medical examination form

A Medical Examination Form is an essential document used by healthcare providers to record a patient’s health status and medical history. This guide offers detailed instructions on how to accurately complete and utilize this form for various purposes, including pre-employment screenings and annual health assessments. Incorporating terms such as Examination Form and Medical Form, this guide aims to assist medical professionals and patients alike in understanding and effectively using these forms to ensure thorough medical evaluations. Through practical examples, we highlight best practices for documenting vital health information, ensuring comprehensive care and record-keeping.

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What is Medical Examination Form?

A Medical Examination Form is a structured document used by healthcare providers to assess an individual’s overall health and medical condition. It typically includes sections for personal information, medical history, current health status, and the results of physical examinations. This form serves as a critical tool in preventive health care, aiding in the early detection of diseases and ensuring that all relevant health information is accurately recorded and easily accessible for both medical personnel and patients.

Medical Examination Format

Patient Information

  • Patient Name:
  • Date of Birth:
  • Medical Record Number:

Medical History

  • Known Medical Conditions:
  • Current Medications:
  • Allergies:

Examination Details

  • Physical Examination:
  • Diagnostic Tests:
  • Results:

Physician’s Observations

  • Observations:
  • Recommended Treatments:
  • Follow-up Schedule:

Physician Signature

  • Signature:
  • Date:

Medical Examination Form PDF

Download the Medical Examination Form PDF to ensure comprehensive health assessments. This form is essential for documenting patient evaluations and includes a section akin to the Medical Report Form for detailed health analysis.

Medical Examination Form California

The Medical Examination Form specific to California incorporates state-specific health criteria and compliance requirements, similar to a Medical Waiver Form, ensuring all necessary health disclosures are addressed legally and effectively.

Medical Examination Report Form

This form is used to record findings from medical examinations, providing a systematic way to document patient health, much like the Medical Clearance Form which is used to certify an individual’s fitness for specific activities.

I-693 Form PDF

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Access the I-693 Form PDF for immigration purposes, which includes a comprehensive medical examination section to ensure compliance with U.S. health standards, functioning similarly to a general Medical Examination Form but tailored for immigration health evaluations.

More Medical Examination Form Samples

Standard Medical Examination Form


File Format

  • PDF

Size: 53 kB


This type of form helps to determine the physical health of the individual who needs to provide his/her medical history background in the form. Questions that are provided to the individual while filling such forms are general to understand the health condition of the individual. On another part of the form, the medical examiner writes the reports found during the entire procedure of the medical test. You also browse our Medical Bill Form

Sample Entry Medical Examination Form

File Format
  • PDF

Size: 66 kB


An entry medical examination form is a kind of form which helps to determine the overall health status of a candidate before recruiting him/her to the required post in an organization. It also helps to understand the physical well-being of the candidate whether he/she is physically fit for the post or not. Questions related to the overall present health of the individual are asked. You also browse our Child Medical Consent Form

Certificate of Medical Examination

File Format
  • PDF

Size: 682 kB


This is a type of form which generally has to be filled up by the students before getting admission in educational institutes. This form requires furnishing the general contact information of the individual, previous medical history records like whether the individual suffered from any sort of contagious disease earlier or not. You also browse our Medical Questionnaire Form

Annual Medical Examination

File Format
  • PDF

Size: 151 kB


An annual medical examination form helps to understand the overall physical health of the individual. It is conducted by authorized physicians to understand the health condition and determine whether the individual is susceptible to any kind of life-threatening disease or not.  The overall health condition can be understood and the individual can take required steps in advance if any problem is detected. The individual has to give the details of his previous medical history including the medical history report of his/her family members. The reports of the medical test findings are given by the medical examiner. You also browse our Medical Information Form

Sample Medical Examination Form for Police Applicants

File Format
  • PDF

Size: 18 kB


A medical examination form for police applicants is a type of form which is required to be filled by the candidates who seek to join the police. This form helps to determine whether the candidates are fit and eligible for the post required for being a police. General questions are asked about the medical history of the candidate. Questions related to the health of the candidate are asked. You also browse our Family Medical History Form

