FREE 10+ Sample Medical Clearance Forms in MS Word | PDF

Medical clearances have different purposes, but they are generally used to assess a patient that needs to be cleared either for purposes of surgery after careful evaluation of his or her own condition or for an employee to return to work after physical examination being conducted by health care experts at the request of the employer. These can also be used on athletes who have been injured while playing and need a clearance to go back to play after being physically evaluated.

Our Sample Forms for medical clearances have different examples for uses on surgery clearance or for employees who are assessed to return to work. We also have clearance examples for athletes that need physical evaluation before they can go back to playing. These forms can be downloaded and used immediately after printing.

Sample Medical Clearance Request Form

Medical Clearance Form for Surgery

Medical Clearance Return Form in PDF

Student Medical Clearance Form Example

Pre-Surgical Medical Clearance Form

Our medical clearance forms for return to work have spaces that need to be filled by a health care professional as necessary conditions before an employee can return to work.

If an employee has been off work for several weeks or months for serious injury sustained either at the workplace or through an accident, having a medical clearance to return to work after recuperation doesn’t necessarily mean the employee is totally fit for work. That’s why it’s very important for medical clearances to be detailed as much as possible. As seen in our examples, there are several questions that a health care professional should fill up and answer as much as he or she can to to prevent a general clearance without specifics on the details of the injury and what is being done to address the full recovery of the injured employee.

For more examples, please check out more from our website or click on the link for more Sample Medical Forms and CDL Medical Forms for those who need to download and print these. These are all available in both Word Doc and PDF files.

Physician Medical Clearance Form

Medical Clearance Form Example

Medical Clearance and Permission Form

Volunteer Medical Clearance Form

Medical Clearance Report Form

Medical Clearance Form Sample

For athletes who compete professionally or in school athletic programs, we also have forms that can be used to either act as guides on a standardized platform that can be immediately filled up by health care professionals.

In most cases, when trying out or participating in varsity sports, every student must be able to complete a required medical review, otherwise he may be disallowed from playing. In professional sports, the guidelines are more strictly enforced considering owner companies are paying players big salaries. Injuries are an accepted risk in sports, and for any athlete to be injured and recover enough to go to work, he must be able to undergo the whole process of being evaluated, assessed, and reviewed before being diagnosed as medically fit to go back to playing.

For companies who need to draft their own forms, please check out our Return to Work Medical Forms for employees who need to be medically cleared for work. These can all be downloaded and printed for immediate use or act as drafts for each company’s specifications.