15 Medical Report Forms

There are different kinds of medical forms and circumstances that we are most likely to encounter in our daily lives. Such circumstances are the dilemmas that undeniably affect our health, both physically and mentally. And these make us have a hard time in keeping up with our family, friends, work, and even with ourselves. Our relationship with other people are also affected due to the fact that our health have some complications. Therefore, in ensuring the safety and security of each and every one, it is essential for an individual to undergo a medical examination once in a while.

Medical exams are not just for those who are employed in a company or an establishment but also the individual people or each member in a family. These would ensure that everyone is healthy and is not susceptible to any diseases, most especially those contagious ones. In presenting the medical results, medical report forms are utilized to show the summary or the overall findings of one’s health conditions. These forms are used as the basis to determine what are the complications discovered and how these should be treated or medicated. By undergoing various of medical tests or physical examinations, health is ensured by uncovering those latent issues with regards to the health of an individual. These forms are also used to report the uncovered diseases in order to treat them as soon as possible.

This is done in order to avoid the transmission of any airborne or other diseases. Technically, medical reports are generated not just for the employee’s welfare but also for the business, the management, and the public or outside the establishment’s. Further on this article are sample forms for medical reports that you may find helpful. In addition, the use of medical report forms, the essential parts of it, and few ways or tips for a healthy life are also provided and explained to you. Take time to browse each report forms and distinguish the differences of each as you gain a full understanding on what these report forms are pertained to, and how these are utilized.

Standard Medical Report Form

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Size: 125 KB

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Basic Medical Report Form

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  • PDF

Size: 44 KB

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Requirement Medical Report Form

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  • PDF

Size: 109 KB

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Confidential Medical Report Form

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  • PDF

Size: 503 KB

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Medical Functional Report Form

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  • PDF

Size: 162 KB

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The Use of Medical Report Forms

These forms for medical reports play a vital role most especially in presenting confidential health information of an individual. These reports also serve as an assessment to see if the company prioritizes the health and safety of their employees and whether proper occupation health is impartially given to each and everyone in the workforce. Such medical assessment is to see whether the company or the establishment conducts a regular appraisal with regards to the sanitation system or process in the workplace. These also assess whether there are assigned or designated authorized people for each of the position in charge of handling healthcare medications and treatments.

Some medical reports are used to identify and indicate what are the hazards or the possible threats that can be found in the workplace. This is done in order for everyone to be aware on what are most likely to occur if safety precautions are not observed and practiced before, during, and after the business operation or working hours. These hazards that would affect the physical and mental health of an employee are classified as the following:

Chemical Hazards

These are pertained to dusts, liquids, mists or fumes, gases, and other chemicals that could affect one’s health. These chemicals might cause irritation to the skin such as rashes, burns, itch, etc. These could also be inhaled which could affect the brain and other internal organs.

Physical Hazards

These kinds of hazards are pertained to noise, temperature, pressure, illumination, radiation, vibration, and other physical hazards that could affect one’s health. These could cause hypertension, hearing loss, tinnitus, and other effects that are harmful to one’s health condition.

Biological Hazards

These are those viral, bacterial, fungal, parasitic, and all other hazards that affect the person biologically. These result to infectious diseases that are caused or transmitted by those living microorganisms.

Ergonomic Stress

These are with regards to exhausting, prolonged standing, low back pain, unfavorable work posture, static or monotonous work, and others that causes discomfort to one’s comportment. These could cause fatigue, stress, languor in one’s ergonomic or comfort in the working environment.

These hazards could also be determined with the use of hazard report forms. And other possible threats that are most likely to be present in the company, at home or just about anywhere you go could also be identified with the use of safety risk assessment forms. These assessment forms help you understand the nature of each hazards that are identified, thus, helping you and your team or family to formulate or come up with different actions or solutions in order to eliminate these. But in most cases that these hazards cannot be eliminated, you will at least have some ideas on how to reduce the risks that each of which contains. The sooner that these hazards are treated accordingly, the lesser chances that these could get worse and affect other people.

