THADDEUS STEVENS COLLEGE OF TECHNOLOGY
THADDEUS STEVENS COLLEGE OF TECHNOLOGY
Physical Exam
Student’s Name: Sex: Age: Date of Birth: ____/____/____
Physical Examination (to be completed by physician).
Height: __________ Weight: __________ Pulse: __________ BP_ __/_ __
FINDINGS NORMAL ABNORMAL FINDINGS
MEDICAL
1. Appearance
2. Eyes/Ears/Nose/Throat
3. Lymph Nodes
4. Heart
5. Pulses
6. Lungs
7. Abdomen
8. Skin
MUSCULOSKELETAL
9. Neck
10. Back
11. Shoulder/Arm
12. Elbow/Forearm
13. Wrist/Hand
14. Hip/Thigh
15. Knee
16. Leg/Ankle
17. Foot
ASSESSMENT OF EXAMINING PHYSICIAN
_____ Cleared without limitation.
_____ Cleared after completing evaluation/rehabilitation for:
_____ Not cleared for:
Recommendations:
Name of Physician (please print): Date:
Address:
Phone # Fax #:
Signature of Physician: Date:
................
................
In order to avoid copyright disputes, this page is only a partial summary.
To fulfill the demand for quickly locating and searching documents.
It is intelligent file search solution for home and business.
Related searches
- disadvantages of technology in education
- use of technology in schools
- importance of technology in business
- benefits of technology in education
- the use of technology in education
- benefits of technology in business
- importance of technology in workplace
- ethics of technology of philosophy
- use of technology in education
- the philosophy of technology pdf
- effects of technology in education
- thaddeus stevens college of technology