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Form EHS-769 Preplacement Physical Examination Request - New York
What Is Form EHS-769?
This is a legal form that was released by the New York State Department of Civil Service - a government authority operating within New York. As of today, no separate filing guidelines for the form are provided by the issuing department.
FAQ
Q: What is Form EHS-769?
A: Form EHS-769 is the Preplacement Physical Examination Request form.
Q: What is the purpose of Form EHS-769?
A: The purpose of Form EHS-769 is to request a preplacement physical examination in New York.
Q: Who needs to fill out Form EHS-769?
A: Employers in New York who require employees to undergo a preplacement physical examination need to fill out this form.
Q: Is Form EHS-769 mandatory?
A: Yes, employers in New York are required to use Form EHS-769 when requesting a preplacement physical examination for their employees.
Q: What information is required on Form EHS-769?
A: Form EHS-769 requires information such as the employee's name, date of birth, job title, and the reason for the preplacement physical examination.
Q: Who should I contact if I have questions about Form EHS-769?
A: If you have questions about Form EHS-769, you should contact your employer or the New York State Department of Health.
Form Details:
- Released on April 1, 2014;
- The latest edition provided by the New York State Department of Civil Service;
- Easy to use and ready to print;
- Quick to customize;
- Compatible with most PDF-viewing applications;
- Fill out the form in our online filing application.
Download a fillable version of Form EHS-769 by clicking the link below or browse more documents and templates provided by the New York State Department of Civil Service.
