FREE 30+ Medical Clearance Forms in PDF | MS Word

To medically clear a patient or an individual, the assigned physician must conduct a medical examination and an observation to determine if a patient will be able to adjust in events of clinic transfer or whenever a new medication will be provided to him or her. After performing the examination, the physician will have to state his or her assessment forms on a medical clearance form to record and to indicate his or her decision with regards to the patient’s welfare.

Blank Medical Clearance Form

Medical Clearance Referral Form

Surgical Medical Clearance Form

Pre-exercise Medical Clearance Form

Objectives of a Medical Clearance Form

There are three main objectives of a medical clearance form. The first is to establish and determine the cause and the symptoms of a possible illness that an individual has. As this is the primary process, the individual who requires the clearance has to be honest and true about his or her statements on the medical form presented by the physician. Additionally, the patient also needs to give his or her  medical history records to the physician.

The second objective is to acquire a medical assessment of the patient’s condition by conducting a thorough examination. The exam will depend on the symptoms and the medical history of the patient. Nonetheless, most exams will include a physical and mental test provided by the administering physician. The last objective of this form is to state the treatments and medication that aid in curing the patient. If the patient has been cured and cleared from any medical illness, the physician can state the programs and activities that the patient will be allowed to participate for further improvement in the patient’s healing process.

Hearing Aid Medical Clearance Form

Basic Medical Clearance Form

Medical Opinion Clearance Form

Kinds of Medical Clearance Forms

Medical clearance forms have a lot of varieties and these are listed as follows:

Airline Agent Medical Clearance Form – This is used in airports and airline companies. It indicates the needs of their passengers as well as the agent who catered the passenger’s flight processing. It contains the general information of the user which includes his or her flight details, escort information and his or her statement of declaration that indicates granting an authorized consent form to the airlines to contact his or her treatment provider for further details about his or her medical condition. The second section of the form is for the passenger’s doctor who is required to describe the passenger’s illness and the type of assistance the passenger may need during the flight.

Airline Agent Medical Clearance Form

Applicant Medical Clearance Form – Applying for a license, renewing an owned document or getting into a job applicant are some of the instances when this medical clearance form is needed. The purpose of the form is to inform the government, agencies, employers and the authority about the medical status of an applicant. This will focus on three sections which are for the patient or the applicant’s information, his or her medical details and his or her permission regarding the need of the agency to obtain an authorized release of information for investigation intentions.

Applicant Medical Clearance Form

Bus Driver Medical Clearance Form – Before a school or educational institution hire a school bus driver, they demand a number of documents such as a driver’s license, a legal identification card and an up to date bus driver medical clearance form. The clearance is needed to assure the school administration that the driver is medically safe while dealing and managing children.

The driver’s name, his or her contractor form, the bus route and the driver’s medical concerns is stated on the form. A trip inspection, and emergency and driver evaluation checklists are also included on the form to serve as a preventive measure in securing that the children will be in safe hands.

Bus Driver Medical Clearance Form

Client Medical Clearance Form – Fitness trainers and instructors are professionals in the field of health and wellness. When a client taps on them to request for a training session, they often require the client to fill out and submit a client medical clearance form. This document is essential in gathering the client’s medical information which will be supported by the client’s physician or healthcare provider.

An informed consent form is enclosed together with the clearance to indicate that the client has been fully informed with regards to his or her health status, the dangers of the exercises and his or her waived rights as he or she joins in the training. Another inclusion is a health and fitness questionnaire form used to determine the stage of participation and the appropriate activities for the client. A set of instructions for the client will be the last attachment of the form to enlist what the client should bring during his or her training.

Client Medical Clearance Form

Course Medical Clearance Form – Physical activities and workshop courses which demands the participant to be active should have a medical clearance form as one of the vital requirements. A course medical clearance form has a list of questions which aids both the physician and the activity organizer to categorize the participant as to what type of program or course will be suitable for him or her.

A health screening and medical test are two processes that the participant may undergo to acquire the clearance. This process allows the physician to write down his or her observations about the participant and to determine if the participant will be allowed for the activities in the course program.

Course Medical Clearance Form

Dental Treatment Medical Clearance Form – According to a survey, a dental patient counts to dental mortality rate every other day. With this, the dental industry is gaining more client speculations as to how they will assure the safety of their patients before, during and after undergoing a dental procedure.

This is why a dental treatment medical clearance form is often required to be answered and filled out by the patient and a licensed physician to secure that the patient will not be meeting any complications. Additionally, the patient’s medical information, as well as the contact details of the physician are also included on the form.

