Healthcare Documents
Medical Forms
Medical Enrollment Form for Active Employees
This document is the Medical Enrollment Form for active employees of Ball State University. It includes sections for employee information, coverage levels, dependent information, and authorization. Please ensure all required fields are filled out and submit to Payroll and Employee Benefits.
Medical Forms
Lutheran CORE Donation Form for Biblical Advocacy
This file is a donation form for Lutheran CORE. It allows supporters to contribute to the advocacy of Biblical authority and network support. Key information such as name, address, and prayer requests are required.
Medical Forms
Limerick City and County Council Housing Application Form
This file is an application form for council housing provided by Limerick City and County Council. It includes information on applicant details, nationality status, other property information, and social welfare status. The form is required to assess eligibility for housing support.
Medical Forms
Application to Transfer Grave Ownership Form
This form is used to transfer grave ownership via probate or letters of administration when the last grave owner has died. It includes sections for grave details, deceased owner details, and new owner details. Executors or administrators must fill out and sign the form, which must be submitted with an embossed copy of probate or letters of administration.
Medical Forms
NYS Fleet Management System User Request Form
This file is essential for New York State agency fleet coordinators. It facilitates user access requests to the NYS Fleet Management System. The form includes sections for user information, OGS account creation, and authorizer details.
Medical Forms
International Prostate Symptom Score (IPSS) Assessment Guide
The International Prostate Symptom Score (IPSS) is a questionnaire used to screen for and assess the severity of symptoms related to benign prostatic hyperplasia (BPH). This document helps evaluate symptoms such as incomplete emptying, frequency, intermittency, urgency, weak stream, straining, and sleeping disruptions. Use this file to accurately determine symptom severity and discuss treatment options with your healthcare provider.
Medical Forms
Employee Performance Evaluation Form - Objective and Fair Assessments
This Employee Performance Evaluation form provides a standardized method for evaluating employee performance, identifying strengths and weaknesses, and making recommendations for job classification and compensation improvements. It includes criteria for various personal traits associated with job success or failure. This form ensures thorough and fair employee evaluations.
Medical Forms
Plant and Plant Product Declaration Form (PPQ Form 505)
The Plant and Plant Product Declaration Form (PPQ Form 505) is required for importers to document the importing of plant and plant products into the United States. This form ensures compliance with the Lacey Act requirements and helps in tracking the origin and composition of imported merchandise. The form includes sections on shipment information, compliance with legal requirements, and instructions for proper completion.
Medical Forms
Preparticipation Physical Evaluation Form
This file is used for the preparticipation physical evaluation of athletes. It includes medical history and physical examination components. It should be filled out by the athlete and a healthcare provider.
Medical Forms
Form 1099-MISC for Miscellaneous Income (2023)
Form 1099-MISC is used to report miscellaneous income such as rent, royalties, prizes, and other payments. The official IRS form is scannable and required for submission. Get the detailed instructions and requirements for filling out this form here.
Medical Forms
Minnesota CDL Medical Self-Certification Form
This form is for all commercial driver's license (CDL) holders in Minnesota. It includes instructions for completing and submitting the self-certification form and medical examiner's certificate. It also contains a Tennessen Warning as required by state law.
Medical Forms
Family Medical History Tree Form
This file provides a template and instructions to create a family medical history tree. Use it to track your family's health history across generations. It includes a sample tree and a blank template for your use.