Student Medical Report Form

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Size: 477 KB

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Children Medical Report Form

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  • PDF

Size: 11 KB

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Employment Medical Report Form

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  • PDF

Size: 369 KB

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Medical Report Form for Driving

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  • PDF

Size: 366 KB

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Driving License Medical Report

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  • PDF

Size: 134 KB

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Medical Examination Report Form

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  • PDF

Size: 30 KB

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Student Medical Examination Report

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  • PDF

Size: 143 KB

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Specified Blank Medical Report

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Size: 262 KB

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The Essential Parts of Medical Report Form

The process for generating or producing a medical report is not completed if there are some essential information that are insufficient or missing. Thus, provisions of these following list of information are significant in order to complete the analysis report.

  • The medical report form basic or general information
    • The date and time of when the report is completed
    • The validity date of the medical report (from and up to when)
    • The person completed the medical report
  • The employee, patient, applicant or the student’s information or personal particulars
    • The full name
    • The nationality
    • The civil status
    • The gender or sex
    • The date of birth
    • The residential address
    • The social security number
    • The national insurance number
  • The undergone medical assessment or examination information
    • The date/s and time/s of the examination/s and interview/s
    • The place of where the examination has taken place
    • The physical examination results
    • The type/s of medical lab tests
    • The results from the lab tests undergone or the list of diagnosis
    • The medical evidences such as lab reports from the medical tests
    • The type/s of medications or treatments prescribed by the doctor or medical practitioner
    • The reasons why such medications are needed
    • The side effects during the medication
    • The additional information from the further consultation and medical investigation
  • The declaration of employee or student that all information provided are true
    • The full name
    • The affixed signature
    • The date of when signed
  • The confirmation or medical verification of medical practitioner that all tests are done accordingly
    • The name of the medical practitioner
    • The signature and the date signed
    • The telephone or contact number
    • The authorized person who verified the form
    • The signature and the date verified
    • The contact information (address and contact number)
    • The official stamp and address

Here are some additional information that are also essential:

  • The person’s past history record of medical information. This is asked in order for the healthcare personnel to know what are the past health complications that have something to do with the present or current health condition of the person. Thus, the relevant or significant medical history that is related to the current state of health condition will be uncovered.
  • The health information or medical background of the family. This information is also needed in order to have further analysis on why such results from medical examinations are derived. Thus, knowing the family health background could help determine whether the complications with regards to health are inborn or hereditary. Yet, the medical release of these confidential information are needed to be approved by the owner/s.
  • The identification verification of the medical practitioner is also important in order to know if he or she is authorized to perform such medications or treatments to the patient or person.

Practitioner’s Medical Report Form

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Size: 273 KB

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In reference to the form above, this form is a medical report form of a medical practitioner who examines the individual employee’s health condition. Technically, this form is used to indicate the list of employees who were examined and were diagnosed with some health defects. Opposite to their names are the details of the diagnosed disorder or disability. In addition, the medication/s or the treatment/s prescribed or recommended is or are also indicated.

When all details are completed, the confirmation that all information are true, correct, and precise is needed. Therefore, the examining doctor or the practitioner affixes his or her signature verification, together with an official stamp and the address of the hospital or medical center. Take time to examine how the form is layered and organized.

Annual Medical Report Form

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Size: 20 KB

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The form above shows the annual medical report of an establishment. This focuses on the medical examinations conducted and findings that were found or diagnosed from each of the employees. This form is based on the number of people who were examined and were diagnosed with the different kinds of diseases or illness. This report shows a summary of how many are diagnosed with the same disorder, disability, or disease. In this way, the management and healthcare personnel will be able to determine what diseases are prone within the period of time.

Referring to the form above, this report form also serves as an assessment of the company or the establishment. This is with regards to their practice of health and safety precautions, and provision of medical clinic with complete facilities and medicine kit/s. This also assesses whether the establishment conducts some health and immunization programs for their employees. The form is used to see whether there are occupational health practitioner/s, physician/s, dentist/s, and nurse/s assigned who are available when circumstances or incidents occur.

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