Driver Medical Examination Form

File Format
  • PDF

Size: 196 kB


Driver medical examination form is a kind of form which is required for individuals who are above 80 years and to determine their ability and fitness for driving vehicles and also such medical forms are required to be filled by the commercial drivers before applying for a driving license. Apart from the usual questions related to the overall physical health and medical history of the individual, the medical examiner writes the reports found from the medical tests regarding the physical and mental health of the individual. You also browse our Medical Appraisal Form

Confidential Medical Examination Form

File Format
  • PDF

Size: 117 kB


A confidential medical examination form is a type of form which is usually filled up by students studying at any educational institutions or employees working for any organization. Such forms are required to be filled up by individuals so that the organization can contact an immediate person known to the organization in case of a medical emergency or accident. The individual is also required to furnish the medical insurance details in the form. The medical examiner fills up the general health information details of the individual after conducting the medical tests. You also browse our Employee Medical History Form

Sample Medical Examination Application Form

File Format
  • PDF

Size: 928 kB


Medical examination is a type of form which has to be filled by individuals who have been exposed to harmful dust particles in industries and look for medical assistance if the individual contacts any sort of disease caused by the exposure of such harmful dust particles. Generally, these kind of queries that the individual needs to answer on such forms are the duration period of the dust exposure, the kind of particles exposed and how were the dust particles exposed in the workplace. You also browse our Medical Card Application Form

Authorization for Medical Examination

File Format
  • PDF

Size: 1 MB


Authorization for medical examination is a kind of form which the patient needs to fill up before giving consent. The patient is asked to authorize a qualified physician to conduct the required medical test and physical examination. You also browse our Medical Release Form

Basic Medical Examination Form

File Format
  • XLS

Size: 54 KB


Entry Medical Examination Form

File Format
  • DOC

Size: 49 KB


Who Can Fill Out Form I-693?

Only a designated civil surgeon authorized by USCIS can complete Form I-693 to ensure compliance with health-related immigration requirements.

  • Find a Civil Surgeon: Use the USCIS locator to find an authorized doctor. You also browse our Medical Statement Form
  • Schedule an Appointment: Contact the surgeon to set a date.
  • Verification: Ensure the doctor is currently designated by USCIS.
  • Complete Examination: The surgeon must perform the exam according to USCIS standards.
  • Sign and Seal: The civil surgeon must sign and seal the form. You also browse our Medical Feedback Form

What Happens at the Medical Exam for I-693?

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The USCIS medical exam includes a thorough check to ensure public safety and adherence to immigration laws.

  • Physical Examination: Assessment of overall physical health.
  • Vaccination Review: Verification against a Medical Certification Form to ensure all vaccinations are up to date.
  • Tuberculosis Test: Mandatory testing for TB.
  • Syphilis Test: Required for applicants aged 15 and older.
  • Mental Evaluation: Checks for signs of mental disorders that might affect public safety. You also browse our Medical Verification Form

What Happens After Submitting I-693?

After submitting Form I-693, the application undergoes several steps towards visa adjustment or green card issuance.

  • USCIS Review: The form is reviewed for completeness and accuracy. You also browse our Medical Order Form
  • Background Check: Conducted to ensure no public health concerns.
  • Adjudication: Decision on your green card application.
  • Notification: You will receive a notice about your application status.
  • Follow-Up: Possible request for additional information or clarification. You also browse our Medical Records Transfer Form

What to Bring to Immigration Medical Exam?

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Being prepared for the immigration medical exam expedites the process and avoids delays.

  • Government-Issued Photo ID: Such as a passport or driver’s license.
  • Vaccination Records: Based on the Medical History Form to verify previous vaccinations.
  • Medical Insurance Card: If applicable, though not mandatory.
  • Payment for the Exam: Confirm payment methods accepted by the civil surgeon.
  • Form I-693: Pre-filled with your information, if possible You also browse our Medical Power of Attorney Form

How Long Does a Green Card Medical Examination Take?

The duration of a green card medical examination varies but typically completes within a few hours.

