Turn your PDF into an API-fillable template in seconds. No signup required.
Try it now
Turn your PDF into an
API-fillable template in
seconds
Upload any PDF to see Anvil's Document AI in action. No signup required.
Products
Workflows
Automate complex document processes
Etch E-sign
Embed white-labeled e-signatures
PDF Services
Fill PDFs with collected or stored data
Webforms
Collect data with mobile-friendly webforms
Document AI
Faster way to build workflows
Document SDK
All you need to automate documents
Industries
Insurance
Rate, quote, and bind faster
Human resources
Automate onboarding documents
Real estate
Secure workflows for buying, selling, renting
Healthcare
Launch HIPAA compliant document workflows
Finance
Automate documents for financial products
Case studies
Learn how businesses have grown with Anvil
Resources
Form library
Ship faster with pre-made form templates
Blog
New features, industry news, customer stories
Help center
Step-by-step guides for using Anvil
Product updates
New features & app improvements
PDF Costs Calculator
Calculate your company's document costs
Features
Overview of all Anvil features
Developers
Get started
A quick introduction to building with Anvil
Documentation
Learn how to build Anvil into your product
API reference
GraphQL types, queries, & more
Open source
Pre-written clients to simplify development
Engineering blog
Technical topics, how-tos, & more
Pricing
Try it free
Get a demo
Products
Industries
Resources
Developers
Pricing
Login
Try it free
Recreation Insurance Form
One API call is all it takes. Free to use.
Fill it over API
Download fillable PDF
AI-generated
4.8 Stars
Insurance form for participants in the Hammonton Recreation Program, covering medical liability and insurance information.
Fill over API
Get it e-signed
Build document flow
Fill out your PDF over API
Send JSON, fill PDF
. It's that simple.
Fast and scalable PDF filling.
Quick
AI-assisted
template setup.
Get started for free
Get your PDF filled and signed
Request e-signatures over
API
.
Save time (& sanity) with
Document AI
.
Style
&
embed
e-sign into your application.
Get started for free
Automate your document flows
Generate
production-ready Webforms
from PDFs in seconds.
Collect reusable, structured data.
Customize document workflows without code.
Get started for free
See other insurance forms
Explore other production-ready form templates
here
.
Assumption Of Risk U.S. National Whitewater Center Activities
PDF template
Legal document outlining participant risks and liability assumptions for outdoor activities at the U.S. National Whitewater Center.
See template
See template
Master Services Agreement
PDF template
A master agreement between Chartis International and MMR Information Systems for providing electronic medical record storage services to insurance customers.
See template
See template
VSP Materials Invoice
PDF template
Detailed instructions for completing and submitting a VSP Materials Invoice for optical services and reimbursement.
See template
See template
NMHU Athletics Handbook
PDF template
A comprehensive guide detailing policies, procedures, and organizational structure for the athletic department at New Mexico Highlands University.
See template
See template
Medical Inquiry Form In Response To An Accommodation Request
PDF template
A medical form to help determine if an employee has a disability and qualifies for reasonable accommodation under the ADA.
See template
See template
Authorization For Disclosure Of Medical Or Dental Information
PDF template
A form that provides authorization for the release of an individual's protected health information to specified parties for various purposes.
See template
See template
High School Athletics Participation Permission Form
PDF template
A consent form for students to participate in interscholastic athletics, acknowledging potential risks and medical information sharing.
See template
See template
McVeigh V. UnumProvident Corporation And Provident Life Accident Insurance Company
PDF template
A federal court order addressing diversity jurisdiction in a disability benefits lawsuit filed by Michael C. McVeigh against insurance companies.
See template
See template
US Judo Hall Of Fame Nomination Form
PDF template
Official form for nominating candidates to the US Judo Hall of Fame across various contribution categories.
See template
See template
NO SURPRISE BILLING PROTECTION FORM
PDF template
A document explaining patient protections from unexpected medical bills and out-of-network care costs, with options to waive those protections.
See template
See template
Mutual Of Omaha Claim Form Fill Able
PDF template
A detailed claim form for reporting accidents and injuries for insurance purposes.
See template
See template
SurgicalAdmission Booking Form
PDF template
A comprehensive form for scheduling surgical procedures, collecting patient demographics, and capturing medical procedure details.
See template
See template
SurgicalAdmission Booking Form
PDF template
Medical form for scheduling surgical procedures and capturing patient and procedure details for hospital admission.
See template
See template
Loss Claim Form
PDF template
Guide for fish harvesters and processors to claim compensation for gear and vessel damage or oil spills related to the Hebron project.
See template
See template
Diving Medical History Form
PDF template
Comprehensive medical screening form for diving applicants to assess physical and mental fitness for diving activities.
See template
See template
Injury Or Accident Report Form (Model Form)
PDF template
A comprehensive form for documenting child injuries, including details about the incident, location, type of injury, and medical treatment.
See template
See template
Chapter 100 Sales Of Cemetery Merchandise, Funeral Merchandise And Funeral Services
PDF template
Administrative rules defining regulations for sales of cemetery and funeral merchandise and services in Iowa.
See template
See template
Sales Of Cemetery Merchandise, Funeral Merchandise And Funeral Services Rules
PDF template
Regulatory rules implementing Iowa Code chapter 523A for the sale of cemetery, funeral merchandise, and services.
See template
See template
DFC Discharge Form
PDF template
A comprehensive medical discharge form documenting client's final medical status, assessment details, and follow-up planning.
See template
See template
Recreational Trails Program Reimbursement Request Guide
PDF template
Guide for submitting reimbursement requests for the Virginia Department of Conservation and Recreation's Recreational Trails Program.
See template
See template
Required NYS School Health Examination Form
PDF template
New York State mandated health examination form for students, documenting medical history and physical health status.
See template
See template
Required NYS School Health Examination Form
PDF template
Comprehensive health examination form for students in New York State, documenting medical history, physical examination, and health status
See template
See template
Driver Monitoring And Contract Amendment
PDF template
Documents related to driver record monitoring services and a contract amendment for Mason County's health services.
See template
See template
United States Court Of Appeals For The Third Circuit Stone Webster Case
PDF template
Appellate court opinion involving a legal dispute between Saudi American Bank, Shaw Group, and Stone & Webster related to bankruptcy and liability
See template
See template
Policy Loan Agreement Form
PDF template
A comprehensive form for requesting a loan against a life insurance policy with personal and banking details collection
See template
See template
Initial Disability Claim Form
PDF template
A comprehensive form for filing an initial disability insurance claim, collecting patient and policyholder information, and documenting disability details.
See template
See template
Travel Expense Reimbursement Form
PDF template
A form for documenting and calculating travel-related expenses for an employee attending a professional conference.
See template
See template
Amicus Curiae Brief Auto Owners Insurance Company V. Pozzi Window Company
PDF template
Amicus curiae brief filed by construction industry associations in support of Pozzi Window Company in an insurance coverage dispute
See template
See template
AP Program Block Submission Form
PDF template
A form for healthcare facilities to submit tissue blocks for pathology program analysis and testing.
See template
See template
Grand Athletics Travel Form
PDF template
A consent form for parents to authorize alternative transportation for student athletes during sports events.
See template
See template
Jansen Volunteer Application Form
PDF template
A comprehensive application form for individuals interested in becoming volunteers with Jansen Hospice and Palliative Care program.
See template
See template
Livestock Risk Protection (LRP) Handbook
PDF template
Comprehensive guide for livestock risk protection insurance application and claims process for agricultural producers.
See template
See template
Purchase Authorization And Invoice Form 312 For Disability Medical Examinations And Laboratory Work
PDF template
Guidelines for local social services departments to complete form DHR/FIA 312 for medical examinations and laboratory work for disability assistance programs.
See template
See template
Parental Consent Form
PDF template
A form that parents or legal guardians must sign to allow children under 21 to participate in activities hosted by Alpha Phi Alpha Fraternity, Inc.
See template
See template
Direct Reimbursement Claim Form
PDF template
A form for submitting vision care reimbursement claims for out-of-network services and eyewear expenses
See template
See template
Student Medical Release Form
PDF template
Medical authorization form for student ministry activities allowing medical treatment and liability release for minors.
See template
See template
HEALTH CENTER MEDICAL HISTORY FORM
PDF template
Comprehensive medical history form for collecting personal health information, emergency contacts, and current medical status for students.
See template
See template
Emergency Medical Release Form
PDF template
A comprehensive medical information form used to collect personal health details and emergency contact information.
See template
See template
ParentGuardian Consent Form
PDF template
A comprehensive consent form for parents or guardians to authorize a child's participation in church activities and medical treatment.
See template
See template
Prescription Drug Reimbursement Form
PDF template
A form for members to request reimbursement for prescription medication expenses through their health plan.
See template
See template
LWC WC 1025.EE Employee Certificate Of Compliance
PDF template
A legal document detailing employee obligations and restrictions while receiving workers' compensation benefits.
See template
See template
Employer Certificate Of Compliance
PDF template
A mandatory certification form for employers to verify compliance with Louisiana workers' compensation insurance requirements.
See template
See template
STATE COMPENSATION INSURANCE FUND CORPORATION WAIVER FORM
PDF template
A form for corporate officers/directors to elect exclusion from workers' compensation insurance coverage under specific California legal conditions.
See template
See template
KK Incident Report
PDF template
A comprehensive form for documenting accidents, injuries, or property damage during events or activities.
See template
See template
Diver Medical Participant Questionnaire
PDF template
A medical screening questionnaire for recreational scuba and freediving participants to assess potential health risks and fitness for diving.
See template
See template
MH 602 (072024) Authorization For Use Or Disclosure Of Protected Health Information
PDF template
A form authorizing the release of protected health information by the Los Angeles County Department of Mental Health.
See template
See template
MetLife Disability Insurance Absence Reporting Guide
PDF template
Comprehensive guide for reporting disability and medical leave claims through MetLife, including FMLA and other absence types.
See template
See template
Proposal Form Export Insurance Policy (EXIP)
PDF template
A form for applying for export insurance cover for single or multiple export contracts with specific eligibility requirements and compliance guidelines.
See template
See template
ARIASU.S. 2017 Spring Conference Request For Proposals Submission Guidelines And Application
PDF template
Request for proposal guidelines for the ARIASU.S. 2017 Spring Conference seeking presentations on insurance and reinsurance industry topics.
See template
See template
Volunteer Application Form (Coaching)
PDF template
Application form for individuals interested in volunteering as coaches with the Bartlett Park District sports leagues
See template
See template
PADI Freediver Medical History Form
PDF template
A medical screening form for participants to assess their fitness for freediving activities by identifying potential health risks.
See template
See template
Student Health Questionnaire Form
PDF template
Instructions and forms for health screening, immunizations, and drug testing for students entering healthcare clinical rotations.
See template
See template
10 Day Agreement Review Cancellation
PDF template
A form for subscribers to request cancellation of a health insurance policy within 10 days of coverage effective date.
See template
See template
MSMUJTC Inquiry Form Onsite Program
PDF template
Comprehensive form for prospective students to provide academic, personal, and professional background information for an onsite educational program.
See template
See template
CONFIDENTIAL EMERGENCY MEDICAL FORM
PDF template
A comprehensive medical form for capturing personal health details, emergency contacts, and critical medical information for emergency situations.
See template
See template
PAYMENT INSURANCE FORM NFCA SURF CITY SHOWCASE RECRUITING CAMP
PDF template
Registration and payment form for athletes interested in participating in a sports recruiting camp, with payment and medical information collection.
See template
See template
CONFIDENTIAL MEDICAL HISTORY
PDF template
Comprehensive medical history form for patients to provide detailed health information to a healthcare provider.
See template
See template
Ross On Wye Photographic Society Competition Entry Form
PDF template
Official entry form for submitting photographs to a local photographic society competition with rules for submission.
See template
See template
Ross On Wye Photographic Society Competition Entry Form
PDF template
Entry form for submitting photographic competition entries with rules and submission guidelines.
See template
See template
Section 1115 Demonstration Proposal For Act 421 ChildrenS Medicaid Option
PDF template
A proposal for a Section 1115 demonstration program related to children's Medicaid coverage and services.
See template
See template
Medical Claim Form
PDF template
A form used to request payment for eligible healthcare services already received from UnitedHealthcare.
See template
See template
Certificates Of Insurance Model Act
PDF template
A model legislative act providing guidelines for the preparation, issuance, and regulation of insurance certificates in property and casualty insurance.
See template
See template
Uniform Standards For Riders, Endorsements Or Amendments Used To Effect Group Term Life Insurance Po
PDF template
Detailed guidelines for creating and filing riders, endorsements, and amendments for group term life insurance policy changes.
See template
See template
Student International Travel Form
PDF template
Comprehensive form for students seeking international travel credit, detailing pre-trip requirements and professionalism expectations.
See template
See template
Motor Vehicle Accident Report
PDF template
Official form for reporting motor vehicle accidents in Missouri where an uninsured party is involved, used to determine insurance and fault compliance.
See template
See template
Privileged Assets Service Request
PDF template
A form for changing address and/or name for RiverSource Life Insurance contract owners
See template
See template
BOARD OF RECREATION AND PARK COMMISSIONERS REPORT
PDF template
Report proposing a Memorandum of Understanding with the Discovery Science Center for a museum at Hansen Dam Park
See template
See template
YMCA Camp DeBoer Camper Medical Form
PDF template
Medical form for YMCA summer camp that includes medication administration consent, health information, and emergency contact details for children attending camp.
See template
See template
Medical Evaluation For Child Care
PDF template
A medical evaluation form for individuals working or volunteering in child care programs, assessing health status and fitness.
See template
See template
Mississippi State Department Of Health WIC Program Vendor Handbook
PDF template
A comprehensive guide for vendors participating in the Women, Infants, and Children (WIC) nutrition program, detailing food purchasing requirements, transaction processing, and compliance guidelines.
See template
See template
Certificate Of Insurance For Services
PDF template
Official document for certifying insurance coverage for services with Texas Department of Transportation (TxDOT)
See template
See template
EMPLOYEE PERSONAL PROPERTY DECLARATION FORM
PDF template
Form for employees to declare personal property used at work and outline claim procedures in case of loss or damage
See template
See template
Form 1560 CS Professional Provider Insurance
PDF template
Insurance form for professional service providers working with the Texas Department of Transportation (TxDOT)
See template
See template
MOTOR VEHICLE ACCIDENT REPORT FORM
PDF template
A comprehensive insurance form for documenting details of a motor vehicle accident in Mauritius.
See template
See template
Artist Declaration Form
PDF template
A legal form for artists selected for the Art in State Buildings Project to declare their responsibilities and transfer ownership rights.
See template
See template
Dental And Eye Care Insurance Enrollment Form
PDF template
A comprehensive form for enrolling in dental and eye care insurance coverage, capturing employee and dependent information.
See template
See template
Insurance Cert. Sample C
PDF template
Detailed guidelines for insurance coverage requirements for contractors in Cook County, Illinois
See template
See template
Section 355 Property Damage Report Form
PDF template
A form for reporting property damage incidents to local government authorities.
See template
See template
Notice Of Hearing On CollabHealth Plan Services, Inc.S Application For Approval Of Proposed Acquisit
PDF template
Official notice of a hearing regarding the proposed acquisition of SoundPath Health, Inc. by CollabHealth Plan Services, Inc.
See template
See template
Blue Mountains Gateball Competition 2013
PDF template
A competitive gateball tournament held at Blue Mountains Croquet Club featuring team events and official rules of play.
See template
See template
Athletic ConsentWaiver Form
PDF template
Consent and liability waiver form for student participation in school athletic programs, acknowledging potential risks and school's limited liability.
See template
See template
Lake Charles Recreation And Parks Minor Waiver Form For Adult Sports League
PDF template
Waiver form for parents/guardians to authorize minor's participation in adult sports league and acknowledge liability risks.
See template
See template
GENERAL CONSENT TO TREAT PATIENT AUTHORIZATIONACKNOWLEDEMENT FO BENEFITS RELEASE
PDF template
Comprehensive dental patient consent form covering treatment authorization, medical information release, insurance benefits, and privacy practices acknowledgement.
See template
See template
Electronic Data Interchange (EDI) Enrollment
PDF template
A form for healthcare providers to enroll or update their Electronic Data Interchange (EDI) submitter credentials for claims submission and processing.
See template
See template
CHG 8 Chapter 5 Real Property Acquisition
PDF template
Policies and guidance for acquiring real property for HUD-funded programs under the Uniform Relocation Assistance and Real Property Acquisition Policies Act (URA).
See template
See template
General Information For Authorization
PDF template
A form for requesting and documenting healthcare service authorization with medical and provider details.
See template
See template
Proof Of Insurance And Emergency Contact Form
PDF template
A form collecting student health insurance details and emergency contact information for record-keeping and safety purposes.
See template
See template
Parental Consent Form (Non Viable Fetus)
PDF template
A consent form for parents to participate in a genetic research study examining inherited causes of childhood brain diseases using DNA samples.
See template
See template
Notice Of Hearing
PDF template
Official notice regarding the revocation of Earl C. Dennis's Washington State insurance producer license due to alleged client misconduct.
See template
See template
Vision Group Insurance Form
PDF template
Insurance claim form for submitting vision care expenses and patient information to Standard Insurance Company.
See template
See template
IHSAA Waiver Form
PDF template
Form allowing outstanding student-athletes to participate in non-school sponsored competitions during the authorized contest season.
See template
See template
Procedures In Case Of Accidents On Diocesan Property
PDF template
Detailed instructions for handling and reporting accidents that occur on diocesan property, including steps for immediate response and documentation.
See template
See template
4 H 869 W Animal Lease Agreement
PDF template
A comprehensive lease agreement for temporarily transferring an animal's care and responsibility between a lessor and lessee with specific health and insurance requirements.
See template
See template
Visit Submission Form
PDF template
A form for tracking fitness center visits to earn health program rewards when online tracking is not available.
See template
See template
Sand Volleyball Registration Form
PDF template
Registration form for sand volleyball teams covering league details, contact information, and team preferences
See template
See template
EVANSVILLE PARKS AND RECREATION SOCCER REGISTRATION FORM
PDF template
Registration form for soccer teams participating in Evansville Parks and Recreation leagues during spring, summer, and fall seasons.
See template
See template
HEADMASTER DS DIVERSIFIED TECHNOLOGIES ConfidentialityNon Disclosure Agreement Form 1501 CV
PDF template
Confidentiality agreement for test observers, proctors, and actors involved in the Medication Aide-Certified competency examination.
See template
See template
150 Mile Contest Approval Form
PDF template
Form for obtaining school board approval for sports competitions over 150 miles from the school's location.
See template
See template
Algonquin Recreation Refund Request Form
PDF template
A form for participants to request refunds for recreation courses and programs offered by the Village of Algonquin.
See template
See template
Retiree Basic Life Insurance Form
PDF template
Form for retirees to elect or decline basic life insurance coverage and designate beneficiaries.
See template
See template
MetLife Enrollment Form
PDF template
Insurance enrollment form for employees to request coverage through their employer's group insurance plan.
See template
See template
PINS Transport Insurance Claim
PDF template
Insurance claim form for transport damage to products purchased from Verkkokauppa.com, covering purchases within Finland for up to 3000 euros.
See template
See template
Province Park Dog Park Membership Pass Application Waiver
PDF template
Annual membership application and waiver for accessing the Province Park Dog Park with accompanying rules and requirements for dog owners.
See template
See template
FH Liability Insurance Form
PDF template
A form for child care providers to declare their liability insurance status for family home child care operations.
See template
See template
Form A Application For Proposed Acquisition Of Control Of Northwest Dentists Insurance Company
PDF template
Legal document detailing a Form A filing for the proposed acquisition of Northwest Dentists Insurance Company by The Dentists Insurance Company.
See template
See template
Home Inventory Form
PDF template
A form for documenting personal property details including item description, manufacturer, serial number, and current value for insurance or record-keeping purposes.
See template
See template
Providence Mountain Emergency Services Consent To Treat Form
PDF template
Medical consent and authorization form for emergency medical treatment for participants in a Providence Mountain program.
See template
See template
Vaccine Administration Record (VAR)Informed Consent For Vaccination
PDF template
Informed consent document for vaccine administration, detailing patient rights, risks, and information sharing permissions.
See template
See template
ARTIST AGREEMENT TERMS CONDITIONS
PDF template
Terms and conditions for artists submitting portrait artworks to the Gunnedah Bicentennial Creative Arts Gallery exhibition.
See template
See template
NAIDOC 2022 SUBMISSION FORM
PDF template
Official submission guidelines and terms for the NAIDOC 2022 art exhibition at Gunnedah Bicentennial Creative Arts Gallery.
See template
See template
ATHLETE UNIFIED PARTNER REGISTRATION FORM
PDF template
Registration form for athletes and unified partners to participate in Special Olympics events, collecting personal and identification information.
See template
See template
Blue Cross Of Idaho Care Plus, Inc. Health Assessment
PDF template
Form for collecting health information from newly enrolled Medicare Advantage members to develop individual care plans.
See template
See template
Family And Medical Leave Act (FMLA) Employee Request Form
PDF template
A form for employees to request leave under the Family and Medical Leave Act, covering personal or family medical situations.
See template
See template
Claim Form
PDF template
Comprehensive form for submitting flexible spending account (FSA) and health reimbursement claims with multiple benefit code options.
See template
See template
Required NYS School Health Examination Form
PDF template
Comprehensive health assessment form for students in New York State schools, documenting medical history and physical examination details.
See template
See template
Form M Medical And Health Insurance Information And Consent For Medical Or Dental Care Of A Minor
PDF template
A medical consent and health insurance information form for minors attending ORU Early College program, authorizing emergency medical treatment.
See template
See template
Adult Athletics Waiver Softball
PDF template
Liability waiver for participants in the City of De Pere Adult Softball Leagues, acknowledging risks and releasing the city from potential claims.
See template
See template
Prescription Reimbursement Claim Form
PDF template
A form for submitting prescription medication reimbursement claims to an insurance provider, detailing member information and pharmacy details.
See template
See template
Volunteer Release Of Liability Waiver Form
PDF template
Legal document releasing liability for volunteers participating in a storm drain marking community event in Melbourne, Florida.
See template
See template
Form 1751a Benefits Enrollment
PDF template
A form for employees to enroll or modify health and welfare benefits at Los Alamos National Laboratory.
See template
See template
Application For Group Term Insurance
PDF template
Insurance application form for group term life insurance policy from Insular Life Assurance Company
See template
See template
Certificate Of Insurance
PDF template
A form for insurance certification for residential rental properties in the City of Oshawa, Ontario, requiring minimum $2,000,000 coverage.
See template
See template
Union Benefits Cancellation Form
PDF template
Form for union members to cancel or modify their existing insurance and benefits coverage across multiple carriers.
See template
See template
18 Degrees Assumption Of Risk, Release And Waiver Of Liability, And Indemnity Agreement
PDF template
A legal document outlining risk assumption, liability release, and COVID-19 related precautions for participation in 18 Degrees programs and facilities.
See template
See template
Patient Registration Form
PDF template
A comprehensive form for collecting patient personal, contact, and medical information for Gateway Pediatrics
See template
See template
American Arbitration Association Award Of Dispute Resolution Professional
PDF template
Arbitration award related to a medical necessity dispute involving an MRI claim from an auto accident
See template
See template
Property And Casualty Insurance Regulations
PDF template
Regulations governing insurance rate and form submissions for property and casualty insurers in Iowa, including electronic filing requirements and hearing procedures.
See template
See template
Employee Enrollment Form
PDF template
A comprehensive form for employees to enroll in health insurance coverage with options for individual and family plans.
See template
See template
NU SHIP Cancellation Form 2019 2020
PDF template
Form for students to terminate their university-provided health insurance coverage at Northwestern University
See template
See template
VEHICLE REGISTRATION FORM
PDF template
A form for reporting vehicle registration details to K&K Insurance for multiple vehicles across multiple states.
See template
See template
Service Order Form
PDF template
A service order form for medical device repair and exchange, specifically for hearing devices.
See template
See template
Union Benefits Cancellation Form
PDF template
A form for union members to cancel various insurance and supplemental benefits from multiple carriers
See template
See template
Eve Gene Black Summer Medical Career Program FAQs
PDF template
A comprehensive FAQ document for a medical mentorship and internship program for students in Los Angeles and adjacent counties.
See template
See template
Uniform Certificate Of Authority Application (UCAA) Primary Application Checklist
PDF template
A comprehensive checklist for insurers applying for a primary uniform certificate of authority, detailing required documentation and filing requirements.
See template
See template
Group Disability Claim Filing Instructions
PDF template
Instructions and form for filing a disability claim with American Fidelity Assurance Company for disability benefits.
See template
See template
Guide For Completing A Damage Report
PDF template
A comprehensive guide for reporting damage and filing claims under a fisheries compensation program for vessel and gear damage related to oil spills.
See template
See template
Workers Compensation Payroll Audit
PDF template
Annual form for reporting employee payroll details for workers' compensation insurance purposes across different job classifications.
See template
See template
MINOR PARTICIPANT EMERGENCY CONTACT AND MEDICAL RELEASE FORM
PDF template
A comprehensive medical and emergency contact form for minors participating in university activities, collecting critical health and contact information.
See template
See template
EMPLOYMENT APPLICATION
PDF template
Standard employment application form for prospective employees seeking positions with the McPherson Recreation Commission.
See template
See template
Out Of School Time Program Intake Discharge Form
PDF template
Comprehensive intake and discharge document for children's out-of-school-time program, collecting demographic, contact, and eligibility information.
See template
See template
Accident Waiver And Release Of Liability Form
PDF template
A legal document releasing liability for participation in an association event or activity, protecting the organization from potential legal claims.
See template
See template
Short Term Disability Claim Form
PDF template
A comprehensive form for filing a short-term disability claim, capturing personal, medical, and employment details for disability benefits.
See template
See template
Geneva Park District Summer Camp Registration Form
PDF template
Registration form for Geneva Park District summer camps for children aged 3-5, including special needs accommodations and payment details.
See template
See template
Tender For Procurement Of Adobe Acrobat Pro DC And Adobe Creative Cloud
PDF template
Tender document by Bank of Baroda for purchasing Adobe Acrobat Pro DC and Adobe Creative Cloud licenses for their Information Technology Department.
See template
See template
TRAVEL RISK ASSESSMENT FORM
PDF template
A comprehensive form for travelers to provide personal and medical information before international travel, assessing potential health risks.
See template
See template
Travel Risk Assessment Form
PDF template
Comprehensive medical and travel risk assessment document for individuals planning international travel, collecting health history and trip details.
See template
See template
SEBB Electronic Debit Service Agreement
PDF template
Form for authorizing automatic monthly payments for SEBB insurance coverage through electronic bank account deductions
See template
See template
Your LegalCare Plan University Of California Legal Expense Insurance Plan
PDF template
A comprehensive legal services insurance plan offering preventive legal services and attorney consultations for University of California members.
See template
See template
IAIABC Electronic Partnering Agreement
PDF template
A document establishing guidelines for electronic data exchange between trading partners in industrial accident claims reporting.
See template
See template
The ARAG Legal Plan
PDF template
Comprehensive legal plan booklet detailing benefits, eligibility, and services for University of California employees and retirees.
See template
See template
WSU Faculty Computer Purchase Exemption Petition
PDF template
Process for Wright State University faculty to request computer equipment that differs from standard university recommendations.
See template
See template
Informed Consent Agreement Parental Version
PDF template
Parental consent form for students under 18 to participate in psychology research experiments at Worcester Polytechnic Institute.
See template
See template
Livestock Risk Protection (LRP) Handbook
PDF template
Comprehensive guide for Livestock Risk Protection insurance program covering form standards, entries, and completion requirements.
See template
See template
Medical Insurance Information
PDF template
A form for collecting medical insurance details for a child's admission to Spaulding Academy & Family Services
See template
See template
2011 FAMILY Membership Renewal And Liability Waiver Form
PDF template
A comprehensive liability waiver for participants in off-road racing activities, assuming risks and agreeing not to sue the organization.
See template
See template
NJ BMW CCA EMERGENCY FORM
PDF template
Confidential medical form for tracking driver emergency contact and health information at motorsport events.
See template
See template
Tuberculosis Risk Assessment Form
PDF template
Medical screening form to assess tuberculosis symptoms and risk factors for individuals with positive PPD test or recent chest X-ray.
See template
See template
NFHS Medical Release Form For Wrestler To Participate With Skin Lesion(S)
PDF template
A medical release form developed by NFHS Sports Medicine Advisory Committee for wrestlers with skin lesions to determine safe participation in sports.
See template
See template
The ARAG Legal Plan
PDF template
A comprehensive legal insurance plan document detailing benefits, eligibility, and services for University of California employees and retirees.
See template
See template
Direct Reimbursement Claim Form
PDF template
A form for requesting reimbursement for vision care services from providers outside the Davis Vision network.
See template
See template
Standardized Application For Pathology Fellowships
PDF template
A comprehensive application form for medical professionals seeking specialized fellowship training in various pathology subspecialties.
See template
See template
Minor Medical Release Form
PDF template
Medical release form for minors participating in activities, providing medication and emergency contact information
See template
See template
Allied Health Public Service Student Medical Form
PDF template
A comprehensive medical form for students in the North Carolina Community College System, requiring medical history, physical examination, and immunization documentation.
See template
See template
School Capital Request Form (PA 097 0474 Requirement)
PDF template
Web-based form for self-assessment and capital request to comply with Public Act 097-0474 requirements for school facilities.
See template
See template
Sumo Wrestling Game Release And Waiver Form Game Rules
PDF template
A legal release and waiver form for participants in a Sumo Wrestling game event, outlining participant risks and liability conditions.
See template
See template
NFHS Medical Release Form For Wrestler To Participate With Skin Lesion(S)
PDF template
Official form and guidelines for allowing wrestlers with skin lesions to participate in competitive events while minimizing transmission risks.
See template
See template
ATHLETICS MEDICAL RELEASE FORM
PDF template
A medical release and information form for student-athletes, authorizing medical treatment and collecting important health details.
See template
See template
Child Enrollment Form
PDF template
Enrollment form for children to register for Montessori or summer program with detailed parent and child information.
See template
See template
Request For Certificate Of Insurance
PDF template
A form used to request an insurance certificate for a scouting activity or event with details about coverage and additional insured status.
See template
See template
Insurance Requirements For GoodsServices, BidsRequests For Proposals, AwardsContracts
PDF template
Detailed guidelines for insurance coverage requirements for contractors and awardees doing business with the City of Tampa
See template
See template
Schulman Gallery Artists Submission Agreement Form
PDF template
Agreement for artists submitting work to the Schulman Gallery's LCCC Juried Faculty and Alumni Exhibition in 2015-2016.
See template
See template
Schulman Gallery Artists Submission Form
PDF template
Submission guidelines and requirements for artists participating in the Annual LCCC Student Exhibition at the Schulman Gallery.
See template
See template
McKenzie Institute Lumbar Spine Assessment Examination
PDF template
Comprehensive medical assessment form for evaluating lumbar spine conditions and patient symptoms.
See template
See template
BUS MEDICAL FORM
PDF template
A form for parents to document medical conditions that bus drivers should be aware of for student safety.
See template
See template
GoodLife Programs Medical Information And Liability Release Form
PDF template
A comprehensive form for participant medical information, emergency contacts, and liability release for GoodLife Programs and Activities.
See template
See template
SCVAA Refund Refund Request Form
PDF template
A form for requesting refunds for youth sports participation with specific eligibility conditions.
See template
See template
Producers Health Benefits Plan Participation Agreement
PDF template
A legal agreement for participation in the Producers' Health Benefits Plan by contributing employers, outlining contribution requirements and trust agreement terms.
See template
See template
SkillsUSA National Leadership And Skills Conference Registration, Personal And Liability Release For
PDF template
Registration and liability release form for participants of the SkillsUSA National Leadership and Skills Conference for high school and college students.
See template
See template
Medical Form
PDF template
A medical screening form for archaeological expedition participants to assess health fitness for challenging field conditions.
See template
See template
Senate Bill No. 1113
PDF template
A bill requiring primary care physicians to include family history questions for hereditary breast and ovarian cancer risk on patient intake forms.
See template
See template
EAP Billing Form
PDF template
Medical billing form for submitting claims to BPA Health for employee assistance program services.
See template
See template
Landlord Tenant Rule No. 3 Elder Rental Program Eligibility, Selection And Other Requirements
PDF template
A comprehensive ruleset governing eligibility, selection, and requirements for an elder rental housing program administered by the Comprehensive Housing Division.
See template
See template
Pre Authorized Debit Agreement
PDF template
A pre-authorized debit form for University of Victoria Graduate Students' Society health and dental insurance plan payments
See template
See template
College Of Education Course Waiver Form (MEd)
PDF template
A form for transferring courses or substituting required courses within the University of Illinois at Chicago (UIC) College of Education graduate program.
See template
See template
Student Chromebook Insurance Form
PDF template
Optional repair plan for student Chromebooks at Penn-Harris-Madison School Corporation, covering up to two repairs for $25 per year.
See template
See template
Emergency Contact Form
PDF template
A form for collecting student emergency contact, medical, and insurance information for campus housing purposes.
See template
See template
Community Literacy Center Volunteer Application Form
PDF template
Application form for volunteers interested in working with youth in literacy and art programs at a community center.
See template
See template
CONSENT AND MEDIA RELEASE FORM
PDF template
A legal document allowing participation in a contest and providing media release consent for minors and adults.
See template
See template
Referral Form
PDF template
A comprehensive form for collecting patient information and medical details for hospice or palliative care referral.
See template
See template
Medical Information Form
PDF template
A comprehensive medical form for veterans and guardians to provide emergency medical details for participation in an Honor Flight.
See template
See template
2017 Paramedic Competition Entry Form
PDF template
Official entry form for the 2017 North Carolina Paramedic Competition, detailing requirements for team participation and submission process.
See template
See template
Therapy Treatment Referral
PDF template
A medical referral form for therapy services covering physical, occupational, and speech therapy treatment options.
See template
See template
New Patient Intake Form
PDF template
Comprehensive medical and personal history form for new patients seeking counseling services, collecting demographic, health, and personal background information.
See template
See template
VISA CHECKLIST
PDF template
Comprehensive guide for applicants seeking a visa to enter Germany, detailing required documents and application process.
See template
See template
GODDARD SKI CLUB MEMBERSHIP APPLICATION
PDF template
Application for membership to the Goddard Ski Club, including personal information, membership type, and liability waiver.
See template
See template
Accident Waiver And Release Of Liability Form
PDF template
A legal document releasing FBC Russellville from liability for potential injuries or damages during an event or activity.
See template
See template
Blake Medical Center Auxiliary, Inc. SCHOLARSHIP APPLICATION
PDF template
Scholarship application for students enrolled in post-secondary healthcare programs seeking financial assistance from Blake Medical Center Auxiliary.
See template
See template
NEW PATIENT INTAKE FORM
PDF template
Comprehensive medical intake form for new patients, collecting personal information, medical history, and current health conditions.
See template
See template
REFERRAL FORM
PDF template
A form for referring patients to OB/GYN services within the IEHP healthcare network, outlining various service options and referral requirements.
See template
See template
DIVING MEDICAL HISTORY FORM
PDF template
Medical screening form for assessing a diver's physical and mental fitness to participate in diving activities.
See template
See template
VERIFICATION OF TRUST FORM
PDF template
A comprehensive form for verifying trust details, ownership, and beneficiary information for insurance policy purposes.
See template
See template
20 21 HYDE Out After School Teen Program Membership Packet
PDF template
Comprehensive enrollment packet for Cordova Recreation & Park District's after-school teen program, providing supervised care and youth development activities.
See template
See template
Crystal Lake School 5th And 6th Grade ChromebookInsurance Form 2019 2020
PDF template
A form for parents to select insurance options for school-issued Chromebook devices for 5th and 6th grade students
See template
See template
Shrewsbury High School Athletic Boosters Family Membership
PDF template
A membership form for families to support Shrewsbury High School athletics with benefits including season passes and scholarship opportunities.
See template
See template
Requisition Form
PDF template
Comprehensive medical form for patient demographics, insurance information, and diagnostic specimen collection details.
See template
See template
ATA Annual Meeting Refund Request Form
PDF template
Official form for requesting refunds for the American Thyroid Association's 89th Annual Meeting registrations and associated events.
See template
See template
Name And Ownership Changes Request Form
PDF template
A form for requesting changes to policy ownership, contact information, and personal details for American Heritage Life Insurance Company policies.
See template
See template
Youth Sports Camps Clinics Audit Form Addition Of Camps
PDF template
Insurance form for auditing or adding youth sports camp sessions with liability and medical payment coverage options.
See template
See template
2019 Art Installation Form
PDF template
A comprehensive form for artists submitting art installations to the Burning Man event, requiring detailed project information and safety guidelines.
See template
See template
Park District Refund Request Form
PDF template
A form for requesting refunds for park district recreation programs, one-day events, and ParkSchool programs with specific refund guidelines and service charges.
See template
See template
APPENDIX 3 DIVING MEDICAL HISTORY FORM
PDF template
Comprehensive medical screening form for assessing an individual's fitness for scuba diving activities by documenting medical history and potential health risks.
See template
See template
Strawberry Recreation District Field Rental Agreement, Waiver And Release
PDF template
A comprehensive form for renting recreation district facilities, covering event details, facility selection, and organizational information
See template
See template
Genetics Referral Form
PDF template
A medical referral form for patients seeking genetic counseling and potential genetic testing services.
See template
See template
MEDICAL HISTORY
PDF template
Comprehensive medical history questionnaire to collect patient health information and potential medical conditions.
See template
See template
Bennett Cerf Dog Park 2019 Membership Form And Release Of Liability
PDF template
Annual membership form for Bennett Cerf Dog Park with required information about dogs and owners, including liability release.
See template
See template
REQUIRED NYS SCHOOL HEALTH EXAMINATION FORM
PDF template
Comprehensive health examination form for students in New York State schools, covering medical history and current health status.
See template
See template
Medical History Form
PDF template
Comprehensive medical history form capturing patient health details, previous treatments, and current medical conditions.
See template
See template
USAV YOUTH JUNIOR VOLLEYBALL PLAYER MEDICAL RELEASE FORM
PDF template
Medical release and consent form for youth and junior volleyball players participating in USAV sanctioned competitions and practices.
See template
See template
Rec PAC Partial Scholarship Application
PDF template
Application for partial scholarships for Rec-PAC summer recreational camp for Fairfax County residents receiving public assistance.
See template
See template
2019 2020 Short Term Disability Information
PDF template
Policy detailing disability income benefits and eligibility for Yavapai College employees, including benefit calculation and claim process.
See template
See template
Summer Camp Accident Waiver And Release Of Liability Form
PDF template
A legal document outlining parent permissions, risks, and liability release for children participating in a summer camp program.
See template
See template
Waxing Consent Form
PDF template
A medical consent form for waxing services that collects client health information and potential skin sensitivity risks.
See template
See template
Rocky Mountain Biological Laboratory Acknowledgment And Assumption Of Risks Release And Indemnity A
PDF template
Legal document outlining risks, activities, and liability release for participants in Rocky Mountain Biological Laboratory programs and research activities.
See template
See template
ATSG FitBit Activity Tracker Program Purchase Form
PDF template
Form for employees to purchase FitBit activity trackers through corporate wellness program with payroll deduction options.
See template
See template
COVID 19 VACCINE CONSENT FORM
PDF template
Medical consent form for receiving COVID-19 vaccination, including patient screening questions and personal information collection.
See template
See template
2020 2021 Flu And Pneumo Insurance Information Form
PDF template
A form for collecting patient information and insurance details for flu and pneumococcal vaccines.
See template
See template
USAV Youth Junior Volleyball Player Medical Release Form
PDF template
Medical release and health information form for youth and junior volleyball players participating in the 2020-2021 season.
See template
See template
Ball Field Rental Procedures
PDF template
Comprehensive procedures and guidelines for renting ball fields from the Champaign Park District, including rental terms, contact information, and field usage rules.
See template
See template
Health Insurance Cancellation Form
PDF template
A form for Tacoma Employees' Retirement System (TERS) retirees to cancel their health and dental insurance coverage.
See template
See template
New Patient Intake Form
PDF template
Comprehensive medical intake form collecting detailed patient health history, gynecological information, and personal background details.
See template
See template
Community Education Class Proposal Form
PDF template
Form for instructors to propose and submit community education class ideas to LEAP's learning program.
See template
See template
Medical History Form
PDF template
Comprehensive form for collecting detailed patient medical history, including past medical conditions and surgical procedures.
See template
See template
2020 Employee Authorization For Payroll Deduction To HSA
PDF template
Form for employees to start, change, or stop payroll deductions for Health Savings Account (HSA) contributions.
See template
See template
46th Annual High School Student Art Competition Entry Form
PDF template
Official entry form for high school students participating in the 46th Annual Art Competition hosted by Quincy Art Center.
See template
See template
Seed Insurance Waiver Form
PDF template
A waiver form for seed owners to confirm they maintain their own insurance coverage for seeds stored at Ioka Farms facilities.
See template
See template
New Patient Intake Form
PDF template
Comprehensive medical form for collecting new patient information, including personal details, contact information, medical history, and healthcare connections.
See template
See template
New Patient Intake Form
PDF template
Comprehensive medical intake form for capturing patient personal, contact, and medical history information for dental practice.
See template
See template
2020May Youth Participant Waiver
PDF template
Legal release of liability and assumption of risks for youth soccer program participation in British Columbia.
See template
See template
MINOR MEDICAL RELEASE FORM
PDF template
Medical release and contact information form for minors participating in the Summit Music Festival seminar program and concert series.
See template
See template
2020 States 4 H OB Medical Form (Non Japan)
PDF template
Medical evaluation form for 4-H international exchange program delegates to assess health and fitness for cross-cultural exchange.
See template
See template
Physical Therapy Of Boulder Patient Intake Form
PDF template
Comprehensive medical intake form for physical therapy patients covering personal information, insurance details, and consent for treatment.
See template
See template
USAV YOUTH JUNIOR VOLLEYBALL PLAYER MEDICAL RELEASE FORM
PDF template
Medical release and consent form for youth and junior volleyball players participating in USAV sanctioned competitions and practices.
See template
See template
USAV YOUTH JUNIOR VOLLEYBALL PLAYER MEDICAL RELEASE FORM
PDF template
Medical release and emergency contact form for youth and junior volleyball players participating in USAV sanctioned competitions and practices.
See template
See template
2020 Rental Application, Contract And Release
PDF template
Comprehensive rental application for facilities at Strawberry Recreation District, covering event details, facility selection, and usage parameters.
See template
See template
RESIDENCY APPLICATION FORM
PDF template
Application form for artists seeking a three-month residency at McCahon House Trust with multiple date options.
See template
See template
UABHSF Office Of Risk Management User Guide
PDF template
A comprehensive guide detailing the practices, procedures, and guidelines for the UAB Office of Risk Management and Insurance.
See template
See template
Main Line Art Center Scholarship Request Form
PDF template
A scholarship request form for students seeking financial assistance to participate in art classes at Main Line Art Center.
See template
See template
Shenandoah Outdoor Adventure Recreation Health And Medical Form
PDF template
Comprehensive health form for participants in Shenandoah University outdoor and adventure recreation programs, collecting medical history and emergency contact information.
See template
See template
SPECIAL EVENT AGREEMENT FORM
PDF template
A comprehensive form for applying to host a special event at National Trail Parks and Recreation District facilities.
See template
See template
SPLASH ZONE RENTAL APPLICATION AND AGREEMENT
PDF template
Application and agreement for renting the National Trail Parks and Recreation District's Splash Zone facility for private events.
See template
See template
Summer 2020 Parks Playgrounds Program Emergency Contact Form
PDF template
Emergency contact form for children's summer recreation program at local parks in Alameda, California, offering free recreational activities for elementary school children.
See template
See template
Preparticipation Physical Evaluation History Form
PDF template
Comprehensive medical history questionnaire for athletes to assess health status and potential medical concerns before participating in sports.
See template
See template
Wheelchair Initial Evaluation Form
PDF template
A comprehensive medical form for evaluating a patient's need and suitability for a wheelchair, including medical and functional assessments.
See template
See template
MEDICAL HISTORY FORM
PDF template
Comprehensive medical history form collecting details about patient's allergies, environmental sensitivities, and dermatologic conditions.
See template
See template
Arizona Interscholastic Association, Inc. Mild Traumatic Brain Injury (MTBI) Concussion Annual Stat
PDF template
A comprehensive form for student athletes to understand concussion risks, symptoms, and reporting responsibilities in sports.
See template
See template
Annual Pre Participation Physical Evaluation
PDF template
A comprehensive health screening form for student-athletes to assess medical eligibility for sports participation during the 2021-22 school year.
See template
See template
Emergency Medical Form
PDF template
Comprehensive medical information and emergency contact form for school students with parent and emergency contact details.
See template
See template
Patient Protection And Affordable Care Act Patient Protection Notice
PDF template
Federal document outlining requirements for group health plans and insurers regarding primary care provider designations for participants and children.
See template
See template
WILDERNESS ADVENTURES ACKNOWLEDGMENT AND ASSUMPTION OF RISKS RELEASE AND INDEMNITY AGREEMENT
PDF template
Legal document outlining risks, liability release, and participant agreement for Wilderness Adventures outdoor programs.
See template
See template
POGS Sickness Benefit Application Form
PDF template
Application form for members of the Philippine Obstetrical and Gynecological Society to claim sickness benefits
See template
See template
Warranty Claim Form
PDF template
Form for submitting warranty claims for prosthetic products and detailing product and patient information.
See template
See template
2021 VOLUNTEER APPLICATION FORM
PDF template
Application form for individuals interested in volunteering at Idaho State Parks, designed for those planning to work more than 40 hours per month.
See template
See template
LHA Trust Funds Grant Application Form
PDF template
Grant application form for LHA Trust Funds members seeking funding for healthcare-related projects, with a maximum award of $25,000.
See template
See template
Idaho Health Examination And Consent Form
PDF template
Required medical examination form for Idaho high school students participating in interscholastic athletics in 9th and 11th grades.
See template
See template
47th Annual High School Student Art Competition Entry Form
PDF template
Official entry form for high school students participating in the annual art competition hosted by Quincy Art Center.
See template
See template
Employee Medical Inquiry Form
PDF template
Medical form for employees requesting workplace accommodations, to be completed by both employee and healthcare provider to assess disability and potential workplace adaptations.
See template
See template
ISETT COMMUNITY POOL MEMBERSHIP 2021 MEMBERSHIP FORM
PDF template
Annual membership form for the Isett Community Pool with pricing options for individuals, families, and seniors.
See template
See template
2021 States 4 H OB Medical Form (Non Japan)
PDF template
Medical history and health assessment form for participants in a cross-cultural youth exchange program.
See template
See template
Brisker V. Ohio Dept. Of Ins., 2021 Ohio 3141
PDF template
Legal case involving Frederick Brisker's appeal of his insurance license revocation by the Ohio Department of Insurance.
See template
See template
2021 Olympic Day Colouring And Drawing Competition Entry Form
PDF template
Entry form for a youth art competition celebrating Olympic themes and sports for various age categories.
See template
See template
Cardiology Medical History Form
PDF template
Comprehensive medical history form for cardiology patients to document health conditions, medications, and allergies.
See template
See template
Permission To Participate Medical Treatment Consent And Release, Waiver, And Indemnity Agreement
PDF template
A comprehensive form granting permission for a child to participate in church activities and providing medical treatment consent and liability release.
See template
See template
Rental Agreement Form
PDF template
A rental agreement form for ski and snowboard equipment rental at Mohawk Mountain, including personal information, equipment details, and liability waiver.
See template
See template
TRS Medicare Eligible Health Plan (MEHP) Prescription Drug Benefit Guide
PDF template
Detailed guide for Teachers' Retirement System of Kentucky Medicare Part D prescription benefit plan managed by Know Your Rx Coalition through Express Scripts
See template
See template
YOUTH JUNIOR VOLLEYBALL PLAYER MEDICAL RELEASE FORM
PDF template
A medical release form for youth and junior volleyball players to document health information and parental consent for participation.
See template
See template
Via West Participant Application
PDF template
Registration packet for participants with required forms for camp enrollment in 2021.
See template
See template
Volunteer Excess Liability Insurance Form
PDF template
Insurance form for occasional volunteers providing liability coverage for park and community service volunteers
See template
See template
Walker Waiver Form
PDF template
Waiver form for participants in an ALS of Michigan walking event, releasing organizers from liability and granting media usage permissions.
See template
See template
Cheyenne Frontier Days Old West Museum Proxy Purchase Policy And Application
PDF template
Policy for purchasing artwork remotely through a proxy system at the Cheyenne Frontier Days Western Art Show and Sale
See template
See template
Patient Intake Form
PDF template
Comprehensive patient registration and consent form for physical therapy services with contact, insurance, and treatment agreement details.
See template
See template
Release And Waiver Of Liability, Assumption Of Risk, And Indemnity Agreement
PDF template
Legal document releasing 3Point0 Studio T from liability for potential injuries or damages during participation in activities.
See template
See template
KEY CONTACT INFORMATION QUESTIONNAIRE
PDF template
A comprehensive form for collecting key contact details for various risk management roles within an agency
See template
See template
2022 2023 Membership Application
PDF template
Comprehensive membership application for youth program registration with detailed member and family information
See template
See template
ParentGuardian Consent And Medical Release Form For 2022 23 JSMC Youth And Junior Youth Events
PDF template
A consent form for parents/guardians to authorize child participation in church youth events and provide medical information
See template
See template
Privit Profile Instructions For Students
PDF template
Comprehensive guide for students to create and complete their digital health record using Privit Profile platform for Wilmington College.
See template
See template
2022 23 SBHC Patient Intake Form
PDF template
Comprehensive medical intake form for patients at Generations Family Health Center, collecting personal, contact, and demographic information.
See template
See template
New York FFA Association Waiver, Release Of Liability, Consent To Medical Attention, Authorizations
PDF template
Waiver form for New York FFA Association event participation, covering liability, medical consent, and risk acknowledgment.
See template
See template
FAM Fellowship Application
PDF template
Application form for a paid academic-year fellowship at the Frist Art Museum designed for students and emerging professionals interested in museum exhibition processes.
See template
See template
Claim Form
PDF template
A comprehensive claim form for medical reimbursement from GlobeMed Qatar/SEIB insurance network covering various healthcare services.
See template
See template
Grand Staircase Escalante National Monument 2022 Artist In Residence Application Form
PDF template
Application form for artists seeking a residency at Grand Staircase Escalante National Monument in partnership with Escalante Canyons Art Festival.
See template
See template
Alternate Travel Form
PDF template
A form allowing parents to authorize alternative transportation for students from school events or competitions.
See template
See template
WILDERNESS ADVENTURES ACKNOWLEDGMENT AND ASSUMPTION OF RISKS RELEASE AND INDEMNITY AGREEMENT
PDF template
Legal document outlining risks, liability release, and participant agreement for wilderness adventure activities.
See template
See template
POGS MAP Sickness Benefit Application Form
PDF template
A form for members of the Philippine Obstetrical and Gynecological Society to apply for sickness benefits for medical and COVID-related conditions.
See template
See template
2022 Art Installation Questionnaire
PDF template
A questionnaire for artists seeking to install art on the open playa at the Burning Man event, requiring online electronic submission of project details.
See template
See template
BHC Non Surgical Program Registration Form
PDF template
Registration form for patients seeking admission to a non-surgical program at Boone Hospital Center, collecting comprehensive personal and medical information.
See template
See template
Lakeside Country Club 2022 Summer Camp Attendance Form
PDF template
Registration form for children to attend Lakeside Country Club's summer camp program with weekly session selection.
See template
See template
Carving Competition Entry Form
PDF template
Official entry form for the International Wood Carvers Association (IWCA) decoy carving competition with multiple classification categories.
See template
See template
Notice Of Privacy PracticeClinics
PDF template
A consent form documenting patient acknowledgment of privacy practices and permissions for health information disclosure and communication.
See template
See template
Adult Medical Release Form
PDF template
Medical information and emergency authorization form for adult participants of the Summit Music Festival
See template
See template
2022 IAG AGM Resources FAQs
PDF template
Document providing resources and information for shareholders attending IAG's 2022 Annual General Meeting on 21 October 2022.
See template
See template
Long Term Disability Claim Form Statement Of Employee
PDF template
A comprehensive form for employees to file a long-term disability claim with Lincoln Financial Group, detailing personal, employment, and medical information.
See template
See template
Marine Warranty Claim Form
PDF template
Claim form for marine equipment warranty service and reimbursement for repairs and replacements.
See template
See template
MEDICAL HISTORY FORM
PDF template
Comprehensive medical form for documenting student's health history, childhood illnesses, current physical conditions, and immunization records.
See template
See template
ISETT COMMUNITY POOL MEMBERSHIP
PDF template
Annual membership registration form for the Isett Community Pool with various membership options and family details.
See template
See template
PATIENTS INTAKE FORM
PDF template
Comprehensive medical intake form for patient registration and insurance information at a podiatry medical practice.
See template
See template
RENTAL AGREEMENT 2022
PDF template
Comprehensive rental policies and requirements for booking event spaces at the Mahogany Beach Club, detailing deposit, cancellation, and facility usage terms.
See template
See template
IMPACT GRANT APPLICATION FORM
PDF template
A comprehensive form for submitting grant proposals at Ridge Meadows Hospital with detailed sections for applicant information, project summary, and departmental approvals.
See template
See template
Intent To Purchase (ITP) Bid Form
PDF template
Bid form for sealed auction of art pieces by notable Western artists at the Charles M. Russell Museum
See template
See template
Easter Seals Colorado Rocky Mountain Village Camper Medical Form
PDF template
A comprehensive medical form for documenting a camper's health status and medical history prior to attending camp.
See template
See template
Medical Release Form
PDF template
Medical consent and emergency contact form for minors attending music camp programs at Sam Houston State University
See template
See template
Form For Documenting Medical And Physical Disabilities
PDF template
A form for healthcare professionals to document student medical disabilities and support academic accommodation requests.
See template
See template
2021 22 Minnesota Sports Federation Fall And Winter Team Membership Form
PDF template
Registration form for sports teams to join the Minnesota Sports Federation for fall and winter leagues across multiple sports.
See template
See template
Garden Grove Teen Action Collaborative ApplicantS Information
PDF template
Consent and liability waiver form for participants in Garden Grove recreational programs and activities, specifically targeting teens.
See template
See template
2023 2024 Membership Application
PDF template
Application for youth membership program covering the period from July 2023 to June 2024, collecting comprehensive child and family information.
See template
See template
2023 2024 Northside ISD Medical History
PDF template
Annual medical history form required for student participation in athletic activities at Northside Independent School District.
See template
See template
USI Vehicle Accident Reporting Form
PDF template
A comprehensive form for documenting details of a vehicle accident involving USI employees or vehicles.
See template
See template
NACSW Frequent Volunteer Reward Program
PDF template
Form detailing guidelines for earning additional trial entry draws through volunteer service at NACSW events.
See template
See template
Athletic Physical Examination Form
PDF template
Medical form certifying a student's physical fitness to participate in interscholastic athletics for the school year.
See template
See template
Annual Pre Participation Physical Evaluation
PDF template
A comprehensive medical screening form for student-athletes to assess their health and fitness for sports participation during the 2023-24 school year.
See template
See template
Chromebook Insurance
PDF template
Insurance policy for Chromebook devices issued to students in grades 5-12, covering accidental damage and device protection.
See template
See template
2023 2024 Student Emergency Form
PDF template
A comprehensive form for collecting student emergency contact details, health insurance information, and parental contact information for school records.
See template
See template
ASCVTS Bundang Thoracic Fellowship Program Application Form
PDF template
Application form for medical professionals seeking a fellowship in cardiovascular and thoracic surgery with the Asian Society for Cardiovascular and Thoracic Surgery.
See template
See template
Cooma Show 2023 Ground Space Booking Form
PDF template
A booking form for vendors and stallholders wanting to secure a site at the 2023 Cooma Show with specific terms and conditions.
See template
See template
AgentAgency Agreement
PDF template
A legal agreement defining the terms of engagement between DENCAP Dental Plans and an independent insurance agent for soliciting dental service agreements.
See template
See template
DNRC General Clauses To Emergency Equipment Rental Agreement
PDF template
A rental agreement for emergency equipment with specific terms and conditions for equipment usage during incidents.
See template
See template
DNRC General Clauses To Emergency Equipment Rental Agreement
PDF template
Standard rental agreement for emergency equipment with detailed clauses covering equipment requirements, liability, and operational conditions.
See template
See template
2024 VOLUNTEER APPLICATION FORM
PDF template
Application form for individuals planning to volunteer more than 40 hours per month at Idaho State Parks and Recreation.
See template
See template
2023 Teen Expeditions Questionnaire And Medical Form
PDF template
Comprehensive medical questionnaire for participants of Lake Champlain Maritime Museum teen expeditions to ensure safety and proper medical support.
See template
See template
Facility Use And Indemnification Agreement Between The City Of Othello And The Greater Othello Chamb
PDF template
Agreement for the Greater Othello Chamber of Commerce to use city parks for the 4th of July Celebration event, including facility use terms and insurance requirements.
See template
See template
Township Of Cramahe Ice Rental Agreement
PDF template
A rental agreement for booking ice time at the Keeler Centre for various events and purposes
See template
See template
Flexible Spending Account Reimbursement Form
PDF template
A form for submitting out-of-pocket healthcare expenses for reimbursement through a Flexible Spending Account (FSA)
See template
See template
Preparticipation Physical Evaluation History Form
PDF template
Medical history and screening form for athletes to assess their health and fitness for sports participation.
See template
See template
Preparticipation Physical Evaluation History Form
PDF template
Comprehensive medical history form for athletes to evaluate health status and potential medical concerns prior to sports participation
See template
See template
PATIENT INTAKE FORM
PDF template
A comprehensive form for patients to complete and schedule appointments at various PanCare Health clinics in Florida counties.
See template
See template
2023 JCC Maccabi Teen Medical Form
PDF template
Medical examination form for teens participating in JCC Maccabi sports and arts activities to verify physical fitness and health status.
See template
See template
Student Medical Information
PDF template
A comprehensive medical form for collecting student health details, emergency contacts, and insurance information for educational program participation.
See template
See template
2023 Rechelle Turner Basketball Camps Medical Release Form
PDF template
Medical release and consent form for participation in basketball camp, including emergency contact and insurance information.
See template
See template
YWCA High Point Membership Form
PDF template
Membership registration form for YWCA High Point that includes liability release, photo release, and membership terms.
See template
See template
PA Schedule E Rents And Royalty Income (Loss)
PDF template
Tax form for reporting rental property income, royalties, and related expenses for Pennsylvania taxpayers.
See template
See template
PW Hong Memorial Fellowship Program Application Form
PDF template
Application form for medical professionals seeking a fellowship with the Asian Society for Cardiovascular and Thoracic Surgery
See template
See template
Kailua Canoe Club Scholarship Application Form 2023 (Individual)
PDF template
A scholarship application form for youth paddlers under 18 years old interested in Hawaiian canoe racing.
See template
See template
Brother Joseph Miggins Service Program Proposal Form
PDF template
A student proposal form for documenting community service project details and intended service activities.
See template
See template
2023 SEASON OUTDOOR AQUATIC CENTER MEMBERSHIP FORM
PDF template
A form for obtaining seasonal membership to the Sheldon Outdoor Aquatic Center, detailing membership types, family requirements, and pool rules.
See template
See template
Town Of Miami Lakes Sports Hall Of Fame Nomination Form
PDF template
A document outlining the nomination process and criteria for inducting athletes and sports contributors into the Town of Miami Lakes Sports Hall of Fame.
See template
See template
SPLASH ZONE RENTAL APPLICATION AND AGREEMENT
PDF template
A rental application for reserving the Splash Zone facility for a private event with associated fees and usage terms.
See template
See template
2023 SUMMER SPORTS CAMP REGISTRATION
PDF template
Registration form for children participating in Calvin University's summer sports camps, including health and liability information.
See template
See template
FORM XI INSURANCE FORM
PDF template
Official insurance form for filing a death claim with details of the deceased, insurance policy, and compensation calculation.
See template
See template
Pre Authorization Request Form
PDF template
A medical pre-authorization form for healthcare providers to request service approval from UHSM, detailing patient and provider information.
See template
See template
Pre Authorization Request Form
PDF template
A form for healthcare providers to request pre-authorization for medical services from UHSM with detailed documentation requirements.
See template
See template
Insurance Renewal Memo
PDF template
Memo discussing the option to waive statutory tort limits and purchase excess liability insurance for the City of Sunfish Lake.
See template
See template
Property Damage Personal Injury Claim Form (Other Than Vehicle)
PDF template
A municipal claim form for reporting property damage or personal injury within the Town of Innisfil's jurisdiction, excluding vehicle-related incidents.
See template
See template
LIC Operations Committee Meeting
PDF template
Two-day conference hosted by Baltimore Life focusing on operational innovation and strategic improvement in the insurance industry.
See template
See template
Invoice Form For Morphology
PDF template
A detailed medical form for collecting patient morphological diagnostic information related to hematological conditions.
See template
See template
Scholarship Application Form
PDF template
A comprehensive scholarship application for artists seeking financial support for art classes, requiring detailed personal and artistic information.
See template
See template
2024 2025 Benefits Enrollment Form
PDF template
Form for employees to select health benefit plans, add or remove dependents, and update personal information for the upcoming benefits year.
See template
See template
Garden Grove Teen Action Collaborative ApplicantS Information
PDF template
Waiver and consent form for participating in City of Garden Grove recreation programs, events, or activities for teens.
See template
See template
Group Medical Plan Waiver Form
PDF template
A form for employees to waive medical plan coverage by certifying alternative health insurance coverage and understanding ACA requirements.
See template
See template
TASBO Membership And Professional Liability Insurance Form
PDF template
Membership registration form for Texas Association of School Business Officials with optional professional liability insurance coverage
See template
See template
TAPPS MEDICAL HISTORY FORM
PDF template
Annual medical history form for students participating in TAPPS athletic and fine art activities to assess health risks.
See template
See template
A.C. Nielsen Tennis Center 2024 25 Annual Membership Application
PDF template
Membership application for A.C. Nielsen Tennis Center covering annual membership from September 1, 2024 through August 31, 2025
See template
See template
Annual Pre Participation Physical Evaluation
PDF template
Medical evaluation form for student-athletes to assess physical fitness and health conditions for sports participation.
See template
See template
Form 24 1b NCAA Division I Drug Testing Consent
PDF template
Mandatory consent form for NCAA Division I student-athletes agreeing to year-round drug testing and understanding associated regulations.
See template
See template
Form 24 3f Drug Testing Consent NCAA Division III
PDF template
Consent form for student-athletes to agree to NCAA drug testing requirements for intercollegiate athletics participation.
See template
See template
2024 2025 Sports Qualifying Physical Examination Medical Eligibility Form
PDF template
Medical form for determining student athletes' medical eligibility and participation in high school sports
See template
See template
Sports Physical Examination Form
PDF template
Comprehensive medical evaluation form for students participating in school sports, requiring parental authorization and medical provider assessment.
See template
See template
2024 2025 SCHOOL YEAR RAP REGISTRATION FORM
PDF template
Registration form for Alameda Recreation and Park Department's after-school program for the 2024-2025 school year.
See template
See template
MEDICAL EXAMINATION FORM
PDF template
Medical form to assess physical and mental fitness of individuals applying for motorcycle event participation licenses.
See template
See template
MEDICAL HISTORY FORM
PDF template
Comprehensive medical history form for capturing individual health details, medical conditions, and consent for medical information sharing.
See template
See template
MEDICAL EXAMINATION FORM
PDF template
A comprehensive medical examination form to assess physical and mental fitness for participating in motorcycle events.
See template
See template
2024 ATLANTIS CROWN Competition Entry Form
PDF template
Entry form for men's and women's gymnastics competition held from December 19-22, 2024.
See template
See template
NRPA Annual Conference Registration Form
PDF template
Registration form for professionals in parks, recreation, and related fields to attend the annual conference.
See template
See template
Preliminary Accident Report
PDF template
A comprehensive form documenting details of a vehicle accident, including driver, vehicle, and third-party information for insurance and risk management purposes.
See template
See template
18th Annual Combat Fishing Tournament Participation Approval Form
PDF template
Official form for military personnel to obtain approval for participating in an annual fishing tournament
See template
See template
Cooma Show 2024 Ground Space Booking Form
PDF template
Booking form for stallholders and vendors to reserve space at the 2024 Cooma Show with detailed terms and conditions.
See template
See template
Dual Membership Form Leonhard Recreation Center Martens Center
PDF template
Form for registering a dual membership at Leonhard and Martens Recreation Centers with options for individual and family memberships.
See template
See template
Notification Of Intent To Use Exhibitor Appointed Contractor
PDF template
Form for exhibitors to declare non-official contractors for The Aesthetic Meeting 2024 event and provide required insurance details.
See template
See template
FIDA Application Form
PDF template
Application form for submitting project proposals to the Fund for the International Development of Archives (FIDA), an initiative of the International Council on Archives (ICA).
See template
See template
Ball Field Rental Procedures
PDF template
Comprehensive procedures and guidelines for renting ball fields from the Champaign Park District, covering rental terms, liability, and usage requirements.
See template
See template
Patient Demographic Form
PDF template
A comprehensive form for collecting patient personal, contact, and insurance information for medical services.
See template
See template
Informed Consent, Voluntary Waiver, Release Of Liability Assumption Of Risks Form
PDF template
Legal consent form for parents/guardians to authorize children's participation in summer youth programs at Clark State College, acknowledging risks and liability waivers.
See template
See template
Ascension Illinois Influenza Vaccination Billing Form
PDF template
Medical form for collecting patient information for influenza vaccination and billing purposes.
See template
See template
2024 Guardian Dental Cancellation Form
PDF template
A form to request cancellation of Guardian Dental insurance coverage by an employee.
See template
See template
Child Medical Disclosure Form
PDF template
Medical information and emergency contact form for children attending summer camp, including health history and parental consent for medical treatment.
See template
See template
Jersey Shore School Education Foundation Student Scholarship Form
PDF template
A scholarship opportunity for Jersey Shore Area High School graduating seniors pursuing healthcare-related college programs with awards of $1000 for one four-year and one two-year program recipient.
See template
See template
Kamehameha Schools Summer Programs Medical Forms
PDF template
Medical evaluation and health history form for children participating in Kamehameha Schools Summer Programs, requiring physical examination and immunization documentation.
See template
See template
HPU Incoming Student Health Information And Immunization
PDF template
Comprehensive health form for incoming students at High Point University, including immunization records and medical consent.
See template
See template
HSA Payroll Deduction Form 2024
PDF template
A form for employees to authorize payroll deductions for Health Savings Account contributions with IRS contribution limits and University contribution details.
See template
See template
Pre Employment Health Clearance Requirements
PDF template
Comprehensive health screening requirements for new medical residents and fellows, including medical history, immunizations, and occupational health screenings.
See template
See template
Incoming Trainee Timeline August 1, 2024
PDF template
Comprehensive timeline and requirements for incoming medical trainees, detailing necessary documentation and submission processes for licensing and staff appointment.
See template
See template
2024 HIGH PERFORMANCE PLAYER WAIVER FORM
PDF template
Waiver and registration form for participants in athletic club activities, covering personal and emergency information along with liability release.
See template
See template
2024 UNC Soccer Camp MEDICAL FORM
PDF template
Medical history and health screening form for participants of UNC Soccer Camp, required for camp participation.
See template
See template
Medical History And Physical Examination Form
PDF template
Medical history and physical examination document for racing car drivers to assess fitness and health conditions for licensing.
See template
See template
Eugene Metro Futbol Club Medical Release Release Of Liability Form
PDF template
Medical and liability consent form for youth soccer player registration and participation in soccer programs.
See template
See template
Jr All American Of Southern California Conference Mandatory Medical Release Form
PDF template
Medical history and physical examination form required for youth athletes participating in Jr All American of Southern California Conference sports programs
See template
See template
2024 Direct Member Reimbursement Request Form
PDF template
A form for Medicare plan members to request reimbursement for dental, eyewear, and hearing aid services.
See template
See template
BOAT NUMBER ACCIDENT WAIVER AND RELEASE OF LIABILITY
PDF template
Legal waiver for participants in the Missouri American Water MR340 river race, acknowledging significant physical risks and releasing event organizers from liability.
See template
See template
PLAN YEAR 2024 ENROLLMENTCHANGE FORM MEDICAL SPENDING CONVERSION (MSC) HEALTH BENEFITS BUY OUT WAIVE
PDF template
Enrollment form for New York City employees to participate in or terminate health benefits buy-out waiver program for plan year 2024.
See template
See template
Community Zone Participation Form
PDF template
Application form for community groups to participate in Aurora's Multicultural Festival by setting up an interactive booth.
See template
See template
National Recreation And Park Association CPRP And CPRE Grant Application Form
PDF template
A grant application form for professional certification in recreation and park management through CPRP and CPRE programs.
See template
See template
GENERAL MEDICALPHYSICAL EXAM FORM
PDF template
Medical examination form for veterans participating in the National Veterans Summer Sports Clinic, to be completed by a clinician.
See template
See template
Group Medicare Enrollment Form Kaiser Permanente Medicare AdvantageSenior Advantage (HMO)
PDF template
Enrollment form for individuals seeking to join Kaiser Permanente's Medicare Advantage/Senior Advantage health plan through a group plan.
See template
See template
20232024 Season
PDF template
Registration and medical information form for volleyball team participants, including contact details, medical history, and insurance information
See template
See template
2024 Player Transfer Request Form
PDF template
A form for requesting player transfer between sports associations or teams for youth athletes under 15 years old.
See template
See template
Lions Park Aquatic Center Membership Application
PDF template
Application for seasonal pool membership at Boonville Lions Park Aquatic Center with pricing and membership details.
See template
See template
Procurement Form 2024
PDF template
Official submission form for the 32nd Annual Museum of Northwest Art (MoNA) Art Auction, collecting artwork donation details and artist information.
See template
See template
TRAPS Conference Registration Form
PDF template
Registration form for professional conference with multiple track sessions and fee structure for members, non-members, and students.
See template
See template
St. Charles Park District Registration Form
PDF template
Registration form for participating in St. Charles Park District programs and activities, including waiver and participant information.
See template
See template
Shipping Form For New York State Fair Entries
PDF template
Shipping guidelines and form for submitting entries to the Wegmans Art & Home Center at the New York State Fair.
See template
See template
GRYD Summer Night Lights 2024 Youth Sport Registration Form
PDF template
Registration form for youth sports participation in the Summer Night Lights program in Los Angeles
See template
See template
2024 Summer Softball League Registration Form
PDF template
Registration form for a summer softball league with various division options and team management details.
See template
See template
Stone X Spade, Inc. Blanket Rental Agreement
PDF template
Comprehensive rental agreement for equipment rental services with detailed payment, insurance, and service terms.
See template
See template
Disability Insurance Claim Packet Instructions
PDF template
Instructions for filing a disability insurance claim with Standard Insurance Company, detailing the application process and required documentation.
See template
See template
2024 North Texas Soccer Tournament Of Champions Team Medical Release Confirmation Form
PDF template
A form confirming that medical release forms for players have been collected and will be available during tournament games.
See template
See template
Credentials Check List For Tournament Teams
PDF template
Detailed guidelines for tournament team documentation and eligibility verification for Dixie Boys Baseball (DBB) tournaments.
See template
See template
VADA Termination Or Voluntary Cancellation Form
PDF template
Form for employees to cancel or terminate their employment benefits including medical, dental, vision, disability, and life insurance.
See template
See template
2024 Vanderbilt Payroll Deduction Form
PDF template
A form allowing Vanderbilt University employees to purchase season tickets via payroll deduction with specific eligibility rules and conditions.
See template
See template
Provincial Winter Fair Release Of Liability Acknowledgement Of Risk
PDF template
Legal document releasing liability for participants in provincial fair activities involving livestock and events
See template
See template
2025 Provider Referral Form
PDF template
A medical referral form for patients seeking enrollment in weight management or diabetes management programs through the Florida Department of Management Services.
See template
See template
Benefits Cancellation Form
PDF template
Form for employees to remove dependents from their healthcare or insurance benefits plan.
See template
See template
2025 ABC Travelling Fellowship Application Form
PDF template
Application for Canadian orthopaedic surgeons to participate in an international medical exchange fellowship program in the United Kingdom, Australia/New Zealand, or South Africa.
See template
See template
2026 Canadian Wildlife Habitat Conservation Stamp And Print Artist Agreement
PDF template
Legal agreement for artists participating in the 2026 Canadian Wildlife Habitat Conservation Stamp and Print competition, outlining terms and conditions of participation.
See template
See template
Group AdministratorS Member Transactions
PDF template
Form for group administrators to manage member insurance coverage changes, cancellations, and reinstatements
See template
See template
Disability Insurance Claim Packet Instructions
PDF template
Comprehensive guide for applying for disability insurance benefits through Standard Insurance Company, detailing claim submission process and requirements.
See template
See template
Health Services Referral Form
PDF template
A comprehensive referral form for various health services targeting children, youth, and pregnant women in Mississippi.
See template
See template
SoonerCareInsure Oklahoma Referral Form
PDF template
A referral form for healthcare providers to refer patients for medical services within the SoonerCare/Insure Oklahoma program.
See template
See template
Alabama First Class Pre K Program Appendix F DECE Incident Report Form
PDF template
A standardized form for reporting serious accidents, injuries, medical situations, or behavior incidents in the Alabama First Class Pre-K Program.
See template
See template
2020 Eve Gene Black Summer Medical Career Program FAQs
PDF template
Comprehensive guide for a medical mentor/internship program for students in Los Angeles and adjacent counties
See template
See template
Road Service Reimbursement Request
PDF template
Form for AAA members to request reimbursement for roadside assistance services in specific states and territories.
See template
See template
Everence HSA Contribution Form
PDF template
A form for making individual contributions to a Health Savings Account through Everence Federal Credit Union with tax year specification options.
See template
See template
Property Loss And Damage Report Form
PDF template
A document for reporting property loss and damage incidents, used for documenting financial transactions and potential insurance claims.
See template
See template
Form 216 F Health Carrier External Review Annual Report Form
PDF template
Annual reporting form for health carriers to provide aggregate information about external review requests in Virginia
See template
See template
Apricus Referral Form
PDF template
A comprehensive medical referral form for patient discharge planning and facility care management services.
See template
See template
Calgary Sketch Painting Club Exhibition Form
PDF template
A form for artists to submit details about their artwork for a Calgary Sketch & Painting Club exhibition.
See template
See template
ART SHOW INVENTORY FORM
PDF template
A form for artists to record artwork details, sales information, and track commission and payments during an art exhibition.
See template
See template
MyFitRx And Kids On The Move Reimbursement Form
PDF template
A reimbursement form for members participating in MyFitRx or Kids on the Move fitness programs, offering up to $50 per benefit year.
See template
See template
Invitation For Bid 22 2325 Smart UPS And Battery Pack
PDF template
Competitive bid solicitation by the Port of Oakland for procurement of Smart-UPS and Battery Pack equipment through the Purchasing Department.
See template
See template
Physician Examination Form
PDF template
A comprehensive medical form required for students to provide health information and undergo physical examination prior to campus arrival.
See template
See template
Participant Liability Release And Waiver Form
PDF template
A comprehensive liability release form for participants in cheer and dance events organized by Varsity Spirit LLC.
See template
See template
USA Volleyball Incident Report Form
PDF template
Comprehensive form for documenting injuries or property damage during USA Volleyball events
See template
See template
USA Volleyball Incident Report Form
PDF template
Official form for documenting injuries or property damage incidents during USA Volleyball events
See template
See template
Final Expense Frequently Asked Questions
PDF template
Comprehensive guide detailing payment methods, billing options, and administrative procedures for final expense insurance policies.
See template
See template
Hanford Employee Welfare Trust Short And Long Term Disability Plan And Disability Equalizer Benefit
PDF template
Summary plan description detailing short and long term disability benefits for Hanford employees
See template
See template
Monthly Grant Funding (MGF) Payment Inquiry Form
PDF template
Form for community partner clinics to inquire about missing grant funding payments for enrolled participants.
See template
See template
Claim Form
PDF template
Official form for submitting property damage or injury claims to the City of Mobile municipal government
See template
See template
PATIENT FEEDBACK FORM
PDF template
A form designed for patients to provide feedback or file complaints with Big Island Healthcare, allowing anonymous submission and formal review process.
See template
See template
NEW PATIENT INTAKE FORM
PDF template
Comprehensive medical intake form for collecting new patient health information, medical history, and family health background.
See template
See template
Request For Proposal Package
PDF template
Guidelines and instructions for submitting a proposal to the Rhode Island Public Transit Authority for insurance broker services.
See template
See template
Enrollment Form
PDF template
A comprehensive form for collecting student and family details, including contact information, family history, and hearing loss information.
See template
See template
Student Medical Form
PDF template
Comprehensive medical form for collecting student health information, medical history, and emergency contact details.
See template
See template
Wisconsin Youth Soccer Association Event Medical Release Form
PDF template
Medical and liability release form for youth soccer participants, covering medical consent and injury acknowledgment.
See template
See template
Retiree Benefits Enrollment Form
PDF template
Form for retirees or surviving spouses to enroll or modify health and dental benefits coverage options.
See template
See template
Notice Of Serious Incident
PDF template
Official documentation of a medical incident involving a resident at a behavioral health facility who experienced seizures and required medical transport.
See template
See template
Group Whole Life Enrollment Forms And Statement Of Insurability Forms
PDF template
Regulatory standards for enrollment forms related to group whole life insurance policies, defining requirements for form submission and usage.
See template
See template
Public Official Bond Surety Application And Indemnity Agreement
PDF template
A surety application and indemnity agreement for public officials seeking bond coverage through a municipal insurance fund.
See template
See template
Reply Form MiFIR Review RTS 2, RTS On Reasonable Commercial Basis And RTS 23
PDF template
A consultation document seeking stakeholder input on technical regulatory standards related to MiFIR financial regulations.
See template
See template
Emergency Contact Form
PDF template
A comprehensive emergency contact and medical information form for high school band and dance students in Fort Bend Independent School District.
See template
See template
24 25 Physical Examination Form
PDF template
Medical form for student athletes to document physical fitness and health status for school sports participation.
See template
See template
2024 Nomination Form
PDF template
A comprehensive nomination form for an award, requiring detailed nominee information and supporting documentation.
See template
See template
Request For Certificate Of Insurance
PDF template
A form used to request a certificate of insurance from Purdue University's Risk Management department.
See template
See template
Certificate Of Compliance Workers Compensation Law
PDF template
A form documenting workers' compensation insurance compliance for Minnesota State Fair licensees, required by state law.
See template
See template
Accommodation Request EmployeeS Serious Health Condition Medical Form
PDF template
A form for employees to request workplace accommodations due to serious health conditions, requiring medical provider verification and details.
See template
See template
Personal Property Inventory Form
PDF template
Insurance claim form for documenting personal property damage and losses with comprehensive item tracking details.
See template
See template
Neighborhood Participation Meeting Sign In Sheet
PDF template
A sign-in sheet for documenting participant attendance at a proposed neighborhood project meeting, with a disclaimer about meeting participation.
See template
See template
Registration For Risk Purchasing Group (RPG)
PDF template
Official form for registering a risk purchasing group to conduct insurance activities in Wisconsin, as required by state statute.
See template
See template
Club Sport Waiver 2024 2025
PDF template
Legal waiver for Villanova University students participating in club sports during the 2024-2025 academic year, acknowledging potential risks and releasing the university from liability.
See template
See template
Town Of Hurley Requirements For Building Permit
PDF template
Comprehensive guide detailing documentation and requirements for obtaining a building permit in the Town of Hurley, New York.
See template
See template
Universal Provider Request For Claim Review Form
PDF template
A standardized form for healthcare providers to submit claim review requests to multiple health plans and MassHealth in Massachusetts.
See template
See template
Public Involvement Form
PDF template
A form for collecting demographic information to ensure inclusive public involvement in transportation decision-making processes.
See template
See template
Connecticut Forms Of Organization
PDF template
Comprehensive overview of different organizational forms for businesses and nonprofits in Connecticut, detailing formation requirements, management, liability, and tax considerations.
See template
See template
UC ANR Waiver
PDF template
A legal waiver for participants attending the 2018 Western Region Leaders Forum events, releasing the University of California from liability for activities and potential risks.
See template
See template
Southern Michigan Insurance Company V State Farm Insurance Company
PDF template
A court of appeals case involving automobile no-fault insurance coverage and personal injury protection benefits for a spouse during ongoing divorce proceedings.
See template
See template
DSS Form 2901 Medical Statement
PDF template
Medical health form for staff, volunteers, and emergency personnel working in child care services, documenting health history and tuberculosis status.
See template
See template
Medical Statement
PDF template
A medical health screening form for staff, volunteers, and emergency personnel working in child care settings in South Carolina.
See template
See template
Medical Statement
PDF template
Medical health screening form for staff, volunteers, and emergency personnel in child care services in South Carolina.
See template
See template
Non UH Event Or Activity Participant Consent, Waiver, Release And Indemnity Agreement
PDF template
Legal document outlining participant consent, risk acknowledgment, and liability release for non-University of Hawaii events or activities.
See template
See template
Participant Consent, Waiver, Release And Indemnity Agreement Non UH Event Or Activity
PDF template
A legal consent and release form for participants in non-University of Hawaii events, outlining health representations, risk assumptions, and liability waivers.
See template
See template
Claim Process For Swasthya Ratna Policy
PDF template
Detailed guide explaining cashless and reimbursement claim processes for insurance policy, covering planned and emergency hospitalizations.
See template
See template
CLAIM FORM FOR HEALTH DEPENDENT CARE EXPENSES
PDF template
A form for employees to request reimbursement for health and dependent care expenses through their Flexible Spending Account (FSA)
See template
See template
Enrollment Form
PDF template
An enrollment form for collecting personal and dependent information for insurance or benefits enrollment with Lincoln Financial Group.
See template
See template
Loss Claim Form
PDF template
A guide for fish harvesters and processors to claim compensation for gear, vessel damage, or oil spills related to the Hibernia project.
See template
See template
University Of Kentucky Medical Inquiry Form In Response To An Accommodation Request
PDF template
Medical form used to assess an employee's disability status and potential accommodations under the Americans with Disabilities Act (ADA)
See template
See template
PATIENT MEDICAL HISTORY FORM
PDF template
Comprehensive medical form capturing patient personal information, current medications, allergies, and past medical history details.
See template
See template
New Patient Intake Form
PDF template
Comprehensive medical intake form for new patients seeking holistic healthcare at the Riordan Clinic, collecting detailed personal and medical information.
See template
See template
Personal Automobile Rate And Rule Manual And Underwriting And Procedures Manual
PDF template
Comprehensive manual for personal automobile insurance rates, rules, underwriting guidelines, and procedures for Capitol Insurance Company.
See template
See template
Laboratory Supply Order Form
PDF template
Form for ordering laboratory specimen collection and shipping supplies for various medical testing needs.
See template
See template
30 Days Needs Assessment Form Status
PDF template
Form used to document assessment status and communication attempts with migrant student families within 30 days of initial contact.
See template
See template
ACORD 35 Cancellation Request Policy Release
PDF template
A standardized form for requesting cancellation or release of an insurance policy, providing clear details and minimal room for miscommunication.
See template
See template
Camp Blue Spruce Medical Form 2016
PDF template
A comprehensive medical form for campers to provide health and emergency contact information for Camp Blue Spruce summer camp.
See template
See template
PIP Checklist
PDF template
A comprehensive checklist for healthcare providers to ensure complete documentation and submission of required forms for personal injury protection insurance claims.
See template
See template
Rotation Assessment Form
PDF template
A medical assessment form for evaluating thoracic spine mobility and potential biomechanical issues.
See template
See template
Senate Bill No. 320
PDF template
New Jersey legislative bill that restricts and regulates access to motor vehicle accident reports for specific parties.
See template
See template
Pension Application Form
PDF template
Comprehensive application form for pension insurance covering employer and employee details for individual or group policies.
See template
See template
AAOS CME SKILLS COURSE REGISTRATION FORM
PDF template
Registration form for AAOS Fundamentals of Knee & Shoulder Arthroscopy course for orthopaedic residents in September 2024.
See template
See template
Institutional Drug Testing Program Student Athlete Notification Form
PDF template
A form documenting notification and consent for drug testing of student-athletes at an educational institution.
See template
See template
Ohio Administrative Code Rule 3344 94 03 Policy
PDF template
Administrative policy outlining safety and communication protocols for university programs involving minors, including emergency procedures and medical considerations.
See template
See template
3364 35 16 Compliance Rules Education And Training
PDF template
University policy outlining compliance education and training procedures for athletics department personnel and student-athletes.
See template
See template
Standardized Application For Pathology Fellowships
PDF template
Comprehensive application form for physicians seeking pathology fellowship training at the University of Texas Southwestern Medical Center.
See template
See template
Administrative Procedure 3810 Claims Against The District
PDF template
Outlines the MiraCosta Community College District's responsibilities and procedures for handling claims involving injuries, property damage, and liability.
See template
See template
ARTH 395 Internship Application Form
PDF template
Application form for students seeking an internship through the Art Department at their academic institution.
See template
See template
Medco Health Prescription Order Form
PDF template
A form for ordering prescription medications through Medco Health, with options for refills, new prescriptions, and payment methods.
See template
See template
ATHLETIC INSURANCE CERTIFICATION FORM
PDF template
A form certifying student insurance coverage for athletic participation at Gateway Middle School
See template
See template
Incident Report Form
PDF template
A comprehensive form for documenting workplace or program-related incidents, including details about the incident, individuals involved, and follow-up actions.
See template
See template
MEDICAL HISTORY FORM
PDF template
Comprehensive medical form collecting patient personal health information, medical history, family history, and COVID-19 screening details.
See template
See template
REENTRY (REPS) SERVICE REQUEST FORM
PDF template
A form used by healthcare providers to request medical services for patients in the California Department of Corrections and Rehabilitation system.
See template
See template
PAXLOVID ORDER FORM FOR OUTPATIENT ORDER SET PER FDA EUA
PDF template
Medical order form for prescribing Paxlovid, an emergency use authorization (EUA) medication for treating mild-to-moderate COVID-19 in eligible patients.
See template
See template
Volunteer Coaching Release Of Liability
PDF template
Legal document releasing the university from liability for risks associated with volunteer coaching activities.
See template
See template
HIPAA 404P Authorization To Release Or Obtain Health Information
PDF template
A form for authorizing the release or obtaining of protected health information under HIPAA guidelines.
See template
See template
System Safety Implementation Plan For The Goddard Space Flight Center Explorers Program Office
PDF template
A comprehensive safety implementation plan for NASA's Goddard Space Flight Center Explorers Program, detailing safety requirements and procedures.
See template
See template
Legal Forms Of Business Organisations An Overview
PDF template
A comprehensive overview of different legal business forms and key considerations for selecting a business structure.
See template
See template
Consulting PhysicianS Compliance Form
PDF template
Medical form for documenting terminal illness assessment, patient competency, and informed decision-making for end-of-life care.
See template
See template
DOH 422 066 PsychiatricPsychological ConsultantS Compliance Form
PDF template
A medical form for documenting psychiatric evaluation and patient mental health status compliance assessment.
See template
See template
HUD Handbook 4240.4 REV 2
PDF template
Guidelines for HUD mortgage endorsement process, focusing on rehabilitation loan procedures and insurance requirements.
See template
See template
Electronic Debit Service Agreement
PDF template
Agreement for automatic monthly payments from a bank account for PEBB insurance coverage.
See template
See template
Pack Overnight Campout Site Appraisal Form
PDF template
A comprehensive checklist for local Boy Scouts of America councils to assess and document potential overnight camping locations for pack activities.
See template
See template
NY Medicaid Provider Enrollment Form For Practitioners
PDF template
A form for healthcare providers to enroll in the New York State Medicaid Program, detailing privacy requirements and enrollment process.
See template
See template
New York State Medicaid Enrollment Form
PDF template
Form for healthcare practitioners to enroll as Medicaid providers in New York State, covering ordering, referring, and managed care network providers.
See template
See template
Medicare Reimbursement Account (MRA) Claim Form Instructions
PDF template
Detailed instructions for submitting Medicare Part B premium reimbursement claims through a Medicare Reimbursement Account.
See template
See template
Independent Contractor Agreement
PDF template
A contract defining the terms of engagement between the Brewster Recreation Department and an independent contractor for services.
See template
See template
Broker Agreement
PDF template
Document detailing requirements for brokers to initiate appointment process with AmWINS Program Underwriters
See template
See template
Medical Service Request Form
PDF template
A form for healthcare providers to request medical services for South Country Health Alliance members with detailed service and patient information.
See template
See template
American Culinary Federation Salon Competition Agreement Form
PDF template
Legal agreement for culinary competition participants outlining competition rules, liability release, and media usage permissions.
See template
See template
Chapter 6 Final Endorsement
PDF template
Detailed guidelines for final endorsement procedures for mortgage insurance transactions involving construction loans.
See template
See template
HUD Handbook 4700.1 REV 1
PDF template
HUD handbook providing guidelines for lending institutions on credit application, investigation, and approval processes for insurance-backed loans.
See template
See template
Youth Member Health History Information
PDF template
A comprehensive health information form for youth members participating in 4-H programs, collecting medical history, medications, and special needs information.
See template
See template
Request For Proposal For Third Party Administrator For Self Insured Workers Compensation And Employe
PDF template
Request for proposal document for selecting a third-party administrator for workers' compensation and employers' liability insurance coverage for Boone County, Missouri.
See template
See template
Incident Or Injury ReportingInsurance
PDF template
A comprehensive procedure for reporting and documenting incidents, injuries, and equipment damage at Piedmont Technical College.
See template
See template
SI 2047 Your Disability Benefit Claim
PDF template
Comprehensive guide and forms for applying for disability insurance benefits, including instructions for claim submission and potential benefit reductions.
See template
See template
Product Standards For Service Contracts
PDF template
Regulatory guidelines for service contract providers in Oregon, defining filing requirements and contract standards for service agreements.
See template
See template
Shareholders Agreement Western Professional Insurance Company
PDF template
A legal agreement defining the terms of share ownership, board composition, and share transfer restrictions among insurance company shareholders.
See template
See template
Out Of Network Reimbursement Form
PDF template
A form for employees to submit out-of-network healthcare service reimbursement claims with detailed patient and service information.
See template
See template
NC Medicaid Enrollment Form
PDF template
Form for choosing or changing Medicaid health plans and primary care providers in North Carolina.
See template
See template
Four Corners Dressage And Combined Training Association Membership Application Form
PDF template
Membership application form for Four Corners Dressage and Combined Training Association with various membership levels and waivers.
See template
See template
COVID 19 Participant Code Of Conduct And Risk Assessment Form
PDF template
A risk assessment and conduct guidelines form for Special Olympics participants during the COVID-19 pandemic
See template
See template
Authorization To Disclose Confidential Information
PDF template
A form authorizing the release of personal medical information to specified parties with details on the type and purpose of disclosure.
See template
See template
DEALERS OPEN LOT GARAGE KEEPERS LEGAL LIABILITY PROPOSAL FORM
PDF template
Insurance proposal form for automotive dealers, parking lots, and related businesses seeking garage keepers legal liability and dealers open lot coverage.
See template
See template
Georgia 4 H Participation Agreement And Waiver Form
PDF template
A legal waiver for participants in Georgia 4-H virtual programs, covering liability and consent for program participation.
See template
See template
Health Requirements For Matriculation
PDF template
Comprehensive health documentation requirements for students, detailing mandatory vaccinations and immunization guidelines.
See template
See template
Suburban Law Enforcement Academy Medical Examination Package
PDF template
Medical examination and approval form for police recruit candidates to assess fitness for law enforcement training program
See template
See template
Patient Intake Form
PDF template
Comprehensive form for collecting patient personal, medical, insurance, and contact information for healthcare providers.
See template
See template
M TIBA OUTPATIENT CLAIM AND PRE AUTHORIZATION FORM
PDF template
A comprehensive healthcare claim form for submitting outpatient medical treatment details and seeking pre-authorization for medical services.
See template
See template
Middlesex School TB Risk Assessment Form
PDF template
A medical form to assess tuberculosis risk for students by evaluating travel history, exposure, and potential testing requirements.
See template
See template
Virginia Service Request Form
PDF template
Official form for insurance agents to request name changes, license updates, and address modifications in Virginia.
See template
See template
CMS 1500 Claim FormAmerican National Standards Institute (ANSI) Crosswalk For PaperElectronic Claims
PDF template
A comprehensive guide explaining how to file Medicare claims electronically or via paper form, detailing the correspondence between paper and electronic claim elements.
See template
See template
Weekly Disability Claim Form
PDF template
A comprehensive form for reporting disability status and medical information for the Greater St. Louis Construction Laborers' Welfare Fund.
See template
See template
ILR Emergency Medical Form
PDF template
A comprehensive form for participants to acknowledge risks, provide emergency medical information, and grant permissions for Institute for Learning in Retirement activities.
See template
See template
INSURANCE COMPLAINT FORM
PDF template
Official form for consumers to file insurance-related complaints with the Office of the Commissioner of Insurance in Wisconsin.
See template
See template
Sample Letter For Insurance Claim Property Damage
PDF template
A template document for filing insurance claims related to property damage, covering motor vehicle and other property damage scenarios.
See template
See template
Direct Deposit Authorization Form
PDF template
Form for authorizing direct deposit of flexible spending account (FSA) or health reimbursement account (HRA) reimbursements.
See template
See template
Disability Claim Application Forms
PDF template
Comprehensive documentation requirements for submitting a disability insurance claim with multiple form and document submission instructions.
See template
See template
Required NYS School Health Examination Form
PDF template
Comprehensive health examination form for New York State school students, capturing medical history and current health status.
See template
See template
Appellate Division Court Document Daniel F. Imrie II V. Andrew R. Ratto Et Al.
PDF template
A court document detailing appeals from judgments and orders in a legal case involving multiple parties and insurance claims.
See template
See template
Form To Be Filled By Appointee On Stipendiary Assignments Of DJST
PDF template
Application form for candidates seeking stipendiary assignments at Seth G.S. Medical College & K.E.M. Hospital Diamond Jubilee Society Trust
See template
See template
Chronic Illness Benefit Application Form 2013
PDF template
Medical application form for registering chronic illness benefits with Discovery Health Medical Scheme for the year 2013
See template
See template
Shift Change Request Form And Advance Time Off Request Form
PDF template
Forms for Town of Beekman Recreation & Parks employees to request time off or shift changes with staff coverage
See template
See template
Program Participant Contact Form
PDF template
A contact form for registering participants in parks and recreation programs, including emergency contact and pickup authorization details.
See template
See template
Fitness Reimbursement Request
PDF template
Form for members to request reimbursement for qualified fitness expenses through Blue Cross Blue Shield of Massachusetts.
See template
See template
UMKC School Of Dentistry Patient Referrals
PDF template
A comprehensive form for referring patients to various dental specialty clinics at the UMKC School of Dentistry.
See template
See template
Blue MedicareRx (PDP) 2024 ENROLLMENT FORM
PDF template
Enrollment form for Medicare beneficiaries who want to join a Medicare Prescription Drug Plan in Connecticut, Massachusetts, Rhode Island, and Vermont.
See template
See template
PROOF OF CLAIM FORM
PDF template
A claim form for potential claimants of a company being liquidated by the Florida Department of Financial Services as Receiver.
See template
See template
Coach Evaluation Form
PDF template
A comprehensive evaluation form for assessing coaches' performance across multiple standards of student-athlete development and program management.
See template
See template
Aflac Continuing Disability Claim Form
PDF template
A form for submitting continuing disability claims with Aflac insurance, providing instructions for online form completion and submission.
See template
See template
Seasonal Survey On Influenza Vaccination Programs For Healthcare Personnel
PDF template
A survey collecting information about influenza vaccination programs and practices for healthcare personnel across different employment groups.
See template
See template
REFUND REQUEST FORM
PDF template
A form for requesting refunds for recreational activities through the East Longmeadow Recreation Department.
See template
See template
Medical Form
PDF template
A medical form for applicants to Notre Dame Seminary's Graduate School of Theology Priestly Formation Program, collecting health and insurance information.
See template
See template
Personal Medical History
PDF template
Comprehensive medical history form for collecting patient health information, medical conditions, family history, and current health status.
See template
See template
Proof Of Death ClaimantS Statement
PDF template
Insurance claim form for reporting and documenting the death of a policyholder, used to initiate a life insurance death benefit claim.
See template
See template
Written Authorization To Enroll Into School Age Program
PDF template
Authorization form for parents to enroll children aged 5 between September and January into a school age program.
See template
See template
NYS Medicaid InstitutionalRate Based Provider Change Of Address Form
PDF template
A form for New York State Medicaid providers to update their correspondence, pay to, and corporate addresses.
See template
See template
Athlete Nomination Form
PDF template
Comprehensive form for athlete registration, personal details, sports experience, and consent for international sporting events
See template
See template
Interactive Registration For Policyholders
PDF template
A confidentiality agreement and registration form for accessing LWCC's online policy and claims information system for policyholders.
See template
See template
FMLA Leave Request Form
PDF template
A form for employees to request leave under the Family and Medical Leave Act for various personal and family medical reasons.
See template
See template
Chair Assessment And Delivery Environmental Questionnaire
PDF template
A comprehensive form for evaluating chair specifications, sizing, and delivery requirements for personalized seating solutions.
See template
See template
Citizens 4 Point Inspection Form
PDF template
A comprehensive inspection form for evaluating property risks and eligibility for insurance purposes, with updated requirements for inspectors.
See template
See template
Gibraltar Residency Application
PDF template
A comprehensive overview of letters of intent for residency applications, explaining their purpose, benefits, and strategic writing approach.
See template
See template
Certificate Of Liability Insurance Form Florida
PDF template
A comprehensive overview of ACORD insurance certificates, explaining their purpose and importance for business risk management.
See template
See template
Acord 27 Form
PDF template
A standard insurance document used to provide proof of property coverage in the insurance industry.
See template
See template
ACORD 35 Cancellation Form
PDF template
A standardized document used to request and document the cancellation of an insurance policy with essential policyholder and policy details.
See template
See template
Incident Reporting Tool
PDF template
Comprehensive form for documenting incidents, injuries, and accidents within BSA programs and activities
See template
See template
Tier 2 Retirement Checklist
PDF template
Comprehensive checklist for Tier 2 retirement application process, detailing required forms and documentation for pension and benefits
See template
See template
Allegany College Of Maryland Athletics Emergency ContactInsurance Form
PDF template
Form for collecting athletic student emergency contact details and health insurance information at Allegany College of Maryland.
See template
See template
Application For Group Insurance CHEIBA Trust
PDF template
A comprehensive insurance application form for employee group insurance coverage with options for various types of insurance benefits.
See template
See template
Student Health Information Form
PDF template
Comprehensive health information form for collecting student medical and contact details at a university
See template
See template
FirstChoice Personal Super Withdrawal Form
PDF template
A form for withdrawing units from a superannuation fund, either as a rollover to another fund or as a cash withdrawal with specific conditions.
See template
See template
Valley ChildrenS Healthcare Outpatient Referral Form
PDF template
A comprehensive medical referral form for patients being referred to Valley Children's Healthcare for specialized medical services.
See template
See template
Medical Referral Form
PDF template
A form for reporting an individual's medical conditions that may impact their ability to safely operate a motor vehicle.
See template
See template
Administrative Rule 722.1 Accident Reporting Procedures And Guidelines
PDF template
Guidelines for reporting and documenting student and staff accidents within a school district, including filing procedures and documentation distribution.
See template
See template
MSDH Motivated To Live A Better Life Referral Form
PDF template
A comprehensive referral form for patients seeking health management support through the Mississippi State Department of Health's lifestyle program.
See template
See template
Workers Compensation Third Party Administrators (TPA) Licensing Packet
PDF template
Licensing documentation for third party administrators handling workers' compensation self-insurance for employers and pools in Tennessee.
See template
See template
Senate Bill No. 768
PDF template
Legislation modifying access rules for motor vehicle accident reports in New Jersey
See template
See template
Notice Of Injury Or Occupational Disease
PDF template
A form used to report workplace injuries or occupational diseases in Nevada, documenting details of the incident and potential worker's compensation claim.
See template
See template
Athletic Injury Report (AIR) Form Information And Procedures
PDF template
Comprehensive guidelines for documenting and reporting athletic injuries in high school and middle school athletic programs.
See template
See template
Medical History Form
PDF template
Comprehensive medical form for students to provide health history and undergo medical screening for enrollment.
See template
See template
GROUP PLANS ENROLLMENT FORM
PDF template
Comprehensive form for employees to select and enroll in group insurance and benefit plans covering life, disability, medical, and supplemental insurance options.
See template
See template
Court Of Appeals Of Washington Opinion Clement Freeman V. Seneca Ventures, Et Al.
PDF template
Legal opinion regarding investment securities litigation involving hotel venture investments and alleged securities law violations.
See template
See template
Express Scripts PharmacySM Home Delivery Form
PDF template
A form for submitting prescription medication orders through Express Scripts' home delivery pharmacy service, including member and patient information, payment options, and shipping details.
See template
See template
HSMV 83392 Insurance Request Form
PDF template
Form for requesting insurance information on a vehicle involved in a crash in Florida, used by individuals or attorneys.
See template
See template
SSU Admission And Discharge Form
PDF template
Medical intake and release document for detainees in immigration health services facilities, tracking health status and disposition.
See template
See template
Questions And Answers From Early Intervention Insurance Assessment Webinar
PDF template
A comprehensive document addressing questions about insurance processes in early intervention services and related forms.
See template
See template
Pyxis Access Request Form
PDF template
Form for healthcare professionals to request access to Pyxis medication management system in specific work areas.
See template
See template
Silent Auction Procurement Form
PDF template
Donation form for collecting item details for the 84th Annual MTRWestern Sports Star of the Year Silent Auction.
See template
See template
Security Incident Report
PDF template
Official form for documenting security incidents at the Mississippi State Department of Health's Office of Health Informatics.
See template
See template
2019 Jijak Youth Camp Medical Release Form
PDF template
A comprehensive medical form for youth camp participants to provide health information, allergies, immunization status, and medical details.
See template
See template
Medical History Form
PDF template
A comprehensive medical history form for sports participation, requiring detailed health information and consent statements.
See template
See template
WakeMed Urgent Care Patient Intake Form
PDF template
Medical form for collecting patient health information, medical history, and current health status at urgent care facility.
See template
See template
Proof Of Claim Form
PDF template
A form for filing claims against Freestone Insurance Company, which is in liquidation, with a deadline of December 31, 2015.
See template
See template
Community Use Of School District Buildings Sites Equipment Facility Request And Agreement Form
PDF template
A form for requesting use of school district facilities and equipment, with liability and insurance requirements.
See template
See template
Refund Request Section 232
PDF template
A U.S. Department of Housing and Urban Development form for requesting refunds related to Section 232 Healthcare Facility Insurance Program.
See template
See template
COVID 19 Participant Code Of Conduct And Risk Assessment Form
PDF template
A comprehensive guidance document outlining participant responsibilities and precautions for COVID-19 safety during Special Olympics activities.
See template
See template
Conditional Commitment Direct Endorsement Statement Of Appraised Value
PDF template
Official HUD document outlining conditions and terms for mortgage insurance and property commitment
See template
See template
REMICADE And Infliximab Mastercard Patient Information Form
PDF template
Form for patients to provide personal information and insurance details for medication rebate program for REMICADE and Infliximab.
See template
See template
Group Benefits EnrolmentChange Form
PDF template
A comprehensive form for enrolling or changing group benefit plan details for employees, including personal information, coverage selection, and benefit options.
See template
See template
Eyer Ropes Challenge Course Release Of Liability, Waiver Of Claims, Assumption Of Risk And Indemnity
PDF template
Legal document releasing liability for participation in high-risk recreational activities at Eyer Ropes Challenge Course.
See template
See template
Refund Process Policy
PDF template
A policy outlining procedures for processing refunds, credit balances, and overpayments for UCR Health patients and third-party payors.
See template
See template
WakeMed Urgent Care Patient Intake Form
PDF template
Comprehensive medical form for collecting patient medical history, past surgical history, family history, and social history at an urgent care facility.
See template
See template
DOT Physical Examination Form
PDF template
Medical examination form for commercial vehicle drivers to assess physical fitness for driving.
See template
See template
Advancing Access Patient Information Form
PDF template
Comprehensive form for collecting patient personal information, contact preferences, and insurance details for medical services.
See template
See template
Subscriber Claim Form
PDF template
A comprehensive insurance claim form for submitting medical service reimbursements to Blue Cross Blue Shield of Massachusetts.
See template
See template
Benefits Administration Letter 99 101
PDF template
Official guidance from the Office of Personnel Management addressing common documentation problems in Federal Employees Retirement System (FERS) applications and retirement claims.
See template
See template
Waiver Of Liability Hold Harmless Agreement
PDF template
Legal document releasing Sam Houston State University from liability for risks associated with study abroad program participation.
See template
See template
Certification Of Trust
PDF template
A form for certifying trust details when a trust is the owner of an Eagle Life insurance annuity contract.
See template
See template
Medical History Form
PDF template
A comprehensive form for collecting patient medical history, current health conditions, medications, and allergies.
See template
See template
Insurance Office Quick Reference Guide 2017
PDF template
Comprehensive reference for filing insurance claims, emergency contacts, and reporting procedures for various types of incidents.
See template
See template
GASLINI INTERNATIONAL PEDIATRIC FELLOWSHIP PROGRAM APPLICATION FORM
PDF template
Application form for medical professionals seeking a fellowship at IRCCS Istituto Giannina Gaslini's pediatric program.
See template
See template
SPECIAL MEETING HOD COMMITTEE VOLUNTEER FORM
PDF template
A form for volunteers to indicate interest in serving on various committees for a Special Meeting of the House of Delegates.
See template
See template
Accident Report Form
PDF template
A comprehensive form for documenting details of a traffic accident, designed for drivers to record witness information and accident circumstances.
See template
See template
Damage Report Form
PDF template
Form for reporting vehicle damage during AAA service, requiring detailed documentation and supporting evidence.
See template
See template
Damage Report Form
PDF template
A comprehensive form for reporting vehicle damage during AAA automotive services, requiring detailed incident documentation.
See template
See template
Preparticipation Physical Evaluation Physical Examination Form
PDF template
Medical evaluation form used to assess an athlete's physical fitness and eligibility to participate in sports activities.
See template
See template
Preparticipation Physical Evaluation Physical Examination Form
PDF template
A comprehensive medical evaluation form for athletes to assess physical fitness and clearance for sports participation.
See template
See template
Booking Form For Tours Cruises
PDF template
A comprehensive booking form for travel tours and cruises, capturing personal details, trip preferences, and payment information.
See template
See template
Amino Acid Laboratory Sample Submission Form
PDF template
A comprehensive form for submitting animal medical samples to the Amino Acid Laboratory at UC Davis for testing.
See template
See template
Submission Form
PDF template
A form for authors submitting manuscripts to Acta Anaesthesiologica Scandinavica, including conflict of interest disclosure requirements.
See template
See template
UNPLANNED ADMISSIONAAU BOOKING FORM
PDF template
A form for booking unplanned hospital admission to the Acute Admissions Unit with comprehensive patient and clinical details.
See template
See template
AAUS Medical Evaluation Of Fitness For Scuba Diving Report
PDF template
A comprehensive medical evaluation form to assess an individual's fitness for scientific scuba diving, including required medical tests and physician's assessment.
See template
See template
Alberta Accident Benefits Initial Claims Process
PDF template
A comprehensive guide for filing insurance claims and accessing medical benefits after an automobile accident in Alberta, Canada.
See template
See template
RENTAL AGREEMENT FOR USE OF SCHOOL DISTRICT EQUIPMENT
PDF template
A rental form for borrowing equipment from the Dickinson Public School District with terms of use and liability provisions
See template
See template
AIChE BEER BREWING COMPETITION WAIVER AND RELEASE OF LIABILITY FORM
PDF template
Legal waiver for participants in an AIChE beer brewing competition, releasing the organization from potential liability and risks associated with the event.
See template
See template
Directions For Completing An ABPN Feedback Module
PDF template
Instructions for psychiatry and neurology professionals to complete a peer or patient feedback module for continuous certification.
See template
See template
AAPS VOLUNTEER FORM
PDF template
A volunteer form for physicians to indicate interest in committee participation and specialty opportunities within the AAPS organization.
See template
See template
Clark Atlanta University Academic Program Proposal Guidelines
PDF template
Guidelines for proposing and approving new and revised academic programs at Clark Atlanta University with detailed review and routing protocols.
See template
See template
Treatment Service Request Form
PDF template
A form for healthcare providers to request and authorize prescription of Nuplazid medication, including patient and insurance information.
See template
See template
Histology Submission Form
PDF template
A detailed form for submitting tissue samples to the UConn Comparative Veterinary Medicine Diagnostic Laboratory for histological processing and analysis.
See template
See template
Patient Intake Form
PDF template
Comprehensive form for collecting patient personal, medical, insurance, and contact information for healthcare services.
See template
See template
Group Insurance Accelerated Benefit Option Claim Form
PDF template
A form for employees or members to claim an accelerated benefit option for terminal illness life insurance claims.
See template
See template
Research Proposal Form (For Projects Using CentRIC Datasets)
PDF template
A proposal form for researchers seeking to use datasets from the Centre for Psychosocial Research in Cancer (CentRIC+)
See template
See template
Accessible Parking Form
PDF template
Application form for individuals with disabilities seeking an accessible parking permit at Eastern Kentucky University
See template
See template
ERAIDER REQUEST FORM
PDF template
Form for non-TTUHSC employees to request an eRaider account, specifying access requirements and responsibilities.
See template
See template
Group Accident Insurance Claim Form
PDF template
A comprehensive claim form for reporting and documenting accident-related insurance claims with detailed instructions and submission guidelines.
See template
See template
Accidental Injury Claim Form
PDF template
Insurance claim form for documenting details of an accidental injury and related medical information for potential insurance coverage.
See template
See template
Vehicle CrashDamage Notice
PDF template
Official form for reporting vehicle accidents, damage, or crashes involving state-owned or managed vehicles in Minnesota.
See template
See template
Auto Accident Report Form
PDF template
Comprehensive form for documenting details of an auto accident, including vehicle, driver, and damage information
See template
See template
NORTHWESTERN UNIVERSITY ACCIDENT REPORT FORM
PDF template
A form for documenting accidents involving university vehicles, detailing damage, driver information, and incident specifics.
See template
See template
Credit Disability Claim Form
PDF template
Instructions for submitting a disability insurance claim for loan protection coverage through American National Insurance Company.
See template
See template
ACCIDENT INCIDENT REPORT FORM
PDF template
A comprehensive form for documenting accidents, incidents, and injuries during sports activities under Kidsports jurisdiction.
See template
See template
AccidentIncident Report Form
PDF template
A form for documenting accidents or incidents that occur during recreation and park district activities, including details about the event, individuals involved, and actions taken.
See template
See template
Accident Report Form
PDF template
A standardized form for documenting details of an accident or injury in a league or organized sports setting.
See template
See template
Accident Report Form
PDF template
A standardized form for documenting details of an accident or injury in a league or organized sports setting.
See template
See template
ACCIDENT REPORT FORM
PDF template
A document used to record details of an accident, including parties involved, location, circumstances, and witnesses.
See template
See template
Club Sports Accident Report Form
PDF template
A comprehensive form for documenting sports-related accidents and injuries for recreational sports participants
See template
See template
Monroe County Recreation Department ACCIDENT REPORT FORM
PDF template
A comprehensive form for documenting details of accidents, injuries, and circumstances within a recreation department setting.
See template
See template
Maritime General Insurance Co. Ltd. Claim Form
PDF template
Comprehensive insurance claim document for documenting vehicle and driver details in case of an insurance claim or occurrence.
See template
See template
Accident Report Form
PDF template
A bilingual form for documenting details of an accident, including location, date, injured person's information, and incident specifics.
See template
See template
DRIVERS ACCIDENT REPORT
PDF template
Official form for documenting details of a vehicle accident involving county personnel, to be completed at the accident scene and submitted to supervisor.
See template
See template
Accident Report
PDF template
Detailed form for documenting accidents, injuries, or damages during Adirondack Mountain Club activities or premises.
See template
See template
Accident Report Form
PDF template
A detailed form for documenting accidents and injuries occurring at a recreational facility, including injury details, immediate actions, and reporting procedures.
See template
See template
IADT Accident Report Form
PDF template
Comprehensive form for documenting workplace accidents, injuries, and subsequent medical treatment with GDPR compliance notice.
See template
See template
ACCIDENT REPORT FORM U3A
PDF template
A form used to document details of an accident, including parties involved, location, circumstances, and injuries.
See template
See template
Rideshare AccidentDamage Report Form
PDF template
A comprehensive form for documenting details of an accident or damage involving a rideshare vehicle and other parties.
See template
See template
NYSPHSAA OfficialS ACCIDENT REPORT FORM
PDF template
A standardized form for documenting accidents involving school sports officials and participants during athletic events.
See template
See template
STATE OF CALIFORNIA ACCIDENT REPORT
PDF template
Official confidential document for reporting non-motor vehicle accidents and potential legal claims involving state entities.
See template
See template
GoTriangle Vanpool Accident Report Form
PDF template
A comprehensive form for documenting details of an accident involving a GoTriangle vanpool vehicle, including driver and insurance information.
See template
See template
City Of Kirkland Accident Report Form
PDF template
A comprehensive form for reporting workplace accidents, injuries, and potential liability claims for City of Kirkland employees.
See template
See template
AccidentIncident Reporting Form
PDF template
Comprehensive guidelines for reporting accidents, incidents, and hazards on university premises, detailing reporting processes and medical response protocols.
See template
See template
Accident Waiver And Release Of Liability Form
PDF template
A legal document that releases event organizers from liability and outlines participant responsibilities for various activities.
See template
See template
ACCIDENT WAIVER AND RELEASE OF LIABILITY FORM
PDF template
A legal document that releases event organizers from liability and assumes personal risk for participation in an activity.
See template
See template
Accident Waiver And Release Of Liability Form
PDF template
Legal document releasing event organizers from liability for potential injuries or damages during the White River Dragon Boat Race and Festival.
See template
See template
Accident Waiver And Release Of Liability Form
PDF template
Legal document waiving liability for participants in indoor baseball training activities, releasing the organization from potential injury or damage claims.
See template
See template
Accident Waiver And Release Of Liability Form
PDF template
A legal document releasing the Lupus Foundation of America and event venue from liability for participation in an outdoor movie event.
See template
See template
BOROUGH OF OAKLAND ACCIDENT WAIVER AND RELEASE OF LIABILITY FORM
PDF template
A legal document that releases the Borough of Oakland from liability for potential injuries or damages during an event or activity.
See template
See template
Accident Waiver And Release Of Liability Form
PDF template
Legal document releasing Lincoln Academy from liability for potential risks and injuries during summer camp participation.
See template
See template
Accident Waiver And Release Of Liability Form
PDF template
Legal document releasing event organizers from liability for potential injuries or damages during participant's event involvement.
See template
See template
Accident Waiver And Release Of Liability Form
PDF template
Legal document outlining risk acknowledgment and liability release for participation in Swerve Robotics activities and workshops.
See template
See template
Release And Waiver Of Liability, Assumption Of Risk, And Indemnity Agreement
PDF template
A legal document releasing Shiloh Christian School from liability for potential injuries or damages during school activities.
See template
See template
Accident Waiver And Release Of Liability Form
PDF template
A comprehensive legal form releasing liability for various activities and events, covering potential risks and participant responsibilities.
See template
See template
Accident Waiver And Release Of Liability Form
PDF template
A comprehensive liability waiver for parents allowing children to participate in summer art sessions with acknowledgment of potential risks and medical authorization.
See template
See template
Accident Wellness Benefit Claim Form
PDF template
Insurance claim form for submitting wellness screening benefits and personal health information to Guardian Life Insurance.
See template
See template
Accommodation Request Assessment Form
PDF template
A medical form used to assess an employee's request for workplace accommodation due to disability or pregnancy-related needs.
See template
See template
Accommodation Inquiry Form
PDF template
A form to collect details about research study requirements and preferences for MRI scanning services.
See template
See template
Insurance Certificate Issuer Contractors
PDF template
Instructions for insurance certificate issuers on how to complete and submit insurance certificates for University of Nebraska contractors.
See template
See template
MEDICAL RELEASE FORM
PDF template
A form granting permission for medical treatment of a student during official academy participation with emergency contact and medical information.
See template
See template
Student Inquiry Form
PDF template
A form for students seeking internships, clinical rotations, and other experiential learning opportunities with the Allegheny County Health Department.
See template
See template
ACH Pre Authorization Form
PDF template
A form authorizing automatic payment deductions for medical consultations and services from a bank account.
See template
See template
CLAIM FORM
PDF template
A comprehensive insurance claim form for collecting detailed policyholder and incident information for processing an insurance claim.
See template
See template
Acknowledgement Of Risk And Waiver Of Liability
PDF template
A comprehensive guide for campus departments on using risk and liability waivers for various activities involving physical activity, travel, or minors.
See template
See template
Activity Participation Waiver
PDF template
A legal document that outlines participant risks and releases the organization from liability during an activity
See template
See template
Acknowledgment Of Risk And Consent Form
PDF template
Legal document for voluntarily participating in a college activity with acknowledgment of potential risks and liability waiver.
See template
See template
ACORD 66 MA
PDF template
Insurance application form for property coverage with detailed submission instructions and legal notices.
See template
See template
ACORD 126
PDF template
Insurance form for capturing details about employee benefits liability coverage and business insurance details.
See template
See template
ACORD 131
PDF template
Standard insurance policy application form for capturing liability and policy details across multiple insurance categories.
See template
See template
Insurance Application Form
PDF template
Comprehensive insurance application form for property coverage with multiple sections for property details, coverage options, and risk assessment.
See template
See template
Certificates Of Insurance And Lenders
PDF template
Analysis of changes to ACORD insurance certificate forms and their impact on Freddie Mac and lenders' acceptance policies.
See template
See template
ACORD 35 Cancellation Request Policy Release
PDF template
A standardized form for requesting cancellation of an insurance policy and documenting release details.
See template
See template
ACORD 855 NY Construction Certificate Addendum
PDF template
Detailed addendum summarizing insurance policy provisions for construction-related general liability coverage
See template
See template
Acord Lost Policy Release Form
PDF template
A form for releasing or managing insurance policy documentation when original policy documents are missing or need to be replaced.
See template
See template
Acord Policy Change Request Form
PDF template
A fillable form for requesting changes to an existing insurance policy with various coverage options.
See template
See template
Amateurism Decision Inquiry Process Frequently Asked Questions
PDF template
A detailed guide explaining the process for institutions to request reconsideration of a prospective student-athlete's amateurism certification decision.
See template
See template
Patient Medical History Form
PDF template
Comprehensive medical history form for collecting patient health information, symptoms, and medical conditions.
See template
See template
Quick Reference Guide MedicalBehavioral Health Providers
PDF template
A comprehensive guide for medical and behavioral health providers on claims submission, pre-authorization, and service procedures for Amida Care health plan.
See template
See template
Medical Information
PDF template
A comprehensive medical form collecting personal health details for emergency preparedness at an event or track setting.
See template
See template
REGISTRATION FORM
PDF template
A comprehensive registration form for participating in Montgomery County recreation activities, including personal information, emergency contact, and disability accommodation options.
See template
See template
PARENTSTUDENT PHYSICAL ACTIVITY WAIVER FORM
PDF template
A comprehensive waiver form for students participating in physical activities at Christendom College, outlining potential risks and legal protections.
See template
See template
Activity Participation Medical Release Form
PDF template
A comprehensive liability release form for participants in activities at Pacific Lutheran University that outlines potential risks and participant agreements.
See template
See template
Activity Participation Waiver Form
PDF template
Legal document that releases Brightpoint Community College from liability for student participation in college activities
See template
See template
ACTIVITYPROGRAM RELEASE And WAIVER FORM
PDF template
A legal document for releasing liability and obtaining consent for participation in organizational activities or programs.
See template
See template
Activity Waiver Form (Release, Waiver And Covenant Not To Sue)
PDF template
A legal document that releases Cape Fear Community College from liability for risks associated with participating in an activity or event.
See template
See template
Naugatuck Valley Activity Waiver Form
PDF template
A comprehensive waiver form for students participating in college-sponsored activities, covering transportation, emergency contacts, and liability release.
See template
See template
Patient Intake Form Holistic Health Assessment
PDF template
Confidential questionnaire for determining patient treatment plan and collecting comprehensive medical and personal information.
See template
See template
Patient Intake Form
PDF template
Comprehensive form for collecting patient personal, contact, medical, and insurance information for chiropractic services.
See template
See template
New Patient Intake Form
PDF template
Comprehensive medical intake form for new patients at Joyanne Kohler Acupuncture, collecting personal and health information.
See template
See template
Acute Inpatient Hospital Assessment Form
PDF template
Form for requesting authorization for hospital admissions and stay extensions for Blue Cross and Blue Care Network commercial plans
See template
See template
USDA Program Discrimination Complaint Form
PDF template
Official form for filing a discrimination complaint with the U.S. Department of Agriculture regarding potential discriminatory practices in USDA programs.
See template
See template
Americans With Disabilities Act Accommodation Request Assessment Form
PDF template
A form for employees to request workplace accommodations under the Americans with Disabilities Act, requiring medical provider documentation of work restrictions or limitations.
See template
See template
Medical Inquiry Form In Response To An Accommodation Request
PDF template
A medical form used to evaluate an employee's disability and potential workplace accommodations under the Americans with Disabilities Act (ADA).
See template
See template
DOH 3608 Uninsured Care Programs Medical Eligibility Form
PDF template
A medical form used to determine patient eligibility for HIV-related care programs in New York State
See template
See template
ADA Program Accessibility Inquiry Form
PDF template
A form for individuals to report accessibility concerns or inquiries related to library programs and services for people with disabilities.
See template
See template
ADA Job Accommodation Request And Medical Inquiry Form
PDF template
A confidential form to help determine reasonable workplace accommodations for employees with disabilities under ADA guidelines.
See template
See template
Diagnostic Imaging Referral Form
PDF template
Comprehensive medical imaging request form for various ultrasound, x-ray, and pain therapy procedures with detailed anatomical options.
See template
See template
ADDITIONDELETION OF STUDENT ATHLETE
PDF template
A form for coaches to add or remove student-athletes from team rosters and report changes to the Compliance Office.
See template
See template
LOCAL 22 HEALTH PLAN DEPENDENT FORM
PDF template
Form for adding a spouse or dependent to the Local 22 Health Plan, requiring personal information and supporting documentation.
See template
See template
Pre Authorization Form Instructions
PDF template
Detailed instructions for completing a medical pre-authorization request form, including required documentation and submission process.
See template
See template
Medical Form Instructions For TeamSnap
PDF template
Step-by-step guide for team managers to upload player medical forms to TeamSnap profiles
See template
See template
Required NYS School Health Examination Form
PDF template
A comprehensive health examination form for students in New York State, documenting medical history and current health status
See template
See template
Indemnification Agreements And Additional Insureds Under Pennsylvania Law
PDF template
A comprehensive legal document examining indemnification agreements, insurance procurement, and additional insured provisions under Pennsylvania law.
See template
See template
Additional Shifts Approval Form
PDF template
Form for documenting and approving additional paid shifts for medical residents and fellows beyond their normal program requirements.
See template
See template
UWS B1242 Accidental Death Dismemberment Insurance
PDF template
Comprehensive employer manual for Accidental Death and Dismemberment insurance policy for University of Wisconsin System employees.
See template
See template
Private Hospitals Discharge Form (ADF96)
PDF template
A comprehensive form for collecting detailed patient discharge data from private hospitals for statistical reporting purposes.
See template
See template
Vermont Advance Directive For Health Care
PDF template
A legal document allowing individuals to specify their health care preferences and designate a health care decision-maker if they become unable to make decisions for themselves.
See template
See template
AdjustmentVoid Request Form
PDF template
A form used by healthcare providers to request adjustments or void payments for medical services.
See template
See template
Accident Report
PDF template
Official form for documenting accidents and injuries associated with Adirondack Mountain Club activities or premises.
See template
See template
Security Incident Report And Self Insurance Form
PDF template
A comprehensive form for reporting and documenting security incidents in Prince George's County Public Schools.
See template
See template
Admission Agreement And Health Assessment
PDF template
Comprehensive form for child enrollment, medical history, emergency contacts, and health assessment for childcare or educational settings.
See template
See template
Athletic ParticipationParental ConsentPhysical Examination Form
PDF template
Official form for high school students to participate in athletic activities, including eligibility verification and parental consent.
See template
See template
Adolescent Vaccination Consent Form (TdapTd, HPV, Meningococcal ACWY)
PDF template
A consent form for parents/guardians to authorize vaccination of adolescents for Tdap/Td, HPV, and Meningococcal ACWY vaccines.
See template
See template
Adopt A Park Volunteer Program
PDF template
A community volunteer initiative allowing groups to assist in maintaining local parks, trails, and recreational facilities through regular maintenance and improvements.
See template
See template
Hospice Volunteer Application Form
PDF template
A comprehensive application form for individuals interested in becoming hospice volunteers, collecting personal, contact, and background information.
See template
See template
MINOR PARTICIPANT EMERGENCY CONTACT AND MEDICAL RELEASE FORM
PDF template
A comprehensive form for collecting emergency contact, medical information, and release authorization for a minor participant.
See template
See template
FMLA Adult Child Disability Medical Inquiry Form
PDF template
A medical form used by the New Mexico Taxation & Revenue Department to determine disability status for FMLA leave to care for an adult child.
See template
See template
New Mexico 4 H Adult Medical And Liability Release Code Of Conduct Contract And Media Release Form
PDF template
A comprehensive form for 4-H adult volunteers covering medical information, liability release, code of conduct, and participation guidelines.
See template
See template
Girl Scouts Of Greater Los Angeles Adult Emergency Information And Authorization For Treatment
PDF template
Emergency contact and medical authorization form for Girl Scouts of Greater Los Angeles adult participants
See template
See template
Adult Registration Form
PDF template
A comprehensive form for collecting patient personal and demographic information for healthcare services.
See template
See template
Adult HIV Confidential Case Report Form
PDF template
Confidential medical reporting form for adult HIV patients in Rhode Island, used for surveillance and epidemiological tracking.
See template
See template
New Patient Intake Form
PDF template
Comprehensive intake form for new patients to collect personal and medical contact details at a healthcare practice.
See template
See template
Adult Legal Form
PDF template
A legal form for adult participants in CISV international programs covering medical guardianship, release, and program consent.
See template
See template
Emergency Medical Form ADULT
PDF template
Comprehensive medical authorization and emergency contact form for adult participants in MUMC trips.
See template
See template
Oklahoma 4 H Youth Development Participant Information Form
PDF template
A comprehensive form for collecting participant health, emergency contact, and medical information for 4-H youth programs and events.
See template
See template
Adult Confidential Medical Information And Emergency Notification Form
PDF template
Comprehensive medical information and emergency contact form for participants in the 2007 Big Sky Regional Science Bowl
See template
See template
Adult Medical Release Form
PDF template
Medical and liability release form for participants in Diocese of Little Rock youth ministry events
See template
See template
Adult Medical Release Form
PDF template
Medical release and consent form for adult participants in environmental education program activities, capturing health information and emergency contact details.
See template
See template
Adult Specialist Request
PDF template
Medical referral form for requesting an adult specialist appointment with patient and insurance details.
See template
See template
Adult Registration Form
PDF template
Comprehensive form for collecting patient personal and insurance information for healthcare purposes.
See template
See template
Adult Folks Scholarship Guidelines
PDF template
Guidelines for Douglas County residents aged 18+ to receive scholarships for recreational activities through Lawrence Parks and Recreation Department.
See template
See template
Community Practice Referral Form Adult Services
PDF template
A referral form for occupational therapy and physical therapy services for adult patients with various health conditions and treatment needs.
See template
See template
Volunteer Application Form
PDF template
Comprehensive form for individuals seeking to volunteer at Cape Fear Valley Health System medical facilities.
See template
See template
NDA Adult Volunteer Registration And Waiver Form
PDF template
A legal waiver form for adult volunteers participating in a neighborhood district association event, releasing the organization from liability.
See template
See template
ONE YEAR ADVANCED ENDOSCOPY FELLOWSHIP APPLICATION
PDF template
Comprehensive application form for medical professionals seeking a one-year advanced endoscopy fellowship at the University of Missouri's Division of Gastroenterology & Hepatology.
See template
See template
Provider Appeal Request
PDF template
A form for healthcare providers to submit appeals for denied claims or authorizations with Advanced Health.
