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How do I fill this out?

To fill out this form, start by ensuring you have the correct medical documents ready. Carefully complete each section with accurate personal information. Review and sign the certification section before submission.

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How to fill out the Medical and Tuberculosis Clearance Procedures?

  1. 1

    Gather all necessary medical documents.

  2. 2

    Complete the personal information section accurately.

  3. 3

    Sign the certificate of medical examination.

  4. 4

    Ensure all forms are in an envelope from the medical facility.

  5. 5

    Submit the sealed envelope in person to Employee Health Services.

Who needs the Medical and Tuberculosis Clearance Procedures?

  1. 1

    New certificated teachers requiring employment verification.

  2. 2

    Substitute teachers needing medical clearance.

  3. 3

    District interns undergoing pre-employment health checks.

  4. 4

    Staff in early education settings needing specific qualifications.

  5. 5

    Individuals applying for adult education positions needing health assessments.

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How do I edit the Medical and Tuberculosis Clearance Procedures online?

Editing this PDF is simple with PrintFriendly. You can make necessary adjustments to your medical details and personal information with ease. Utilize the editing tools to ensure the form meets your requirements.

  1. 1

    Open the PDF in PrintFriendly.

  2. 2

    Select the text you want to modify.

  3. 3

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  4. 4

    Review the edits for accuracy.

  5. 5

    Download the edited PDF to your device.

What are the instructions for submitting this form?

Submit this form, including all required medical documents, in a sealed envelope to: Employee Health Services, 333 S. Beaudry Ave., 14th Floor, Room 110, Los Angeles, CA 90017. Make sure the envelope has a stamp from the medical facility to verify its authenticity. Utilize the provided contact details for any inquiries regarding submission.

What are the important dates for this form in 2024 and 2025?

Key important dates for the forms are as follows: Ensure all medical clearances are completed prior to employment starting date. Tuberculosis tests need to be done within 60 days of the hire date, and medical examinations should be conducted within six months prior.

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What is the purpose of this form?

The purpose of this form is to ensure that new certificated employees meet the health and safety standards required by the Los Angeles Unified School District. It safeguards the well-being of both employees and students. Compliance with these health requirements is essential for employment eligibility.

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Tell me about this form and its components and fields line-by-line.

The form includes various components that capture necessary personal and medical details.
fields
  • 1. Personal Information: Includes name, address, contact details, and employee number.
  • 2. Tuberculosis Clearance: Confirms tuberculosis status and includes required medical examinations.
  • 3. Medical Examination Certification: Signed certification from a licensed health care provider.
  • 4. Acknowledgment: Declaration stating accuracy of provided information.

What happens if I fail to submit this form?

Failure to submit this form may result in delays in your employment process and could lead to withdrawal of your job offer. It is crucial to provide accurate and timely health information to meet the district's requirements.

  • Delayed Employment: Not submitting the form on time could postpone your start date.
  • Job Offer Withdrawal: Incomplete or inaccurate submissions may lead to withdrawal of employment offers.
  • Health Risks: Ensuring proper medical clearance helps mitigate health risks to students and staff.

How do I know when to use this form?

This form should be used prior to commencing any certificated position within the Los Angeles Unified School District. It is applicable to new hires who need to demonstrate medical fitness for employment. Any individual working with students must complete this to ensure compliance with health regulations.
fields
  • 1. New Certificated Employee: Use this form to submit health information as a new hire.
  • 2. Substitute Teacher: Required for substitute teachers with prospective assignments.
  • 3. Teaching Intern: Necessary for interns aiming for certification and employment.
  • 4. Adult Education Instructor: Needed for educators in adult learning environments.
  • 5. Early Education Staff: Required for those working in early childhood settings.

Frequently Asked Question

How do I access this medical clearance form?

You can download the medical clearance form directly through the PrintFriendly website.

What documents are needed to fill out the form?

You will need your personal identification and medical examination results to complete the form.

Can I edit the form after downloading?

Yes, PrintFriendly allows you to edit the PDF before downloading.

Do I need to print the form after editing?

You can download the form as a PDF and print it later if needed.

Is there a deadline for submitting this form?

Yes, the form should be submitted before your scheduled employment date.

Who should I contact for help with this form?

For assistance, you can contact Employee Health Services.

Is the form available in other languages?

Currently, the form is only available in English.

What happens if I submit the form late?

Late submission may delay your employment processing.

Can I save my information on PrintFriendly?

You can edit and download PDFs but not save them on the site.

What if I make a mistake on the form?

You can easily edit the form again before final download.

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Medical and Tuberculosis Clearance Procedures

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