bluehive.com/services/fitness-for-duty-evaluation/prepare
Lista de Preparación
Marque cada elemento mientras se prepara para su cita.
Qué Llevar
5 elementosCómo Prepararse
2 elementosGeneral
1 elementoQué Esperar
Esto es lo que sucederá durante su visita.
Request Evaluation
Employer requests FFD evaluation with job description and specific concerns.
Schedule Assessment
Employee is scheduled with a qualified evaluating physician.
Complete Evaluation
Physician conducts comprehensive evaluation based on job requirements.
Receive Determination
Employer receives fitness determination and any recommended restrictions or accommodations.
¿Necesita Ayuda?
¿Tiene problemas para encontrar la clínica o tiene preguntas sobre su cita? Nuestro equipo de soporte está aquí para ayudar.
Scan for digital version
Formularios típicamente usados durante una visita de Fitness for Duty Evaluation
BlueHive no completa los formularios — los proveedores lo hacen. Estos son los formularios oficiales que un proveedor puede usar durante esta visita, para que sepa qué esperar.
- USCG MarinerCG-719K
Application for Merchant Mariner Medical Certificate
CG-719K is the medical evaluation form a licensed practitioner completes for any mariner applying for or renewing a Merchant Mariner Credential (MMC) or Medical Certificate. The National Maritime Center reviews submissions and issues the certificate.
View form details - Workers’ Comp
Physician's Report
Physician's Report — state-prescribed clinician report used by the state workers’ comp agency.
View form details - Workers’ CompICA Form 102
Worker's and Physician's Report of Injury
Worker's and Physician's Report of Injury (ICA Form 102) — state-prescribed clinician report used by the state workers’ comp agency.
View form details