  • Examination Time: Generally takes 1-2 hours depending on tests required. You also browse our Medical Expense Form
  • Lab Results: Waiting time for lab tests may extend the total duration.
  • Follow-Up Visits: Additional visits if further testing is needed.
  • Report Preparation: Time for the civil surgeon to complete and seal the form.
  • Scheduling: Availability of appointments can affect overall timeline. You also browse our Medical Physical Form

What is Next After Medical Exam Green Card?

Following the medical exam, the next steps involve USCIS processing the application towards final decision.

  • Document Submission: Ensure all required documents, including the Medical Release Form, are submitted.
  • USCIS Processing: Waiting for USCIS to process and review your application.
  • Interview: Potential interview requirement.
  • Approval Notification: Receive notice of your status adjustment.
  • Issuance of Green Card: Upon approval, the green card is issued. You also browse our Medical Records Release Form

What Documents are Needed for USCIS Medical Exam?

Proper documentation is critical for the USCIS medical exam to proceed smoothly.

  • Form I-693: To be filled by the civil surgeon.
  • Photo Identification: Passport or other government-issued ID.
  • Immunization Records: As per the Dental Medical Clearance Form requirements.
  • Medical Records: Any relevant medical documentation.
  • Payment: Civil surgeon’s fee for the exam. You also browse our Medical Renewal Form

Advantages of Medical Examination Form

  • The physical health condition of an individual can be traced You also browse our Medical Proposal Form
  • The individual can understand his present physical condition
  • Helps the organization in tracing the health conditions of their employees
  • Life-threatening diseases can be detected beforehand You also browse our Medical Complaint Form

Use and Purpose of a Medical Examination Form

The use and purpose of medical examination forms are to get the updated report on the overall health condition, detect any life threatening disease earlier and for the organizations to identify and keep a tab on the health conditions of their employees. You also browse our Medical Clearance Daycare

Online Availability of a Medical Examination Form

The medical examination form is now available both in the word format and PDF on our website. All the forms will serve various purposes of a different individual. The forms are available in customized size. Any person, who demands this particular form, can easily download it from the website and can edit it according to his or her wishes.  The template for this particular form has a huge demand in the market. The company believes that the forms that are available on the website will guide the people in successfully completing their work. It will be good if further suggestions based on our working comes from your side. You also browse our Medical Permission Form

How Long After I-693 to Get a Green Card?

The time between submitting your Form I-693 and receiving a green card can vary, typically extending several months to a year, depending on USCIS case backlogs and the specific details of your Medical Consent Form.

How Much Does the I-693 Exam Cost?

The I-693 medical examination costs can range from $200 to $500. Costs might increase if additional tests are needed, which could be detailed in a Medical Authorization Form provided by the clinic.

How Long is Form I-693 Good For?

Form I-693 remains valid for two years from the date the civil surgeon signs it, as outlined in the Medical Evaluation Form.

What Happens in I-693 Exam?

During the I-693 exam, a USCIS-approved civil surgeon will conduct a thorough physical examination, assess vaccination records, and perform tests for communicable diseases as specified by the Medical Information Release Form.

How Long Does It Take to Get Immigration Medical Exam Results?

Getting results from an immigration medical exam can take from a few days to two weeks, depending on lab processing times and the specifics detailed in your Medical Necessity Form.

Can I Eat Before Immigration Medical Exam?

Yes, you can eat before an immigration medical exam unless otherwise instructed by your healthcare provider, which would be noted in your Travel Medical Form if relevant for travel-related health checks.

Does My Insurance Cover a Green Card Medical Exam?

Typically, health insurance does not cover the cost of a green card medical exam as it is categorized as part of an immigration process, much like services outlined in a Medical Claim Form that are not usually covered by standard health insurance plans.

In conclusion, the use of a Medical Examination Form, especially a Health Examination Form, is essential for accurate record-keeping and assessment in medical settings. These forms facilitate comprehensive evaluations, ensure consistency in data collection, and support effective healthcare delivery. Proper utilization helps in maintaining detailed health records, contributing to improved patient care and medical outcomes.

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