Chicago Public Schools Employee Physical Examination Form
This form is required for employment with Chicago Public Schools and assesses the physical health of applicants. All candidates must complete a tuberculosis screening and provide medical information from their physician. Ensure all sections are filled accurately to facilitate a smooth employment process.
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How do I fill this out?
To fill out this form, begin by entering your personal information in the required fields. Next, provide details regarding your physical examination and any relevant medical history. Finally, ensure that your physician completes the necessary sections related to your health assessment.
How to fill out the Chicago Public Schools Employee Physical Examination Form?
1
Gather personal information such as your name and contact details.
2
Complete the health history section honestly and accurately.
3
Have your physician fill out and sign the examination details.
4
Submit the form along with any required documents, like TB test results.
5
Ensure all fields are filled before submission.
Who needs the Chicago Public Schools Employee Physical Examination Form?
1
Job applicants at Chicago Public Schools need to submit this form to verify their health status.
2
New employees must have this assessment completed to meet employment requirements.
3
Current employees undergoing health evaluations for job retention will utilize this form.
4
Temporary staff may also be required to provide this examination for a clean health record.
5
School volunteers might need to submit this form to ensure compliance with health regulations.
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What are the instructions for submitting this form?
To submit the completed Employee Physical Examination Form, please send it via email to healthservices@cps.edu, or fax it to 773-553-1181. You may also submit the form at the Employee Health Services office located at 125 South Clark Street, Chicago, IL 60603. It is advisable to retain a copy of the submitted form for your records.
What are the important dates for this form in 2024 and 2025?
Important dates for the CPS Physical Examination Form in 2024 include the requirement for TB tests to be completed within 90 days prior to employment. For 2025, ensure that physical examinations are conducted in a timely manner to align with the employment start dates. Always check for new updates regarding form requirements annually.
What is the purpose of this form?
The purpose of the Employee Physical Examination Form is to ensure that all candidates for Chicago Public Schools employment are in good health and free from communicable diseases, particularly tuberculosis. This form serves as a critical document to assess the physical fitness of job applicants and ensure they meet the health standards set by the Illinois School Code. Additionally, the physician's assessment is crucial in determining the candidate's ability to perform essential job functions.
Tell me about this form and its components and fields line-by-line.
- 1. Personal Information: Includes fields for employee name, address, email, and phone number.
- 2. Health History: Requires detailed health history and identification of any allergies.
- 3. Physical Examination: Sections for physician's assessment including vital statistics and test results.
- 4. TB Screening: Specific requirements for tuberculosis testing, including dates of tests.
- 5. Signature: Signature fields for both the applicant and examining physician.
What happens if I fail to submit this form?
Failure to submit this form may result in the inability to process your employment application. It is essential for meeting health standards, and not submitting could delay your hiring process. You may also miss critical deadlines for job onboarding.
- Delayed Employment: Without this form, your application may not progress.
- Compliance Issues: Not meeting health requirements could lead to withdrawal of job offer.
- Inability to Start Work: You may be unable to begin working without submitted health documentation.
How do I know when to use this form?
- 1. Initial Employment Application: Required for all new candidates applying for jobs.
- 2. Annual Health Assessment: Utilized by current employees to confirm ongoing health compliance.
- 3. Volunteer Opportunities: Needed for individuals wishing to volunteer in schools.
Frequently Asked Question
How do I fill out the CPS Physical Examination Form?
Start by entering your personal information, then complete the medical history and examination details.
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Is it possible to download the PDF after editing?
Absolutely! After you've made your edits, you can download the updated file.
How do I share the PDF once I've filled it out?
You can share the PDF via email or social media using the sharing options provided.
What if I forgot to sign the form?
You can sign the PDF by clicking on the signature field before downloading.
Are there any requirements for the physical examination?
Yes, the examination must be performed by a licensed physician.
Do I need to provide my TB test results with the form?
Yes, TB test results must be included and should be from within the past 90 days.
What if I have allergies?
You should indicate any allergies in the relevant section of the form.
How will I know if my form was submitted successfully?
You'll receive a confirmation once your form has been submitted and processed.
Can I print the form directly from PrintFriendly?
Yes, you can print the document directly after editing.
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