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Employee Physical Form

Free employee physical exam form template for documenting a pre-employment or job-related medical fitness evaluation.

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This free employee physical form covers Purpose of Exam, Job Demands Reviewed, Determination, Physician Certification with 6 clearly marked [placeholder] fields to fill in — built for small business owners and first-time managers handling an HR moment professionally without a dedicated HR department to lean on. Copy it into your own word processor, fill in the placeholders, and review it — or adapt it — before use. It's part of docstoc's free document template library, alongside business, legal, real estate, finance, and HR templates. Every template here is free to copy with no signup required, and each one carries a plain disclaimer: this is a starting point for informational purposes, not a substitute for advice from a licensed professional in your jurisdiction.

Template — click to edit

Employee Physical Examination Form

Employee/Applicant: [Name] · Position: [Title] · Date of Exam: [Date] Examining Physician: [Name, Practice]

Purpose of Exam

[ ] Pre-employment (post-offer) [ ] Return-to-work [ ] Periodic/job-required (e.g. DOT)

Job Demands Reviewed

[Brief description of physical job demands the physician evaluated against — lifting requirements, standing/sitting, etc.]

Determination

[ ] Fit for duty without restriction [ ] Fit for duty with the following restrictions: [Describe] [ ] Not fit for duty at this time

Physician Certification

I certify that I have examined the above individual and the determination above reflects my professional medical judgment.

Physician signature: ______________________ Date: ____________ [License Number]

*This document is provided for informational and educational purposes only and does not constitute legal or medical advice. Under the ADA, a pre-employment physical can only be required AFTER a conditional job offer has been made, and only if required of all entering employees in the same job category — requiring one earlier in the process is a common compliance mistake.*

Edit directly in the box above. Download PDF anytime — the docstoc.io footer is always included and cannot be removed.

What's included

Edit online — click the document, fill in placeholders, download a PDF
4 standard sections: Purpose of Exam, Job Demands Reviewed, Determination, Physician Certification
6 clearly marked [placeholder] fields for quick personalizing
Free to use — no account or signup required
Fully editable — adjust any clause to match your actual situation
Includes a signature block, ready to print or sign digitally
Fixed docstoc.io footer on every PDF (not removable)

Who this template is for

Freelancers & solo founders

Handling routine business paperwork without commissioning custom legal drafting for every document.

Small businesses

Standardizing recurring documents — leases, agreements, notices — across a growing operation.

Anyone reviewing before signing

Using a clear starting structure to understand what a document should cover, even if a lawyer finalizes it.

Growing teams

Formalizing hiring and performance processes as a company adds its first employees.

FAQ

Is this employee physical form template really free?

Yes — this Employee Physical Form template on docstoc is free to view, edit online, and download as a PDF with no account or signup required.

What does this employee physical form cover?

This hr template includes Purpose of Exam, Job Demands Reviewed, Determination, Physician Certification. Fill in the [bracketed] placeholders, edit any clause online, then download a PDF — the docstoc.io footer stays on every export.

Is this legal advice?

No. Employment documents sit on top of a mix of federal, state, and sometimes city labor law — at-will employment rules, required notices, and what you can and can't put in writing all vary. Have an employment attorney or HR professional confirm this fits your jurisdiction before you use it.

Can I edit the wording?

Yes — edit directly on the page, adjust any section or clause, and re-fill the 6 placeholder fields to match your situation before downloading a PDF. It's a starting structure, not a rigid script.

Where can I find more free templates like this?

Browse more free hr and related document templates in the docstoc library at /document-templates/.

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