Dental Treatment Medical Clearance Form

Medical Clearance Questionnaire Form – Aside from the diving equipment needed for scuba diving and shark swimming activities, a professional diver must be medically stable and fit to dive. A diver medical clearance form includes a medical questionnaire which determines whether the diver has asthma, epilepsy or any disease which can be dangerous during the diving sessions.

Acquiring an approved medical clearance is not only essential for the diver’s safety but as well as the safety and security of his or her diving team members. The form also acts as a diving schedule form which contains the specified time and date when the diving activity will take place.

Medical Clearance Questionnaire Form

Firefighter Medical Clearance Form – Firefighters should not only be brave and strong but also physically well and fit. To determine if a firefighter applicant or volunteer is medically ill, an organization must require the applicant to undergo a medical exam and submit a firefighter medical clearance signed by a licensed physician.

A disclaimer of liability or liability waiver is stated in the form to indicate that the firefighter has been informed about the risks and dangers of his or her job as a volunteer which further waives his or her rights in suing the organization or the government if he will be involved in an accident.

Firefighter Medical Clearance Form

Reassignment Medical Clearance Form – Nowadays, gender equality and acceptance has been the subject of debates and views of most people. Surgeries become one of the options to achieve the dreams of some individuals who aim to have the opposite gender category from what they are born with. This is when a gender reassignment medical clearance form serve a huge purpose for securing the safety and health of the surgery client.

This form indicates the assessment and action plan that the physician will recommend to the client’s surgeon for the reassignment procedure. It is essential that the client understands the risks and the medical possibilities for him or her to be aware and to take the appropriate medications requested by the licensed physician.

Reassignment Medical Clearance Form

Hydrotherapy Medical Clearance Form – Arthritis and paralysis are medical conditions which can be treated with hydrotherapy or water cure. However, not all individuals who are diagnosed with these conditions can be allowed to join a hydrotherapy session, and swim in a heated pool as most pool establishments want to retain the safety and cleanliness of their premises.

This is why a hydrotherapy medical clearance form is given to the interested individual before he or she  will be granted full permission to dive into the pool. The clearance states the details of the participant, his or her emergency contact information, the name of the doctor who provided the clearance and the infections, illness or other diseases that the participant has. An acceptance of risk agreement form is also enclosed with the document which signifies the confirmation of the individual to manage the risks associated with the pool activities.

Hydrotherapy Medical Clearance Form

Massage Therapy Medical Clearance Form – A massage can either be soothing to one’s senses or may be dangerous as it may trigger the illness of an individual. Precaution must always be taken when getting a massage to avoid health complications. To cater precautionary measures, massage therapists and their staff provide a massage therapy medical clearance form to their massage clients. This document is essential as it is a tool for listing the contact information of the client, his or her physician’s details, his or her restrictions which are recommended by the physician and the type of massage appropriate for the client’s medical status.

Massage Therapy Medical Clearance Form

Player Medical Clearance Form – Before an individual can participate in a physically draining game, he or she needs to supply a proof that he or she is medically, physically and mentally healthy. The document that the participant will use is a player medical clearance which he or she can acquire from the game organizers or from his or her coach.

Though the form is targeted for his or her information, the individual will not be responsible for filling out the medical form but his or her legal guardian and physician. The users of the form must state if the participant is fit enough to play in the games or if there are limitations for the participant’s actions.

Player Medical Clearance Form

Police Officer Medical Clearance Form – Similar to firefighters, applying to be a police officer requires an individual to be physically ready, fit, brave and mentally active. With this, the police department of a state requires their applicants to undergo a physical examination based on their gender since males and females have varying strength limitations.

The observations and the results of the examination is stated on a police officer medical clearance form which is completed by the physician of the police department. This form also indicates the health care provider’s name, address and contact information to let the department and the applicant reach each other in the event of questions and inquiries regarding the medical results.

Police Officer Medical Clearance Form

Return to Work Medical Clearance Form – Employees who acquired an injury or experienced a recent illness has to present a medical clearance. The return to work clearance form in medical indicates the approval of the employee’s physician with regards to the intention of the employee in heading back to his or her workplace.

The form contains an employee information section which caters the details of the returning employee, department information referring to the employee’s assigned work area and a section for the physician’s observation as to whether the employee is allowed to have his or her regular duty or if there would be a special duty schedule for the employee.

Return to Work Medical Clearance Form

Medical Clearance to Return Form – As the aforementioned return-to-work is for employees and business staff, this clearance to return form are for students in an educational institution. It is important to have this form to determine if the student has received medical treatment from a licensed physician and if the student has been cured of his or her claimed illness.

