Medical-Physical Statements $39
Scheduling Your Appointment
Complete your medical history survey below. It is designed specifically for childcare employees. A Nurse or Physician will review your answers.
Click 'Pay and Schedule Your Appointment."
*You are making a precautionary appointment in the event we need to call you.
*We will ONLY call if you list a medical condition on your medical history form.
*You will receive an email confirming if we need to call you during your appointment. Please check your emails.
*Your Medical Physical Statement or Health Evaluation form will be emailed after your appointment through our "SignNow" app.
Stop! You may not fill out this form for another person. More details on the next page once you click "Pay & Schedule Your Appointment."