the form design.

How to Create Good Simple Physical Exam Form

To create a good form, you need to put the info as complete as possible. Just like, in the sample physical forms, there are some detail information that you need to put in the list. To create the form design properly, you need to create it based a good arrangement.

The first step you need to do is writing the title information of the form in the top of the form. Then, there will be some boxes in tables that needs to be filled out. These tables require your general personal data such as name, address, date of birth, city or state you are living and the zip code.

Then, move on to the next section, you will find this part that is known as consent for examination and the release of information. In this part, you will need to leave signature and the date of filling out the form next to it.

There will be tables with box that you can check. Here, you will choose what kind of activities that you have been doing such as physical therapist, speech therapist, occupation therapist, home health aide, masters in social work, registered nurse, clerical, and the licenses practical nurse.

After that, you will be asked about the type of the physical examination that you have been going, checking it whether you come by annually by every three years or you choose return to work or pre-employment.

There is always noted existed that is given to the physicians that shows as health care provider. This physicians will be responsible to manage your medical evaluations, examinations, and the significant laboratory test.

Then, there will be medical questions that is related to you. However, please note that only the physician can only fill out this. Some of questions that related to medical track listed in the sample physical exam templates is about employees’ medical history.

The medical history that usually listed in the form is about neurological and infection disease. The neurological usually consists of seizure disorder or epilepsy, dizziness or fainting, weakness or paralysis, and swelling of lower extremities. The employees will only need to answer with yes or no.

The infection disease consists of certain diseases such as tuberculosis, hepatitis, mumps, measles, syphilis, gonorrhea. These questions need to be answer with yes or no. This will show about your health condition and medical history. This is only the simple sample.

In some condition, there are more complex samples with more details information required. Usually, the employees will only to fill out the form. You can try to check all of the models that are provided for you. Knowing this physical exam form will help you to create a good form.


employee physical exam form
general physical exam form

Similar Posts: