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Forms for UVa Academic Employees

Authorization for Treatment Form

Authorization for Release of Information Form

Other Forms

Medical History Form for Nonmedical Employees

Medical History Form for Medical Employees

CDL Medical Exam Form

Bus Driver Physical Form

OSHA Respiratory Medical Questionnaire

Last modified on: November 27, 2006

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UVA-WorkMed

P.O. Box 800357

Charlottesville, VA 22908

434-243-0075

fax: 434-243-0078

Maintained by Jon Schuch

© 2008 by the Rector and Visitors of the University of Virginia

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