See template
See template
Provider Appeal Request
PDF template
A form for healthcare providers to request an appeal of a denied claim or authorization with Advanced Health.
See template
See template
Advanced Illness Benefit Application Form
PDF template
Application form for palliative care through the Advanced Illness Benefit for advanced cancer/oncology care by Anglovaal Group Medical Scheme.
See template
See template
Advance Directive Information Document
PDF template
A comprehensive guide explaining advance directives, their purpose, importance, and how to designate a healthcare agent.
See template
See template
Service Request Form
PDF template
Medical form for requesting sleep-related diagnostic services and documenting patient sleep disorder symptoms.
See template
See template
Advantage Plus Enrollment Form
PDF template
Enrollment form for Kaiser Permanente Medicare Advantage optional supplemental benefits package in the Mid-Atlantic States Region.
See template
See template
Medical Information And Physician Release
PDF template
A medical form for documenting participant health status and physician clearance for exercise participation at Oregon State University's Adaptive Exercise Clinic.
See template
See template
AEDBleed Kit Inspection Form
PDF template
A comprehensive inspection form for checking the operational readiness and condition of an AED and associated emergency medical supplies.
See template
See template
Automated External Defibrillator (AED) Post Incident Report Form
PDF template
A comprehensive form for documenting events involving the use or attempted use of an Automated External Defibrillator at Middle Georgia State University.
See template
See template
AED Incident Report Form
PDF template
A comprehensive form for documenting and reporting incidents involving the use or attempted use of an Automated External Defibrillator (AED)
See template
See template
Child Find Referral Form
PDF template
Comprehensive referral form for collecting infant/toddler medical and demographic information for early intervention services.
See template
See template
Athletic Equestrian League Accident Report
PDF template
A detailed form for documenting accidents and incidents during equestrian events or competitions.
See template
See template
REFERRAL FORM
PDF template
Medical referral form for eye-related consultations and treatments in Edmonton, Alberta.
See template
See template
PATIENT INTAKE FORM
PDF template
A comprehensive form for collecting client and pet information for veterinary emergency and specialty care services.
See template
See template
Commercial Prescription Drug Claim Form
PDF template
A form for submitting prescription drug claims to Aetna Pharmacy Management for reimbursement or processing.
See template
See template
Prescription Drug Claim Form
PDF template
A comprehensive form for submitting prescription drug claims to Aetna Pharmacy Management for reimbursement or processing.
See template
See template
AETNA STUDENT HEALTH CLAIM FORM
PDF template
Insurance claim form for Aetna Student Health covering medical and accident-related expenses for university students.
See template
See template
Covenant Not To Sue And Indemnity Agreement
PDF template
Legal document waiving liability and assuming risk for participation in Aero Club flying activities.
See template
See template
Affidavit Of Domestic Partner Status And Tax Dependency Status
PDF template
A form for employees to declare domestic partner and dependent status for health and welfare benefits eligibility
See template
See template
CAA Affiliated Society Membership Form
PDF template
Membership form for affiliated societies to join the College Art Association with tiered annual fees based on organization size.
See template
See template
Insurance Form For County Affiliates
PDF template
Insurance documentation form for county-level cattle industry affiliate events in Missouri.
See template
See template
Active Duty Tour (ADT) Order Request For Military Medical Rotations
PDF template
Official form for military personnel to request and document active duty tour assignments for medical rotations
See template
See template
Accidental Injury Claim Form
PDF template
Insurance claim form for documenting details of an accidental injury for potential insurance benefits and reimbursement.
See template
See template
Continuing Disability Claim Form
PDF template
A claim form for filing a continuing disability insurance claim with Aflac, requiring detailed patient and policyholder information.
See template
See template
Initial Disability Claim Form
PDF template
Insurance claim form for reporting disability due to sickness or injury, used by Aflac for processing disability claims.
See template
See template
M0272B Flexible Spending Account Claim Form
PDF template
Form for requesting reimbursement from a Flexible Spending Account for medical and dependent care expenses.
See template
See template
Initial Disability Claim Form
PDF template
Comprehensive form for filing a disability insurance claim covering various types of disability including accidents, sickness, pregnancy, and cancer.
See template
See template
AFLAC Optional Insurance
PDF template
Document detailing optional insurance offerings from AFLAC for the Housing Authority of the City of Los Angeles (HACLA)
See template
See template
Sickness Claim Form
PDF template
A comprehensive form for filing insurance claims related to sickness, disability, hospitalization, and other health events with Aflac.
See template
See template
AFSCME Local 127 PPO Benefits Matrix
PDF template
Comprehensive dental insurance plan detailing coverage levels for various dental treatments and services.
See template
See template
Augustus Brown Pool Guest Feedback Form
PDF template
A survey form to collect guest experiences and feedback about the Augustus Brown Pool facilities and services.
See template
See template
Messe Frankfurt Exhibition GmbH Terms And Conditions
PDF template
Comprehensive terms and conditions governing participation in Messe Frankfurt exhibitions and events for potential exhibitors.
See template
See template
Adventures In Good Company, Inc. Acknowledgment And Assumption Of Risks Release And Indemnity Agree
PDF template
A legal document outlining participant risks, liability release, and indemnification for Adventures in Good Company (AGC) trips.
See template
See template
ADVENTURES IN GOOD COMPANY, INC. ACKNOWLEDGMENT AND ASSUMPTION OF RISKS RELEASE AND INDEMNITY AGREE
PDF template
Legal document detailing risks, liability release, and participant responsibilities for Adventures in Good Company travel trips.
See template
See template
Reed Insurance Agency Bill Invoice Form
PDF template
A form used by Reed Insurance to document policy transaction details, billing information, and payment verification.
See template
See template
52675 (0820) Checklist
PDF template
A comprehensive checklist for insurance agents applying to contract with Americo, outlining required documentation and process steps.
See template
See template
AgentS Report
PDF template
A form for agents to report and settle surety bond transactions with details about bond execution and premiums.
See template
See template
Art Grows Rexburg Children Teen Art Competition Entry Form
PDF template
Official entry form for the Art Grows Rexburg art competition for children and teens, detailing submission guidelines and liability terms.
See template
See template
Medical Reimbursement Form
PDF template
Form for members to request reimbursement for medical services covered under their health plan
See template
See template
High Adventure Activity Medical Form
PDF template
A medical form for certifying individual fitness for high-risk adventure activities for youth organizations.
See template
See template
New Patient Intake Form
PDF template
Comprehensive medical intake form for new patients seeking plastic, reconstructive, or pediatric head and neck surgical services.
See template
See template
Instructions For Completion Of Application For Specified Service Authority Allied Health Professiona
PDF template
Detailed guidelines for completing an application for medical staff service authority for allied health professionals at Eaton Rapids Medical Center.
See template
See template
Surgical Booking Request Office Reference Guide
PDF template
A guide for completing the Provincial Surgical Booking Request form to facilitate consistent surgical scheduling and resource allocation.
See template
See template
2024 25 Consent To Treat Form
PDF template
Consent form allowing medical treatment for minor athletes when parents are not immediately available during sports activities.
See template
See template
2024 25 CONSENT TO TREAT FORM
PDF template
A form providing parental consent for sports medicine services for minor athletes participating in interscholastic activities in Arizona.
See template
See template
Arizona Interscholastic Association Annual Preparticipation Physical Evaluation
PDF template
A comprehensive medical screening form for student-athletes to assess their health and fitness for sports participation.
See template
See template
HYPERSENSITIVITY PNEUMONITIS (HP) PANEL
PDF template
Medical diagnostic form for testing hypersensitivity pneumonitis and avian panel allergens from the Medical College of Wisconsin.
See template
See template
PATIENT MEDICAL HISTORY FORM
PDF template
Comprehensive medical history form for collecting patient's personal and family health information, past medical conditions, and surgical history.
See template
See template
AIM Issuing Orphan Endorsements
PDF template
Instructions for issuing an orphan endorsement to a policy issued outside the AIM+ environment.
See template
See template
Artist Residency Program
PDF template
A residency program offering artists from various disciplines an opportunity to pursue their creative practice in a supportive, community-based environment with access to specialized studio facilities.
See template
See template
AIR TOUR BOOKING FORM
PDF template
A comprehensive travel booking form for reserving holidays with Woods Holidays Limited, covering passenger details and travel arrangements.
See template
See template
AISA Risk Management Program For Local Level Sports
PDF template
Comprehensive guidelines for school sports programs focusing on athlete safety, injury prevention, and risk management protocols.
See template
See template
Patient Intake Form
PDF template
A comprehensive form for new patients to provide medical history and contact information for a naturopathic wellness center.
See template
See template
Resident Assessment
PDF template
Comprehensive intake form for documenting a resident's medical history, health status, functional capabilities, and personal information for care facilities.
See template
See template
Preparticipation Physical Evaluation (Interim Guidance) Physical Examination Form
PDF template
A comprehensive medical examination form for athletes to assess physical fitness and health status prior to participation in sports activities.
See template
See template
Allegations Contained In The StateS Complaint Against Dr. Sun
PDF template
Legal document detailing allegations of inappropriate pain medication prescriptions by Dr. Sun for multiple patients with questionable medical necessity.
See template
See template
Alfred State Workshop AllergyMedical Form
PDF template
A comprehensive medical form for documenting a camper's allergies, medical conditions, and emergency contact information.
See template
See template
Springfield Platteview Community Schools Health Examination Form
PDF template
A comprehensive health and immunization form for students in kindergarten through 12th grade in Springfield Platteview Community Schools.
See template
See template
Allied, Therapeutic And Psychology Extender Benefit Application Form For 2024
PDF template
Application form for healthcare benefit coverage under the Retail Medical Scheme's Essential Plus Option for allied, therapeutic, and psychology services.
See template
See template
Pre Authorization Checklist For Acute LymphocyticLymphoblastic Leukemia
PDF template
A medical form used by healthcare providers to pre-authorize treatment for pediatric leukemia patients through the Philippine Health Insurance Corporation.
See template
See template
Accident Coverage Claim Form
PDF template
Insurance claim form for reporting accidental injuries and seeking coverage benefits from American Heritage Life Insurance Company.
See template
See template
What To Do In Case Of An Accident
PDF template
A step-by-step guide for handling an automobile accident and reporting a claim to Allstate Insurance.
See template
See template
CANCELLATION REQUEST FORM
PDF template
A form used to request cancellation of medical laboratory tests with detailed documentation requirements.
See template
See template
Participant Accident WaiverRelease Of Liability Form
PDF template
A comprehensive liability waiver for participants in motorcycle events, covering risks, personal fitness, and legal responsibilities.
See template
See template
Blue Cross Medical Travel Benefit Claim
PDF template
A claim form for medical travel expenses for members of the Arrow Lakes Teachers' Association submitted to Pacific Blue Cross.
See template
See template
Transfer Or Discharge Form
PDF template
A form used to document and record the transfer or discharge of a resident from a healthcare facility, including essential transfer details and accompanying documentation.
See template
See template
Enrollment Form
PDF template
A comprehensive enrollment form for dental and vision insurance coverage through an employer's benefit plan.
See template
See template
Enrollment Form
PDF template
A comprehensive form for enrolling in dental insurance coverage, including subscriber and dependent information, coverage options, and coordination of benefits.
See template
See template
ENROLLMENT FORM VISION ONLY
PDF template
A comprehensive enrollment form for vision insurance coverage, allowing employees to add or modify vision insurance benefits.
See template
See template
AAO HNSF 2022 Annual Meeting OTO Experience Call For Science Submission Guidelines
PDF template
Guidelines for submitting scientific presentations to the AAO-HNSF Annual Meeting, including eligibility requirements and speaker responsibilities.
See template
See template
Nomination For An AMA Award
PDF template
Official form for nominating medical professionals for various American Medical Association awards and recognitions.
See template
See template
All Musicians Club And Musicians Performance Studio Club Membership Form
PDF template
Membership application and liability waiver for the All Musicians Club and Musicians Performance Studio Club for Laguna Woods Village residents and guests
See template
See template
MultiCare Auburn Medical Center PGY1 Pharmacy Residency Application Information
PDF template
Application instructions and requirements for PGY1 pharmacy residency at MultiCare Auburn Medical Center
See template
See template
AM Club And Extra Innings Payment Agreement
PDF template
Payment agreement for school year programs offered by Homewood-Flossmoor Park District, covering AM Club and Extra Innings programs.
See template
See template
Medical Examination Report For Bus Transit System Driver
PDF template
Comprehensive medical examination form for bus transit system drivers to assess health conditions and fitness for duty.
See template
See template
AMERICAN CLUB PRE EMPLOYMENT MEDICAL EXAMINATION FORM2019
PDF template
Comprehensive medical examination form for seafarer pre-employment screening with multiple medical tests and assessments.
See template
See template
Dental Claim Form
PDF template
A comprehensive form for submitting dental insurance claims, requiring patient and employee information, treatment details, and authorization signatures.
See template
See template
Enrollment Change Waiver Group Insurance Form
PDF template
Insurance form for enrolling, changing, or waiving group dental insurance coverage for employees and their dependents.
See template
See template
COBRA Eye Care Insurance Form
PDF template
Form for documenting employee and dependent eye care insurance coverage under COBRA regulations.
See template
See template
Hearing Insurance Enrollment Form
PDF template
A comprehensive form for employees to enroll in or modify hearing insurance coverage for themselves and dependents.
See template
See template
Group Insurance Form Eye Care
PDF template
Insurance enrollment form for group eye care coverage, allowing employees to enroll, change, or waive insurance benefits
See template
See template
AMG At Home Admission Check
PDF template
Comprehensive admission checklist and information for patients interested in AMG Senior Medical Group's at-home medical services.
See template
See template
AMG Requisition Form
PDF template
A form used by surgeons to request amniotic membrane grafts (AMG) from Ramayamma International Eye Bank.
See template
See template
AMI Insurance Application
PDF template
A comprehensive insurance application form for personal health coverage with options for individual or family plans.
See template
See template
Student Health Examination Form
PDF template
Medical examination form for students, documenting health history, physical examination, and immunization status.
See template
See template
RD AN No. 4694 (4274 D And 1951 R)
PDF template
Administrative notice providing clarification and guidance for Intermediary Relending Program (IRP) processing and servicing requirements.
See template
See template
Angeles New Waiver Forms FAQ
PDF template
Comprehensive guide explaining the Sierra Club's new Participation Agreement, its purpose, usage, and implementation details.
See template
See template
Animal Incident Report Form
PDF template
A detailed form for reporting animal-related incidents involving bites, scratches, or other exposures to an animal.
See template
See template
Indiana DowngradePolicy Change Form
PDF template
A form for making changes to an individual Anthem Blue Cross and Blue Shield insurance policy, excluding certain types of modifications.
See template
See template
MAD Artists Residency Application Form
PDF template
Application form for artists seeking residency at MAD studio space for January-March 2024 period.
See template
See template
Annual Health Evaluation Form
PDF template
A comprehensive health evaluation form for tracking medical history, lifestyle factors, and current health status.
See template
See template
Ohio DowngradePolicy Change Form
PDF template
A form for making changes to an individual insurance policy with Anthem Blue Cross and Blue Shield, excluding certain types of modifications.
See template
See template
Member Claim Form
PDF template
Insurance claim form for submitting medical expenses and service details to Anthem Blue Cross health insurance.
See template
See template
Prescription Reimbursement Claim Form
PDF template
A form for patients to submit claims for prescription medication reimbursement from their insurance provider.
See template
See template
Medical Insurance Claim Form
PDF template
A standard medical insurance claim form for submitting patient information and medical service details to an insurance provider.
See template
See template
Medical Claim Form
PDF template
A comprehensive medical claim form for submitting healthcare service details and patient information to Anthem Blue Cross insurance.
See template
See template
Dental Claim Form
PDF template
Official form for submitting dental insurance claims and treatment documentation to dental benefit plans.
See template
See template
Medical Claim Form
PDF template
A comprehensive form for submitting medical insurance claims, collecting patient, subscriber, and medical service information.
See template
See template
Medical Claim Form
PDF template
A comprehensive medical claim form for submitting healthcare service reimbursement claims to Anthem Blue Cross and Blue Shield insurance.
See template
See template
PPO Dental Blue Complete
PDF template
Comprehensive dental insurance plan offering flexible network options and preventive care coverage for active and retired police association members.
See template
See template
Short Term Disability Claim Form
PDF template
A form for employees to file a claim for short-term disability benefits with insurance details and authorization.
See template
See template
Medical Claim Form
PDF template
A standard medical insurance form for submitting healthcare service claims and patient information to an insurance provider.
See template
See template
Out Of Network Vision Services Claim Form
PDF template
A claim form for submitting vision care expenses to Blue View Vision when receiving services from out-of-network providers.
See template
See template
AO Alliance (AOA) ORP Fellowship Application Form
PDF template
Application form for medical professionals seeking a fellowship with the AO Alliance in orthopedic and trauma surgery
See template
See template
AO Alliance (AOA) Surgeon Fellowship Application Form
PDF template
Application form for surgeons seeking a fellowship with the AO Alliance, requiring detailed professional and personal information.
See template
See template
COVID 19 Assumption Of The Risk Forms
PDF template
Proposal for risk mitigation forms to address COVID-19 exposure in fraternity settings, covering various participant types.
See template
See template
Texas Department Of Insurance, Division Of Workers Compensation Adopted Amendments To Chapter 133
PDF template
Amendments to medical billing forms and procedures for the Texas workers' compensation system, specifically updating electronic billing and pharmacy claim forms.
See template
See template
Assumption Of The Risk And Hold Harmless Agreement
PDF template
Legal document outlining risk assumption and liability waiver for contractors working in a fraternity chapter facility.
See template
See template
Administrative Procedure 354 Risk Management And Third Party Promotion
PDF template
Administrative procedure outlining the school district's guidelines for managing risks associated with third-party events and promotions in schools.
See template
See template
Release And Waiver Of Liability Form
PDF template
Liability waiver for students enrolled in De Anza College's adapted swimming courses, outlining participation requirements and risk assumptions.
See template
See template
PARTICIPANT MEDICAL HISTORY FORM
PDF template
Confidential medical history form for collecting participant health information for trips and activities by APEX
See template
See template
Incident Report
PDF template
Official form for documenting significant incidents during polo matches, including player misconduct or pony abuse.
See template
See template
Medical Information Release Form
PDF template
A form allowing parents or legal guardians to specify who can receive medical information about their child from Angelina Pediatrics, PLLC.
See template
See template
Tuberculosis Case Management Manual
PDF template
A comprehensive manual providing guidelines, resources, and forms for tuberculosis case management in Missouri.
See template
See template
Equality Analysis Template
PDF template
Assessment of leasing 0.35 acres of public recreation land to Hitchin Bridge Club for clubhouse and parking construction.
See template
See template
Appendix 5 Medical Release Form
PDF template
A medical release form for seniors participating in the Community Healthy Activities Model Program, allowing notification of primary care physician.
See template
See template
NSW Health UndertakingDeclaration Form
PDF template
Form for health workers and students to declare compliance with infectious disease screening and vaccination requirements for NSW Health facilities.
See template
See template
RELEASE, WAIVER OF LIABILITY, COVENANT NOT TO SUE
PDF template
Legal document releasing Columbus State University from liability for potential injuries during a camp or conference event.
See template
See template
Institutional Drug Testing Program Student Athlete Notification Form
PDF template
A form documenting the notification and consent process for student-athletes selected for mandatory drug testing.
See template
See template
Business Growth Accelerator (BGA) Proposed Program Budget Form
PDF template
A detailed budget form for program income, funding sources, and expenditures for the Business Growth Accelerator program.
See template
See template
Individual Park Inventory Form
PDF template
Comprehensive form for documenting recreational facilities, amenities, and characteristics of a park or recreation site.
See template
See template
NAPNAP Faculty Declaration Form
PDF template
A form for presenters to declare potential financial conflicts of interest and off-label drug or medical device discussions.
See template
See template
Appendix T San Diego Police Department Crime Laboratory Feedback Form
PDF template
A detailed evaluation form for forensic evidence collection and assessment during a medical forensic examination.
See template
See template
Essex County Fairgrounds Task Force Application Checklist
PDF template
Comprehensive checklist for rental application and requirements for using Essex County Fairgrounds facilities.
See template
See template
Charitable Trust Of The Auckland Faculty Royal New Zealand College Of General Practitioners Applicat
PDF template
Comprehensive assessment form for evaluating research grant applications from general practitioners in New Zealand.
See template
See template
ARTIST RESIDENCY APPLICATION FORM
PDF template
Application form for artists seeking residency opportunities at coGalleries in Berlin, Nairobi, or Beijing.
See template
See template
FHNO Institutional Fellowship Application Form
PDF template
Application form for fellowship in Head and Neck Oncology/Reconstructive Surgery with comprehensive applicant details collection.
See template
See template
JOB APPLICATION FORM (STUDENT WORKER)
PDF template
An application form for students seeking on-campus employment at North South University's Central Library
See template
See template
Application For Policy Changes (High Net Worth Products Except Signature Wealth)
PDF template
Insurance policy modification form for making various changes to an existing life insurance policy, including smoking class adjustments and other policy updates.
See template
See template
Service Request Form
PDF template
A form for submitting and tracking information technology service requests within an organization.
See template
See template
Texas Tech University System Camp And Conference Non Sports And Sport Camps Insurance Application
PDF template
Insurance application for Texas Tech University System camps covering participant and staff insurance details
See template
See template
City Of Los Angeles Department Of Recreation And Parks Application For Use Of Facilities
PDF template
An application form for using city recreation facilities, requiring detailed event and participant information.
See template
See template
APPLIED LEARNING STUDENT EVALUATION FORM
PDF template
A comprehensive form for students to provide detailed feedback about an educational program or learning experience.
See template
See template
Medical Appeals And Reinstatements Sections 717273
PDF template
Comprehensive guide for NYC employees seeking medical reinstatement, detailing required documentation and submission procedures.
See template
See template
STUDENT INCIDENT REPORT FORM
PDF template
A comprehensive form for documenting student incidents, including details of the event, student's account, and additional comments from faculty or preceptors.
See template
See template
Direct AgentAgency Electronic Appointment Onboarding Process
PDF template
Detailed guide for agents and agencies to electronically complete their appointment process with Scott and White Health Plan and FirstCare Health Plans.
See template
See template
Functional Medicine Clinic Appointment Time Agreement
PDF template
Agreement outlining fees and policies for patient appointments, including no-show and late cancellation charges.
See template
See template
Resident Insurance ProducerInsurance AdjusterReal Estate Appraiser Background Check Consent Form
PDF template
A consent form for criminal history record checks required for licensing insurance producers, adjusters, and real estate appraisers in Minnesota.
See template
See template
APPLICATIONS Service Request Form
PDF template
Internal form for requesting IT service and system modifications within an organization's technology infrastructure.
See template
See template
Observation And Interview Research Instruments
PDF template
A set of research forms for collecting qualitative data about artists' creative processes through observation, interviews, and document analysis.
See template
See template
Teacher Program Agreement Media Release Form
PDF template
A document for teachers participating in UCLA's AP Readiness Program, including program commitment and media release consent.
See template
See template
Albuquerque Public Schools Domestic Partners Policy
PDF template
Policy outlining benefits eligibility for employees with domestic partners, including medical, dental, and insurance coverage.
See template
See template
APTA Technology Terms And Conditions White Paper
PDF template
A white paper discussing technology-related terms and conditions for IT procurement contracts in public transit agencies.
See template
See template
Guidelines For Filing Applications For Dry Cleaning Facilities
PDF template
Official guidelines from Westchester County Department of Health for submitting permit applications for dry cleaning facilities, including requirements and documentation needed.
See template
See template
Aquatics Cancellation Form
PDF template
A form for withdrawing from YMCA aquatics classes with refund and payment policy details.
See template
See template
OCCUPATIONAL MEDICAL SURVEILLANCE PROGRAM PHYSICAL EXAMINATION FORM
PDF template
A comprehensive medical examination form for documenting employee health status and physical condition for the United States Department of Agriculture.
See template
See template
Arkansas Motor Vehicle Accident Report (SR 1)
PDF template
Official form for reporting motor vehicle accidents involving property damage over $1,000 or bodily injury/death.
See template
See template
Application For Architects And Engineers Professional Liability Insurance
PDF template
Insurance application for architecture and engineering firms seeking professional liability coverage with detailed firm information and financial reporting requirements.
See template
See template
Architects And Engineers Professional Liability Insurance Application
PDF template
An insurance application for architects and engineers to evaluate professional liability coverage eligibility.
See template
See template
Remdesivir Prescribing DeclarationStreamlined IPU Application Form
PDF template
A form for healthcare professionals to request and prescribe Remdesivir for COVID-19 patients meeting specific criteria.
See template
See template
Arizona SPDSCLUE Waiver Form
PDF template
A form allowing buyers and sellers to waive property disclosure statement and insurance claims history report in a real estate transaction.
See template
See template
Recommended Finish Floor Elevation Affidavit
PDF template
A document for property owners acknowledging flood risk information and recommended floor elevation based on FEMA Base Level Engineering data.
See template
See template
Sunday Studio Art 101 Classes Registration Form
PDF template
Registration and medical consent form for art classes for children ages 10-15 at the Art Gallery of Guelph.
See template
See template
Sunday Studio Art 101 Classes Registration Form
PDF template
Registration and consent form for children's art classes at the Art Gallery of Guelph, including class selection, medical information, and emergency contacts.
See template
See template
Accident Report Form
PDF template
A form for reporting accidents during ART teaching activities, used to comply with public liability insurance requirements.
See template
See template
Pictures Of John Gray Art Competition Entry Form
PDF template
An entry form for an art competition related to the Pictures of John Gray project by Codpiece Theatre
See template
See template
Contribution Form
PDF template
A donation form for contributing to various scholarships and programs within the Emporia State University Art Department.
See template
See template
Arthur Latham Park Pavilion Rental Agreement
PDF template
Agreement for renting park pavilions, detailing rental terms, fees, and responsibilities of the renter.