Submitting this document with other supporting medical forms depends on the educational institution who receives the form. However, if a set of medical forms is sent with this document, the student is requested to submit a photocopy of the forms, and omit in sending the original papers as they may be tampered and may be lost in the delivery process.

Medical Clearance to Return Form

Medical Surgery Clearance Form – Though anesthesia is a helpful way to relax a patient, it is also a danger to people whose body system do not tolerate the effects of the drug. Surgeons, dentists and any medical practitioner who incorporates a hint of pain to their patients such as extracting a tooth needs to acquire an approved and legal surgery anesthesia medical clearance from their patient’s personal physician. The clearance is similar to obtaining a medical consent which is a requirement before any medical-related activity will be done.

Medical Surgery Clearance Form

Importance of Medical Clearance for Psychiatric Patients

Patients diagnosed with previous psychiatric disorders are the main targets of a medical clearance examination. The clearance’s significance is that it aids in determining the type of facility where the patient should be sent for curing his or her disorder. Without a licensed physician’s medical clearance, the patient may not be sent to the appropriate facility and may acquire an additional trauma which will complicate his or her medical state.

The presented medical clearance is also used for indicating that a patient no longer has a medical illness or disorder and that the patient can already continue living his or her lifestyle. Additionally, if a patient still has the disorder, the clearance proves that the patient is capable to manage himself or herself, and the disorder will not be a hindrance for the patient’s performance in his or her job or in school.

Medical Clearance Request Form

Fitness Medical Clearance Form

Nurse Medical Clearance Form

Significant Areas in a Medical Clearance Form

A medical clearance should not be limited to the statement of the physician with regards to the condition of his or her patient. This document must have a section which deals with the medical history of the patient including the medicines that he or she took a few years ago and the programs where he or she was previously enrolled to cure the illness he or she got involved. Most medical clearances also have a formal letter on the first section which describes the intentions of the organization of why they required the clearance.

The letter is addressed to the physician and the patient as it may also have the list of programs or the activities associated with the patient’s participation. Additionally, a medical clearance is more effective if it contains a medical waiver. The role of the waiver in this clearance form is to assure that the patient knew about the risks, the results of the medical examination and the intentions of the organization in gathering the relevant and personal information of the patient for record-keeping purposes.

How to Acquire a Medical Clearance

Athletes, teachers, students, and all other people in this world may be required to submit a completed and signed medical clearance for varying intentions. With this, the steps below will aid an individual in the process of acquiring his or her needed clearance:

Gather your documents.

All the medical forms that you have will serve as your records of your medical history. These documents help your physician or your healthcare provider in studying your background.

Fill out the form.

The agency who gave you a medical clearance request form should enclose a medical clearance document that you need to fill out with your information. After filling out the area designated for you, submit the form to your physician and have him or her indicate your symptoms and the moods that you have observed in the past few days. The reason why the physician should be the one to state your symptoms is due to the usage of medical terms which are necessary for your treatment and observation.

Perform in an exam.

A physical examination will be the first medical exam that you will undergo which includes a checkup with your vital signs, visual capacity, as well as examining your reflexes. If your disorder is related to your mental health, then a mental or psychological examination will be catered to you by your physician. The physician or the assigned health care provider may hand you an examination document which requires you to state answers that best describes your mood, attitude, behavior and your current situation in life.

The last step to acquire the clearance is to wait for the confirmation or the decision of your physician. As soon as he or she had reviewed your case, he or she will present you the clearance along with his or her recommendations and suggestions for you and the requiring agency.

Medical Pool Clearance Form

Mutual Patient Medical Clearance Form

Medical Evaluation Clearance Form

Basic Medical Clearance Form

How to Use a Free Medical Clearance Form

Medical clearance forms can be found at any agency and organization who aim to provide enjoyment and safety to their clients as well. These forms can also be downloaded from our site wherein there are numerous choices and varieties of document formats. To use our forms, follow the steps below:

Step 1: Choose the form that suits your preferences and needs.

If you need a medical clearance for surgery, then look for the form which is targeted for surgical procedures. On the other hand, if you need a form for your university, then use the medical clearance that target students who will be returning to school.

Step 2: Download the form.

Simply click on the download button beside the form of your choice. After which, you may need to verify your existence by typing the code required on the box.

Step 3: Open and edit.

The forms on our site can be used as your guide and example. With this, you must remove the unnecessary entries on the clearance form to assure that the document you are making will only cater relevant data.

After following the three main steps, you will be able to save and use your form to all your intentions. Nonetheless, you should always remember that there are specific sections on the form which are designated for the physician that you must not fill out. As soon as these sections have been completed, you can then submit and wait for the confirmation of the agency addressed on your form.