See template
See template
EvCC Articulation Request Checklist For CTE Dual Credit Program
PDF template
A form for high schools to request articulation or update existing articulation for Career and Technical Education (CTE) dual credit courses with Everett Community College.
See template
See template
Prospective Member Insurance Qualification Information
PDF template
Insurance qualification form for prospective pilots seeking membership in Artisan Aviation Inc., collecting personal and flight history information.
See template
See template
Artist Agreement
PDF template
Legal agreement outlining terms between an artist and Cedar Gallery for artwork exhibition, sales, and promotional use.
See template
See template
Submission Usage Agreement With The Art Of Autism Website And Affiliated Sites, Social Media And New
PDF template
A legal agreement for artists submitting artwork to The Art of Autism, outlining usage permissions and submission guidelines.
See template
See template
Art Service Scholarship Form
PDF template
Scholarship application for students pursuing art as a major at ECCC with specific service requirements and academic criteria.
See template
See template
Art Service Scholarship Form
PDF template
A scholarship application form for students interested in pursuing art as a major at E.C.C.C. with specific eligibility and service requirements.
See template
See template
MMB Insurance Form
PDF template
A form for documenting artwork details and insurance values for an art exhibition by the Madison Arts Commission.
See template
See template
4th Annual Art Event Submission Guidelines
PDF template
An art event raising mental health awareness through creative submissions from artists with mental health service experience in Maryland.
See template
See template
Westlake Porter Public Library ArtWalk Submission Form
PDF template
Guidelines and submission form for community art display at Westlake Porter Public Library's ArtWalk program for local artists.
See template
See template
Alexandria Soccer Association Medical Release Form
PDF template
A medical authorization form allowing team officials to obtain medical attention for a child during soccer activities.
See template
See template
Central Registry Referral Form
PDF template
A referral form for documenting spinal cord injury or disability cases for the Arkansas Spinal Cord Commission's central registry.
See template
See template
ICARUS MEDICAL, LLC ORDER FORM
PDF template
Order form for custom knee braces with patient and measurement information.
See template
See template
Referral Form
PDF template
Medical referral form for new patient intake and treatment evaluation at Ascend Health Center, focusing on mental health services.
See template
See template
Assumption Of Risk, Waiver, Release And Indemnity Agreement
PDF template
Legal document outlining risks and liability for participation in various recreational activities at the Anne Springs Close Greenway.
See template
See template
Student Accident Report Form
PDF template
Comprehensive form documenting details of student accidents and injuries within a school district setting.
See template
See template
ASE Organizational Membership Application
PDF template
Organizational membership application for multiple members from the same institution to join or renew ASE membership with various professional categories and pricing tiers.
See template
See template
ASE Membership Application Form
PDF template
Organizational membership application form for joining or renewing membership in the American Society of Echocardiography with various membership categories and pricing.
See template
See template
Liability Waiver Form For ASF Members
PDF template
A legal document waiving liability for children participating in activities at Scandinavia House Children's Center and authorizing emergency medical treatment.
See template
See template
League Purchase Form
PDF template
Form for Cal Poly clubs and organizations to purchase intramural sports leagues with six teams during quarterly periods.
See template
See template
ASIIS Enrollment Application
PDF template
Application for organizations to enroll in the Arizona State Immunization Information System (ASIIS) for healthcare providers and facilities.
See template
See template
ASNC Payer Policy Feedback Form
PDF template
A form for physicians to report issues and provide feedback about health plan and insurance carrier interactions related to medical imaging services.
See template
See template
Alabama State Port Authority Truck Control Terminal
PDF template
A form for truck drivers to provide required information for delivering cargo at an Alabama port terminal.
See template
See template
MEDICALVISION CLAIM FORM
PDF template
A comprehensive claim form for submitting medical and vision insurance claims, requiring detailed employee and patient information.
See template
See template
AYSO Assessment Feedback Form
PDF template
A form for referees to provide feedback on their assessment experience within the American Youth Soccer Organization (AYSO) referee program.
See template
See template
COVID 19 Assumption Of The Risk Forms
PDF template
Comprehensive guidance for creating risk assumption forms to address COVID-19 exposure in fraternity settings, with five different versions for various participant types.
See template
See template
Asthma Assessment Form For School
PDF template
Comprehensive form to collect detailed medical information about a student's asthma symptoms, triggers, and management for Seattle Public Schools.
See template
See template
Athlete Emergency Contact Form
PDF template
A form for collecting student athlete emergency contact details and medical conditions for use by school athletic department personnel.
See template
See template
Special Olympics Medical Form
PDF template
Comprehensive medical form for Special Olympics athletes documenting health history, conditions, and participation details.
See template
See template
Special Olympics Medical Form
PDF template
Medical examination form for determining an athlete's fitness to participate in Special Olympics sports programs, requiring medical professional evaluation.
See template
See template
Athlete Of The Year Nomination Form
PDF template
A nomination form for recognizing outstanding athletes in the Town of Paradise for achievements during the 2021 calendar year.
See template
See template
A1 Athlete Registration
PDF template
Official registration and release form for Special Olympics athletes detailing participation rights, medical consent, and personal information usage.
See template
See template
Athletic T ShirtUniformApparel Approval Form
PDF template
Official form for approving athletic and non-athletic t-shirt designs and apparel for a team or club.
See template
See template
ATHLETIC CLEARANCE PACKET PAYMENT FORM
PDF template
A comprehensive form for high school athletes to obtain clearance for sports participation, including health information, parental permission, and fee details.
See template
See template
Athletic Emergency Contact Form
PDF template
A comprehensive form collecting medical, contact, and emergency information for student athletes.
See template
See template
ANNUAL ATHLETIC FACILITES AGREEMENT
PDF template
An agreement between an Athletic Association and North Lebanon Township detailing terms of facility usage, responsibilities, and liability requirements.
See template
See template
TRUSSVILLE PARKS RECREATION ATHLETIC FACILITY RENTAL FORM
PDF template
Form for renting athletic facilities and spaces in the Trussville Parks & Recreation system with pricing and time slot details.
See template
See template
Athletic FieldCourt Permit Information
PDF template
Comprehensive guide for obtaining and using athletic field permits in Denver, including information about locks, lighting, restrooms, and field maintenance.
See template
See template
North Boone High School Student Parent Athletic Handbook
PDF template
Guidelines and regulations for extracurricular activities at North Boone Unit School District 200 for students and parents.
See template
See template
TMU Athletics Secondary Insurance Disclosure Form
PDF template
Detailed explanation of athletic injury insurance coverage for student athletes at The Master's University, outlining insurance policy terms and student responsibilities.
See template
See template
ParentGuardian Communication Athletic Screening
PDF template
Guidelines for student athletes participating in strength and conditioning sessions during COVID-19 period, including health screening and safety requirements.
See template
See template
WCGS Athletics Travel Permission Form 2022 2023
PDF template
A consent form for parents of student athletes allowing transportation and medical authorization for off-campus sports events
See template
See template
PHYSICAL FORM
PDF template
Medical form for student athletes to document personal health history and undergo physical examination before participating in sports.
See template
See template
Melba Schools Activity Policy
PDF template
Comprehensive policy document covering insurance waiver, drug testing consent, and activity participation guidelines for Melba School District students.
See template
See template
Athletic Camp Medical Release Form
PDF template
A medical release and photo consent form for children participating in athletic camps at Southern Illinois University Carbondale.
See template
See template
PREPARTICIPATION PHYSICAL EVALUATION MEDICAL HISTORY
PDF template
Annual medical history form for students to assess potential health risks in athletic participation.
See template
See template
ATHLETICS PURCHASE ORDER REQUEST FORM
PDF template
A form used to request purchases for athletic department activities, requiring approval from advisors and athletic directors.
See template
See template
Interscholastic Athletic Opportunities Disclosure Form 21.1
PDF template
Form documenting school athletic team demographics, enrollment, and sponsorship information for Title IX compliance.
See template
See template
Interscholastic Athletic Opportunities Disclosure Form 21.1
PDF template
Form documenting school athletic team demographics, enrollment, and sponsorship information for Title IX compliance.
See template
See template
Interscholastic Athletic Opportunities Disclosure Form 21.1
PDF template
Form documenting school athletic team demographics, enrollment, and sponsorship information for Title IX compliance.
See template
See template
Athletic Travel Form
PDF template
A comprehensive form for student-athletes detailing emergency contact information, medical details, and consent for medical treatment during athletic participation.
See template
See template
Adobe Training Provider Program Agreement
PDF template
Legal agreement defining terms and conditions for membership in Adobe's Training Provider Program, including benefits and eligibility requirements.
See template
See template
Accessible Technology Purchase Form
PDF template
Form for requesting electronic and information technology purchases to ensure accessibility for students and users in academic settings.
See template
See template
MedicalForensic Examination Form
PDF template
A detailed forensic medical examination form for documenting physical findings in sexual assault cases, covering body diagrams and genital examination for both female and male patients.
See template
See template
Waiver Service Request Form (DP 1022)
PDF template
A form for requesting changes or new services in a waiver program, to be completed when team concurrence is not achieved.
See template
See template
ATTACHMENT B VENDOR PROFILE
PDF template
A vendor document detailing insurance requirements and company profile information for a municipal contract in Duluth, Minnesota.
See template
See template
Attendance Form
PDF template
A form designed to collect demographic and stakeholder information for participants in Food Systems Summit Dialogues, focusing on participant diversity and inclusivity.
See template
See template
Bishop Canevin Attendance Notice
PDF template
Official school document for recording student absences, tardiness, early dismissals, and medical appointments.
See template
See template
Attendance Register
PDF template
A comprehensive form for documenting participant demographics, sectors, and stakeholder groups in a dialogue or event.
See template
See template
MINOR YOUTH EMERGENCY MEDICAL CONTACT, HEALTH HISTORY AND TREATMENT AUTHORIZATION
PDF template
A comprehensive medical contact and health authorization form for minors participating in a program, collecting emergency contacts, health information, and parental consent for medical treatment.
See template
See template
Attending PhysicianS Compliance Form
PDF template
Medical form documenting physician compliance and patient consent for end-of-life medication request in the District of Columbia.
See template
See template
Long Term Disability Claim Form
PDF template
A comprehensive medical form for documenting a patient's disability claim, including medical history, diagnosis, treatment, and current condition.
See template
See template
West Kentucky ATV Recreational Area Release And Waiver Of Liability And Indemnity Agreement
PDF template
Legal document releasing liability for participants entering and using the West Kentucky ATV Recreational Area for off-highway vehicle riding.
See template
See template
New Academic Program Proposal Form
PDF template
A comprehensive form for proposing new academic programs at Fitchburg State University, detailing program specifics, requirements, and implementation plans.
See template
See template
Consent To Use Sound And Image Recordings That May Contain Identifying Information For Education
PDF template
A consent form allowing physicians to use patient images and sound recordings for educational purposes with patient's understanding of potential identification.
See template
See template
IHS Diabetes Care And Outcomes Audit, 2024
PDF template
A comprehensive audit form for tracking diabetes patient health metrics, screenings, and examinations
See template
See template
Patient Intake Form
PDF template
Comprehensive patient intake form for collecting personal, contact, and medical insurance information at Auburn University Clinical Health Services clinics.
See template
See template
Universal Service Request Form
PDF template
Form for comprehensive employee medical examinations, drug testing, and workplace health screening documentation.
See template
See template
HOLD HARMLESS, VOLUNTARY WAIVER, AND ASSUMPTION OF RISK FORM
PDF template
A legal document that releases Auburn University from liability for potential injuries or damages during a field trip event.
See template
See template
Authorization Form For Insurance Complaint
PDF template
A form authorizing a representative to discuss and access medical information related to an insurance complaint or appeal.
See template
See template
Authorization And Driving History Form
PDF template
A form documenting employee driving authorization, vehicle operation details, and liability requirements for state vehicle use.
See template
See template
WaiverAuthorization Form
PDF template
A legal liability waiver for participants in Keep Florence Beautiful community activities and events.
See template
See template
Williamson County Schools Procedure Authorization Form
PDF template
A form for authorizing medical procedures to be administered to a student during school hours, requiring physician and parental consent.
See template
See template
HIV Related Information Release Authorization Form
PDF template
Legal form authorizing release of medical and HIV-related information under New York State confidentiality laws
See template
See template
Authorship Agreement Form
PDF template
A form documenting individual contributions and authorship criteria for academic or medical research publications.
See template
See template
Autism Emergency Contact Form
PDF template
A comprehensive emergency contact and personal information form for individuals with autism, designed to assist in case of emergencies or potential wandering incidents.
See template
See template
Autism Emergency Contact Form
PDF template
A comprehensive form collecting critical personal and medical information for individuals with autism in case of emergency or potential wandering incidents.
See template
See template
Autism Profile And Emergency Contact Form
PDF template
A comprehensive form for documenting critical medical, contact, and behavioral information for individuals with autism
See template
See template
DriverS Accident Report Form
PDF template
A comprehensive form for documenting details of a vehicle accident, including driver, vehicle, and accident information.
See template
See template
Auto Accident Report Form
PDF template
A comprehensive form for documenting details following a motor vehicle accident, including vehicle, driver, and injury information.
See template
See template
Automobile Accident Report
PDF template
Comprehensive form for reporting vehicle accidents involving University of Delaware vehicles or employees
See template
See template
Auto Accident Report Form
PDF template
A comprehensive form for documenting details of a vehicle accident involving Oregon State University personnel, vehicles, or property.
See template
See template
New PIP Patient Form
PDF template
Detailed form for documenting vehicle accident details and patient information for insurance or medical purposes.
See template
See template
Auto Incident Report Form
PDF template
A comprehensive form for documenting details of an auto collision involving a nonprofit organization's vehicle.
See template
See template
Client Interview Form Auto Accidents
PDF template
Comprehensive form for collecting client information related to an auto accident insurance or legal claim.
See template
See template
Colony Specialty Automobile Vehicle Inspection Form
PDF template
Comprehensive inspection form for evaluating the condition of vehicles and trailers, assessing various mechanical and safety components.
See template
See template
Vehicle Accident Report Form
PDF template
A comprehensive form for documenting details of a vehicle accident, including driver, vehicle, damage, and witness information.
See template
See template
Avera EConsult Assessment Form
PDF template
A comprehensive medical assessment form for telemedicine patient consultations, capturing patient information and physical examination details.
See template
See template
Project Authorization Request (PAR)
PDF template
Project Authorization Request for modifying an existing IEEE standard related to local and metropolitan area network virtual bridged local area networks.
See template
See template
Arbitration Award Certas Direct Insurance Company V. Allstate Insurance Company Of Canada
PDF template
Arbitration award resolving an insurance priority dispute between two insurers following a motor vehicle accident in 2018.
See template
See template
Award Agreement (Agreement To Pay Benefits)
PDF template
Official form documenting workers' compensation benefits agreement between an injured worker and employer/insurance carrier.
See template
See template
Premium And Billing Change Request
PDF template
A form for changing insurance premium payment methods, including pre-authorized check plan and billing modifications for American Heritage Life Insurance Company policies.
See template
See template
Animal Workers Medical Surveillance Consent For Medical ScreeningEvaluation
PDF template
A consent form for medical screening and evaluation of individuals working with animals at the University of Idaho.
See template
See template
Medical Expense Claim Form
PDF template
A form for employees to claim medical expenses through a Flexible Spending Account with detailed submission instructions.
See template
See template
Alfond Youth Community Center New England Sports Camps Medical History Form 2023
PDF template
Comprehensive medical history and emergency contact form for children attending various sports camps in Maine.
See template
See template
AYSO Referee Exam Feedback Form
PDF template
A form for reporting problems or suggestions about AYSO referee exams to the National Referee Program.
See template
See template
Patient Authorization Form
PDF template
A form authorizing AstraZeneca to use and share patient health information for support services and coordination of care.
See template
See template
Member Request For Medical Reimbursement Form
PDF template
A form used by UnitedHealthcare Community Plan members to request reimbursement for medical services, co-payments, coinsurance, and deductibles.
See template
See template
Securing Waivers Of Liability From Volunteers Of Nonprofit Organizations
PDF template
A comprehensive guide for nonprofit organizations on obtaining and using liability waivers to protect against potential legal claims from volunteers.
See template
See template
Benefit Application Form (BA1)
PDF template
Application form for members of the New Zealand Firefighters Welfare Society to claim benefits and reimbursements.
See template
See template
Allen R Baca Center New Membership Form
PDF template
Registration form for membership at Allen R Baca Center recreational facilities for different age groups and membership types.
See template
See template
CIAC Background Check Consent Form
PDF template
Consent form for high school sports officials in Connecticut requiring a criminal background check for officiating authorization.
See template
See template
CIAC Background Check Consent Form
PDF template
Consent form for high school sports officials in Connecticut to undergo a mandatory criminal background check for the 2011-2012 school year.
See template
See template
City Of Auburn Parks And Recreation Department Background Screening Policy
PDF template
Policy establishing mandatory criminal background checks for coaches, instructors, and volunteers in Auburn Parks and Recreation programs to ensure participant safety.
See template
See template
My Choice Wisconsin BadgerCare Plus Authorization Form
PDF template
A comprehensive form for requesting healthcare service authorizations under the BadgerCare Plus program in Wisconsin.
See template
See template
Laurel High School Marching Band Medical Form
PDF template
Medical form for Laurel High School Marching Band students to provide health and emergency contact information for band activities.
See template
See template
Medical History Form
PDF template
A comprehensive medical history form for collecting student health information, emergency contacts, and family medical history.
See template
See template
Bangs Ambulance Events Request Form
PDF template
Form for requesting ambulance and medical support services for events with specific scheduling details.
See template
See template
Chronic Appliance Benefit Application Form
PDF template
Medical application form for patients seeking insurance coverage for chronic medical appliances and equipment through Bankmed.
See template
See template
BANNER UNIX ACCOUNT APPLICATION FOR EMPLOYEES
PDF template
Form for employees to request access to various Banner modules and Unix accounts at Texas Southern University
See template
See template
BANNER UNIX ACCOUNT APPLICATION FOR EMPLOYEES
PDF template
Form for requesting access to Banner and Unix system modules for Texas Southern University employees
See template
See template
Medical History Form
PDF template
Comprehensive medical history form for patients seeking weight loss treatment, collecting personal, medical, and insurance information.
See template
See template
Health Is Wealth Patient Intake Form
PDF template
Comprehensive medical intake form collecting patient personal, employment, emergency contact, and insurance information.
See template
See template
Baseball Medical Release Form
PDF template
A medical authorization and consent form for baseball participants, allowing medical treatment and acknowledging potential risks of participation.
See template
See template
Health Care Personnel (HCP) Baseline Individual TB Risk Assessment
PDF template
A screening form to assess tuberculosis risk factors for healthcare personnel through a series of yes/no questions about travel, immunosuppression, and TB exposure.
See template
See template
Westlake Charter School BASE Program Registration Packet
PDF template
Registration packet for Westlake Charter School's before and after school program, providing details and required forms for student enrollment.
See template
See template
St. Ignatius Basketball Camp Liability Waiver Form
PDF template
Liability waiver and emergency contact form for participation in St. Ignatius Basketball Camp for student-athletes.
See template
See template
ACHD Bathing Place Incident Report Form
PDF template
A comprehensive form for reporting incidents and injuries at public bathing facilities, including water rescues and medical treatments.
See template
See template
VolunteerParental Consent Form
PDF template
Legal document outlining volunteer responsibilities, liability waivers, and consent for volunteering at Bernie's Book Bank, including provisions for minor volunteers.
See template
See template
Liability Media Release Form
PDF template
A release form for parents/guardians to authorize child participation in music school programs and grant media usage permissions.
See template
See template
BC3NP Enrollment Form
PDF template
Healthcare enrollment form for collecting patient contact, demographic, and service needs information.
See template
See template
Sport Injury Accident Report Form
PDF template
A comprehensive form for documenting sports-related injuries or accidents during an event, capturing details about the injured person and medical response.
See template
See template
Patient Insurance Information Form
PDF template
Comprehensive form for collecting patient medical insurance and health coverage details for claims processing.
See template
See template
Claim Form To Pay InsuredSubscriber
PDF template
A comprehensive insurance claim form for documenting medical treatment, injury, or preventive care for reimbursement purposes.
See template
See template
Claim Form To Pay InsuredSubscriber
PDF template
A comprehensive form for submitting medical insurance claims, capturing patient details, treatment information, and other coverage details.
See template
See template
Claim Form To Pay InsuredSubscriber
PDF template
A comprehensive insurance claim form for submitting medical treatment claims with detailed patient and treatment information.
See template
See template
Educators Health Alliance Medical And Dental Enrollment Form
PDF template
A medical and dental insurance enrollment form for Educators Health Alliance, allowing new applications and changes to existing coverage.
See template
See template
Member Reimbursement
PDF template
A form for members to request reimbursement for healthcare expenses paid out-of-pocket directly to providers.
See template
See template
SNFAcute IPR Assessment Form
PDF template
Prior authorization form for skilled nursing facility and inpatient rehabilitation services for Blue Cross Blue Shield of Michigan and Blue Care Network providers.
See template
See template
Member Reimbursement
PDF template
A form for Blue Cross Blue Shield members to request reimbursement for healthcare expenses paid out of pocket.
See template
See template
Medical Expense Claim
PDF template
A claim form for submitting medical expenses to Blue Cross and Blue Shield of Alabama for reimbursement.
See template
See template
Member Reimbursement
PDF template
Form for members to request reimbursement for healthcare expenses paid out-of-pocket.
See template
See template
Member Claim Form
PDF template
A form for filing healthcare claims with Blue Cross Blue Shield of North Carolina, detailing patient and insurance information for reimbursement of medical services.
See template
See template
Prescription Drug Claim Form
PDF template
A form for submitting prescription drug claims, allowing members to request reimbursement for pharmacy expenses.
See template
See template
Change Of Address Form
PDF template
Form for updating a customer's address with Blue Cross Blue Shield of Mississippi to ensure proper mail delivery.
See template
See template
Western Carolina University Base Camp Cullowhee Health And Medical Form
PDF template
A health screening form for participants in outdoor activities, collecting medical history and emergency contact information.
See template
See template
My Benefit Plan Summary
PDF template
Comprehensive healthcare benefit plan summary for SEIU Clerical Employees detailing coverage limits and medical benefits.
See template
See template
My Benefit Plan Summary
PDF template
Comprehensive health benefits summary for full-time employees of Brant Community Healthcare System through Green Shield Canada.
See template
See template
ADPH F BCL 136 Alabama Department Of Public Health (ADPH) Bureau Of Clinical Laboratories (BCL) Requ
PDF template
A comprehensive laboratory testing request form used by healthcare providers to submit patient specimens for clinical testing in Alabama.
See template
See template
Member Billing Form
PDF template
A form for submitting medical bills from non-participating healthcare providers for reimbursement or claim processing.
See template
See template
Member Reimbursement Form
PDF template
A form for healthcare members to request reimbursement for out-of-pocket medical expenses they have paid directly.
See template
See template
MEDICAL INFORMATION FORM
PDF template
A comprehensive medical form for participants of outdoor adventure trips, collecting health, emergency, and medical history information.
See template
See template
Participant Agreement
PDF template
Agreement detailing COVID-19 safety protocols and participant responsibilities for Ringette BC club activities and Team BC athletes.
See template
See template
BCS Fellow (FBCS) Application Guidance For OMs
PDF template
Comprehensive guidance for professionals applying to become a BCS Fellow, detailing application requirements and criteria.
See template
See template
BDIAP Glasgow 2020 Educational Fellowship Application Form B
PDF template
Application form for medical or scientific professionals seeking an educational fellowship with the British Division of the IAP in Glasgow
See template
See template
Mental HealthSubstance Use Treatment Claim Form
PDF template
A claim form for submitting mental health and substance use treatment services to Beacon Health Options for reimbursement.
See template
See template
Physical Examination Form
PDF template
A comprehensive medical form for documenting a student's physical health assessment by a healthcare provider.
See template
See template
Ancillary Order Form
PDF template
A medical form for ordering orthotic services, therapy, and documenting patient diagnostic information.
See template
See template
Beazley Financial Institutions Directors Officers Proposal Form
PDF template
A comprehensive proposal form for financial institutions seeking Directors & Officers liability insurance coverage, requiring detailed company information and ownership details.
See template
See template
MEDICAL HISTORY FORM
PDF template
Comprehensive form for collecting patient personal information, medical history, insurance details, and current health status.
See template
See template
Independent Contractor Agreement
PDF template
A legal document defining the terms of an independent contractor relationship with the Bel Air Recreation Committee, outlining responsibilities and tax obligations.
See template
See template
Beneficiary Designation
PDF template
A form for designating beneficiaries for an insurance or retirement plan, allowing members to specify beneficiary allocation and revocability.
See template
See template
M NCPPC BENEFITS ENROLLMENTCHANGE FORM
PDF template
Form for employees to enroll or change benefits, covering medical, dental, and prescription plans for new hires or those experiencing qualifying life events.
See template
See template
Health Sector Occupational Pension Scheme (DEATH BENEFIT APPLICATION FORM)
PDF template
A form for claiming death benefits for deceased health sector workers in Ghana, to be completed by beneficiaries.
See template
See template
Benefits Billing Form
PDF template
A form for employees to elect benefits continuation options during FMLA or general leave of absence
See template
See template
Benefits Cancellation Form
PDF template
Form used to remove dependents from an employee's benefits plan and modify coverage options.
See template
See template
Benefits Cancellation Form
PDF template
Form for employees to cancel or modify health, dental, and life insurance benefits with Haverhill Public Schools.
See template
See template
Dental Insurance Plan
PDF template
Insurance plan detailing dental coverage eligibility for employees and their dependents at the University of Nebraska.
See template
See template
Benefits Enrollment Form
PDF template
A comprehensive form for employees to select and enroll in medical, dental, and optional insurance benefits
See template
See template
Informed Consent, Voluntary Waiver, Release Of Liability, Assumption Of Risk, And Photography Releas
PDF template
Legal document for parental consent and liability release for child participation in a program at Bethel University
See template
See template
Bachelor Of Fine Arts Application Form
PDF template
Application form for students seeking admission to the Bachelor of Fine Arts program at the University of Nevada, Reno.
See template
See template
Bachelor Of Fine Arts (BFA) Application Form
PDF template
Application form for students seeking admission to the Bachelor of Fine Arts degree program with concentration selection and approval process.
See template
See template
Bachelor Of Fine Arts Application Form
PDF template
A comprehensive guide for students applying to the Bachelor of Fine Arts program, detailing admission requirements, application process, and program expectations.
See template
See template
BOISE FIRE DEPARTMENT MEDICAL RELEASE FORM
PDF template
Medical form for evaluating and releasing firefighters to full duty after injury or medical assessment.
See template
See template
Health Savings Account Transfer Request Form
PDF template
A form for transferring health savings account assets from a previous trustee/custodian to Benefitfocus Account Services HSA.
See template
See template
BGCC Program Refund Request
PDF template
A form for parents to request a refund for a BGCC (Boys & Girls Club of America) program participation
See template
See template
Discharge Form
PDF template
A form used to document and track patient discharge details for behavioral health clinical services.
See template
See template
Patient Medical History Form
PDF template
Comprehensive medical history form collecting patient's personal health information, medical history, symptoms, and current health status.
See template
See template
FederalDOT Testing Form
PDF template
Comprehensive medical screening and drug testing form for transportation workers requiring federal agency compliance.
See template
See template
MFFA Angling Competition Entry Form
PDF template
Form for recording details of fish caught during an angling competition, including species, length, and medal history.
See template
See template
BIIS Participant Registration Form
PDF template
Registration form for athletes with physical disabilities to participate in Bridge II Sports programs and activities.
See template
See template
Billing 101 What You Need To Know
PDF template
A comprehensive guide addressing billing, reimbursement, and professional practice considerations for athletic trainers seeking third-party payor reimbursement.
See template
See template
Grant In Aid Billing Form
PDF template
Form for trail clubs to request reimbursement for trail maintenance and equipment expenses from state grant funds.
See template
See template
We CanT Wait Act Of 2023
PDF template
A bill to allow disabled individuals to elect to receive disability insurance benefits during the mandatory waiting period.
See template
See template
We CanT Wait Act Of 2024
PDF template
A bill to permit disabled individuals to elect to receive disability insurance benefits during the waiting period.
See template
See template
BIMA Bash Auction Procurement Form 2023
PDF template
A form for artists to donate artwork or experiences for the Bainbridge Island Museum of Art's 10th Anniversary fundraising auction.
See template
See template
Histology Service Request Form
PDF template
A form for requesting histology services including tissue processing, embedding, staining, and immunohistochemistry for human or animal biospecimens.
See template
See template
Oncology Prescription Referral Form
PDF template
A comprehensive form for submitting oncology patient prescription details, insurance information, and clinical data for medication authorization.
See template
See template
Patient Intake Form
PDF template
Comprehensive medical form for collecting patient personal, contact, medical, and insurance information with consent authorization.
See template
See template
Harvard University Biosafety Manual
PDF template
Comprehensive guide for laboratory safety protocols, biosafety levels, and procedures for handling biological materials at Harvard University.
See template
See template
Release And Assumption Of Risk Form
PDF template
Legal document releasing the Bermuda Institute of Ocean Sciences from liability during scientific, research, or recreational activities.
See template
See template
Bainbridge Island Swim Club Change In Billing Application
PDF template
Form for swimmers to request temporary leave or permanent retirement from Bainbridge Island Swim Club with billing adjustments.
See template
See template
Bainbridge Island Swim Club Change In Billing Application
PDF template
Form for swimmers to request temporary leave or permanent retirement from the Bainbridge Island Swim Club, including changes in billing group levels.
See template
See template
Exhibition Proposal Form
PDF template
A form for students to propose and submit details for an art exhibition at a university gallery.
See template
See template
Arts In Corrections MONTHLY ATTENDANCE SHEET FY 20 21
PDF template
Attendance tracking form for arts programs in correctional facilities, documenting participant attendance and class details.
See template
See template
Credit Card Pre Authorization Form
PDF template
A form authorizing The Viva Center to charge credit card for services with pre-approved billing parameters.
See template
See template
Driver Agreement Form
PDF template
A form documenting driver responsibilities and information for university club sports team vehicle transportation.
See template
See template
Design Competition Entry Form 2024
PDF template
A form for participants to submit creative badge design entries for a competition organized by Pawprint Family.
See template
See template
PATIENT INTAKE FORM
PDF template
Comprehensive medical intake form for collecting patient health information, medical history, and current health status.
See template
See template
Official Travel Request Form
PDF template
Comprehensive travel request form for participants, volunteers, and staff to provide travel details and personal information for a trip.
See template
See template
Blood Body Fluid Exposure Report
PDF template
A form documenting blood or body fluid exposure incidents for students, tracking medical testing and follow-up procedures.
See template
See template
Blood Drive
PDF template
Blood donation drive organized by American Red Cross at Mt. San Antonio College to collect blood donations.
See template
See template
TEST REQUEST
PDF template
A comprehensive medical test request form for collecting patient information and specifying various laboratory tests to be performed.
See template
See template
Health Insurance Claim Form
PDF template
Comprehensive form for collecting patient medical insurance information, health coverage details, and claim submission details.
See template
See template
Blue Cross Blue Shield Insurance Claim Form
PDF template
A comprehensive medical insurance claim form for collecting patient and insurance information for medical service reimbursement.
See template
See template
Blue Cross Blue Shield Change Of Address Form
PDF template
A form for Blue Cross Blue Shield members to update their contact information and address details.
See template
See template
Member Claim Form
PDF template
A comprehensive medical claim form for submitting healthcare service expenses to Anthem Blue Cross insurance.
See template
See template
Enrollment And Change Form
PDF template
Healthcare insurance enrollment and change form for selecting medical and dental coverage options through Blue Cross Blue Shield
See template
See template
Santa Monica College Confidential Medical History
PDF template
A comprehensive medical history form for students to document personal health information and medical background.
See template
See template
Blue View VisionSM Reimbursement Form
PDF template
A form for submitting out-of-network vision care service reimbursement claims to Blue View Vision insurance.
See template
See template
Bert Miller Nature Club Waiver
PDF template
Annual waiver form for Bert Miller Nature Club members and guests to acknowledge risk and provide emergency contact information.
See template
See template
All FUR Fun Stay Play Dog Care Service Agreement Form
PDF template
A service agreement for dog daycare and boarding services, outlining responsibilities, risks, and liability limitations.
See template
See template
Boca Raton Bowl Trip Registration Form
PDF template
Registration form for University of Memphis students to attend the Boca Raton Bowl Game featuring the Tigers against Western Kentucky.
See template
See template
Exhibitor Appointed Contractor Form
PDF template
A form authorizing a non-official contractor to design, set up, and/or dismantle an exhibit at a trade show event with specific insurance requirements.
See template
See template
Exhibitor Appointed Contractor Form
PDF template
Form authorizing a non-official contractor to design, set up, or dismantle an exhibit at BOMA 2022 trade show event.
See template
See template
Bond Application (For Corporation Partnership)
PDF template
Application form for corporations and partnerships to request a surety bond from Pacific Union Insurance Company
See template
See template
Fidelity Bond Purchase Agreement
PDF template
A document for purchasing fidelity bond packages to assist ex-offenders and at-risk job applicants in securing employment through insurance coverage.
See template
See template
Termination Of Membership Form
PDF template
A form for members to officially resign from the Bonitas Medical Fund and terminate their medical scheme membership.
See template
See template
Booking Terms And Conditions
PDF template
Comprehensive booking terms and conditions for travel services outlining customer rights, obligations, and important travel guidelines.
See template
See template
BOOKING FORM
PDF template
Comprehensive booking form for travel expedition including personal, medical, and payment details
See template
See template
BOOKING CONTRACT FORM AAPI JAPAN AND SOUTH KOREA TOUR APRIL 07 20, 2024
PDF template
A comprehensive travel booking contract for a tour to Japan and South Korea with detailed traveler and insurance information.
See template
See template
Booking Form
PDF template
A comprehensive travel booking form and travel guidance document providing instructions for booking trips and essential travel preparation information
See template
See template
Booking Form
PDF template
A comprehensive guide for booking travel, including login instructions, passport requirements, and travel protection recommendations.
See template
See template
Book Order Form
PDF template
Order form for a commemorative book about the Michigan Society of Thoracic and Cardiovascular Surgeons' history.
See template
See template
Academic Degree Program Proposal Form
PDF template
A form for proposing and documenting new academic degree programs with institutional and accreditation details.
See template
See template
BostonSight (HIPAA) MEDICAL RECORDS RELEASE FORM
PDF template
A form that allows patients to grant permission for BostonSight to share their medical information with specified individuals or organizations.
See template
See template
Suspect Foodborne Or Unknown Etiology Botulism Case Interview Form
PDF template
A detailed medical form for collecting comprehensive information about a potential botulism case, including patient demographics, clinical information, and medical history.
See template
See template
Suspect Foodborne Or Unknown Etiology Botulism Case Interview Form
PDF template
A detailed medical form for collecting comprehensive information about a potential botulism case, including patient demographics, clinical information, and medical history.
See template
See template
Bounce House Vendor Agreement
PDF template
A formal agreement outlining rules and regulations for bounce house vendors operating in City of Lincoln parks.
See template
See template
License Authorization Form
PDF template
A form for medical facilities to authorize product ordering and certify licensing for prescription drugs, medical devices, and controlled substances.
See template
See template
Camp Medical Form
PDF template
A medical form for parents/guardians to provide health information and medical history for children attending summer camp.
See template
See template
Pension Plan Benefit Application Form
PDF template
A comprehensive form for union members to apply for pension benefits, covering member information, reason for benefit request, and required certifications.
See template
See template
AMWA Branch Annual Report Form
PDF template
Annual reporting form for branches of the American Medical Women's Association to document branch activities and leadership
See template
See template
RELEASE, INDEMNIFICATION AND HOLD HARMLESS AGREEMENT
PDF template
Legal document for releasing liability and obtaining consent for YMCA program participation and activities.
See template
See template
BRASSEl Pilar Program Medical Form
PDF template
Confidential medical history form for participants in an archaeological research program at El Pilar, collecting personal health information and emergency contact details.
See template
See template
Consent To Treat Form
PDF template
A medical form authorizing treatment, information release, and benefit assignment for medical services at a healthcare facility.
See template
See template
Patient Medical Referral Form
PDF template
Comprehensive medical referral form capturing patient demographics, diagnostic information, and key health metrics
See template
See template
Swain County Athletic Hall Of Fame HOF Brick Order Form
PDF template
Order form for purchasing personalized commemorative bricks honoring Swain County High School athletes and sports contributors.
See template
See template
Medi Cal To Healthy Families Bridging Consent Form
PDF template
A consent form allowing transfer of Medi-Cal case file information to the Healthy Families Program for low-cost health coverage for children.
See template
See template
Patient Intake Form
PDF template
Comprehensive form for collecting patient and family medical contact information for pediatric medical practice.
See template
See template
Sales Order Form
PDF template
Order form for BIBA (British Insurance Brokers' Association) Broker Assess system license, capturing company and contact details for membership registration.
See template
See template
Sales Order Form
PDF template
Sales order form for purchasing BIBA Broker Assess licensing with staff pricing and contact details.
See template
See template
BRYC Elite Academy Medical Release Form
PDF template
A medical consent form allowing treatment for a youth athlete in case of injury or medical emergency during sports activities.
See template
See template
Informed Consent, Release Agreement, And Authorization
PDF template
A comprehensive consent and medical authorization document for participating in Scouting activities, covering emergency medical treatment and risk acknowledgment.
See template
See template
Emergency Action Plan (EAP)
PDF template
A comprehensive guide for coaches to prepare and respond to emergency situations during practices and competitions.
See template
See template
JOINT BSMS DEGREE PROGRAM AUDIT FORM
PDF template
A form for students to document their eligibility and plan for a combined bachelor's and master's degree program at FAU.
See template
See template
LOEWENBERG SCHOOL OF NURSING HEALTH EXAMINATION FORM (FORM 003)
PDF template
Comprehensive health history and screening form for nursing students to document medical background and potential health concerns.
See template
See template
BTEC 255 Medical Billing Uniform Course Syllabus
PDF template
A comprehensive course syllabus for medical billing, covering procedures, professional skills, and insurance claim processing.
See template
See template
REQUISITION FORM
PDF template
A form for patient information, billing details, and physician consent for medical testing by BillionToOne.
See template
See template
2015 Creative Art Competition Entry Form
PDF template
Entry form for an art competition addressing the theme of breaking the silence on child sexual abuse
See template
See template
Budget Form Training To Competence Externship
PDF template
A budget form for applicants seeking funding for an externship program, requiring detailed expense documentation and submission at least one month prior to start date.
See template
See template
F. BUDGET FORM
PDF template
Budget form detailing income and expenses for a teen mentoring program, including funding request from the Sisters of Charity Foundation.
See template
See template
Budget Form Reproductive Health Externship Clinical Abortion Observation
PDF template
A form for medical students to document and request funding for expenses related to a reproductive health externship or clinical abortion observation program.
See template
See template
Building Rental Agreement
PDF template
Comprehensive rental agreement for utilizing the Nashville Dog Training Club facility, detailing rental fees, insurance requirements, and liability terms.
See template
See template
BuildOn Medical Form
PDF template
A comprehensive medical form for participants traveling to do physical labor in a remote community, focusing on detailed health history and potential medical risks.
See template
See template
Accident Waiver And Release Of Liability Form And Photo Release
PDF template
Legal document waiving liability for participants in a recreational event, covering potential risks and injuries.
See template
See template
OVERSEAS TAVEL RISK ASSESSMENT FORM
PDF template
A comprehensive form for staff and students to assess risks associated with international travel to high-risk areas.
See template
See template
Aflac Dental Claim Form
PDF template
A claim form for submitting dental insurance details and patient information to Aflac.
See template
See template
Burglary Insurance Proposal Form
PDF template
An insurance proposal form detailing coverage, exceptions, and terms for burglary insurance by M & C General Insurance Company Ltd.
See template
See template
Business Entity Affiliation Cancellation Form 202C
PDF template
Official form for cancelling business entity licensee affiliations in New Mexico, used to notify the Office of Superintendent of Insurance about licensee terminations.
See template
See template
DCCAS Guide To Choosing The Right Legal Form For Your Business
PDF template
A comprehensive overview of different business entity types, their characteristics, ownership, registration, management, and liability considerations.
See template
See template
BUS TRIP OVERNIGHT MEDICAL RELEASE FORM
PDF template
Medical and contact information form for student campus visit, including health insurance and emergency contact details.
See template
See template
Play At Own Risk Waiver And Participant Consent To Treat Form
PDF template
Legal waiver and medical consent form for participants in a regional basketball championship tournament
See template
See template
Physical Examination Form For Driver Applicant
PDF template
Medical evaluation form for assessing a driver's physical fitness, particularly for school bus drivers in Florida.
See template
See template
Feedback Form
PDF template
A bilingual survey assessing individuals' understanding and intentions regarding health insurance coverage and preventive care services.
See template
See template
Property And Casualty Certificate Of Insurance Act
PDF template
Legal code defining rules and definitions for property and casualty insurance certificates in Utah, including scope, applicability, and key terms.
See template
See template
Accident Report Form
PDF template
A form for collecting comprehensive details about a vehicle accident for insurance claim purposes.
See template
See template
CADRE PROPOSAL FORM
PDF template
A form for faculty and staff to propose and submit a cadre program for review by University Ministries.
See template
See template
WEST VIRGINIA WESLEYAN COLLEGE CAFETERIA PLAN MEDICAL CARE EXPENSE CLAIM FORM
PDF template
A form for submitting medical expense reimbursement claims under a cafeteria plan with detailed certification and documentation requirements.
See template
See template
ResidencyFellowship Non ERAS Common Application Form
PDF template
Comprehensive application form for medical residency and fellowship programs at the University of Connecticut School of Medicine
See template
See template
CAHC Provider Accreditation Application
PDF template
Application document outlining requirements for provider accreditation by CAHC, including legal authority, business registration, and compliance verification.
See template
See template
Service Request Form
PDF template
A comprehensive form for making changes to an insurance policy, including beneficiary updates, name changes, address changes, and coverage cancellation.
See template
See template
Member Reimbursement Claim Form
PDF template
Detailed instructions for submitting a medical reimbursement claim to an insurance provider with guidelines for documentation and submission process.
See template
See template
DIVER BOOKING FORM
PDF template
Comprehensive form for collecting diver personal information, experience details, travel insurance, and equipment rental preferences for a diving trip.
See template
See template
CALLIGRAM COMPETITION 2024
PDF template
An artistic competition for students to create visual text art (calligrams) themed around classroom objects and scenes.
See template
See template
Certificate Declaration Form
PDF template
Form for students declaring a certificate program at Mississippi State University's College of Agriculture and Life Sciences (CALS)
See template
See template
AccidentIncident Reporting Form
PDF template
A comprehensive form for documenting accidents and incidents involving coaches, fencers, and members of the public during fencing activities.
See template
See template
PatientS Information Form
PDF template
Comprehensive medical form for collecting patient personal, contact, insurance, and healthcare provider information.
See template
See template
Camp Card Drive For 25 Achiever
PDF template
Tracking form for scouts participating in the Camp Card "Drive for 25" fundraising program
See template
See template
Camp Dina Medical Form PhysicianS Page
PDF template
Medical form for physician documentation required for camp enrollment and health tracking.
See template
See template
Camp Dora Golding Medical Form
PDF template
A comprehensive medical form for parents to provide health and emergency contact information for children attending Camp Dora Golding.
See template
See template
Camp Potlatch 2020 Medical Form
PDF template
A comprehensive medical form for parents/guardians to provide health information for children attending Camp Potlatch summer camp.
See template
See template
Position Description Summer Camp Instructor
PDF template
Seasonal job opportunity for instructors at Como Park Zoo and Conservatory, responsible for teaching and managing summer camp activities for children ages 4-14.
See template
See template
AU STRING CAMP Liability Medical Release Form
PDF template
Liability and medical release form for Anderson University String Camp participants, covering medical information, emergency contacts, and participant waivers.
See template
See template
Camp LMU Registration, Informed Consent, Student Medical Release Form
PDF template
A comprehensive registration form for Camp LMU that collects camper personal information, emergency contacts, medical details, and photo release consent.
See template
See template
Camp Potlatch 2022 Medical Form
PDF template
A comprehensive medical form for parents to provide health details about their child attending Camp Potlatch summer camp.
See template
See template
University Of Arkansas Camps Insurance Form
PDF template
Form for calculating insurance charges for university camps based on participants and duration
See template
See template
Payroll Deduction Authorization
PDF template
Authorization form for North Carolina A&T State University employees to deduct recreation center fees from payroll
See template
See template
Jewelry Warranty Claim Form
PDF template
A form for submitting warranty claims for jewelry items, including personal details, school information, and payment instructions.
See template
See template
Program Coverage Cancellation Request Form
PDF template
A form for requesting cancellation of various vehicle protection and service programs with refund details and contract termination acknowledgment.
See template
See template
Request To Cancel Coverage Form
PDF template
A form detailing reasons and documentation required for canceling health insurance coverage with specific qualifying events.
See template
See template
Payroll Deduction Credit Card Stop Form
PDF template
Form for cancelling University of Alabama at Birmingham (UAB) Recreation Center membership with payroll deduction or credit card stop options.
See template
See template
Miscellaneous Deductions And Insurances Cancellation Form
PDF template
Form for cancelling optional insurance plans and miscellaneous deductions not subject to pre-tax restrictions.
See template
See template
New Consultation Referral Form
PDF template
Medical referral form for new patient consultation at an oncology clinic, collecting patient diagnosis, referral details, and medical history.
See template
See template
Cancer Claim Form
PDF template
Claim form for filing a cancer-related insurance claim with Aflac New York, requiring policyholder and patient details along with medical documentation.
See template
See template
Patient Intake Form
PDF template
Comprehensive medical intake form for collecting patient health history, contact information, and current medical status.
See template
See template
CLAIM FORM AND INSTRUCTIONS
PDF template
A comprehensive insurance claim form for filing wellness exam benefits with instructions for submission and processing.
See template
See template
CANINE SUBMISSION FORM
PDF template
Legal form for submitting veterinary diagnostic specimens to Kansas State Veterinary Diagnostic Laboratory with billing and specimen information.
See template
See template
CAOS Fellowship Application Form
PDF template
An application form for medical professionals seeking a fellowship in computer-assisted orthopaedic surgery with the International Society for Computer Assisted Orthopaedic Surgery.
See template
See template
Standardized Application For Pathology Fellowships
PDF template
A comprehensive fellowship application form for pathology residency candidates covering personal, educational, and training details.
See template
See template
MEDICAL HISTORY FORM
PDF template
A comprehensive form for patients to provide detailed medical information relevant to dental treatment and health assessment.
See template
See template
Prescription Drug Claim Form
PDF template
A comprehensive form for submitting prescription drug claims, including standard, compound, and Medicare-related prescriptions and test kits.
See template
See template
Billing Inquiry Form
PDF template
A form for patients to request fee waivers, reductions, or contest billing issues for healthcare services at CAPS (Counseling and Psychological Services).
See template
See template
Release Of Information Authorization Form
PDF template
A form authorizing Counseling and Psychological Services (CAPS) to release protected clinical information to designated persons or agencies.
See template
See template
Standardized Application For Pathology Fellowships
PDF template
Comprehensive application form for medical professionals seeking specialized pathology fellowship training across various subspecialties.
See template
See template
Standardized Application For Pathology Fellowships
PDF template
Official application form for pathology fellowship candidates, covering personal information, education, and fellowship specialization preferences.
See template
See template
Standardized Application For Pathology Fellowships
PDF template
Comprehensive application form for medical professionals seeking specialized fellowship training in various pathology subspecialties.
See template
See template
Capital Access Program (CAP) Notice And Waiver Form
PDF template
A formal document outlining borrower acknowledgment and waiver for participation in the Capital Access Program loan enrollment process.
See template
See template
FMLA InformationRequest Packet
PDF template
Comprehensive packet of forms and instructions for employees requesting Family and Medical Leave Act (FMLA) leave through Carbon County HR.
See template
See template
Youth Sports League Roster Waiver
PDF template
A comprehensive form for youth sports team registration, including player and guardian contact information and liability release.
See template
See template
Care Coordination Referral Form
PDF template
A form for requesting care coordination assistance for members with various health and support needs
See template
See template
Caregiver Consent Act Affidavit
PDF template
An official form allowing non-guardian caregivers to consent to medical treatment for minors under specific circumstances in West Virginia.
See template
See template
CAREGIVER CONTACT FORM
PDF template
A form for patients to provide details about a designated caregiver who can be contacted regarding their medical care and treatment.
See template
See template
Caregiver Medical History Form
PDF template
A medical history form for caregivers to provide health background information for TNT staff review
See template
See template
CaregiverS Authorization Affidavit
PDF template
A legal document authorizing a caregiver to enroll a minor in school, access medical care, and educational records
See template
See template
Pre Authorisation Form Care
PDF template
A detailed medical insurance form for patients seeking cashless hospitalization, capturing personal, medical, and insurance details.
See template
See template
Care Management Referral Form
PDF template
A referral form for recommending patients with complex medical or behavioral health conditions to care management programs.
See template
See template
Mail Service Order Form
PDF template
A form for ordering prescriptions through mail service with health history and participant information collection.
See template
See template
Prescription Reimbursement Claim Form
PDF template
A form for submitting prescription medication reimbursement claims with detailed patient and insurance information requirements.
See template
See template
Prescription Reimbursement Claim Form
PDF template
A form for submitting prescription medication reimbursement claims to an insurance provider or healthcare plan.
See template
See template
Carrier Contact Form
PDF template
Form for collecting contact details and information for workers' compensation insurance carriers in Utah.
See template
See template
CASE EVALUATION FORM
PDF template
A comprehensive medical assessment form for evaluating patient seating needs and physical condition using a BRODA chair.
See template
See template
Consent Form For Case Reports
PDF template
A consent form for patients to authorize publication of medical information in journals or theses while maintaining patient anonymity.
See template
See template
Adobe Customer Story Unum
PDF template
Case study highlighting how Unum improved customer service and document processing speed using electronic signatures and digital document management.
See template
See template
CASL Medical Release Form
PDF template
A comprehensive medical release and liability waiver form for soccer players, allowing medical treatment and releasing organizations from liability.
See template
See template
Medical History Form
PDF template
A comprehensive form for collecting medical information about a student's health conditions, medications, allergies, and parental consent for over-the-counter medication.
See template
See template
Casualty Assessment Form
PDF template
Comprehensive medical assessment form for documenting patient condition, injuries, and treatment details.
See template
See template
Catalog Declaration Form
PDF template
A form for students to declare or update their academic program catalog term and requirements at Oregon State University-Cascades.
See template
See template
Catalog Declaration Form
PDF template
A form for students to update their academic catalog year when adding new majors or minors not available during their initial enrollment.
See template
See template
Catastrophic Sick Leave Request Form
PDF template
A form for employees to request catastrophic sick leave due to extended illness or injury as defined by Alabama state law.
See template
See template
Animal Patient Medical Record
PDF template
Comprehensive medical intake form for documenting a veterinary patient's health status and physical examination details.
See template
See template
Instructions For Application To Sell UnitedHealthcare Products
PDF template
Comprehensive guide for agents and agencies seeking authorization to sell UnitedHealthcare insurance products and complete the appointment process.
See template
See template
Patient Medical Information Form
PDF template
Comprehensive medical intake and tracking form for patient demographics, facility details, and medical specimen information.
See template
See template
MONTREAT COLLEGE ATHLETIC DEPARTMENT SPORT PREPARTICIPATION EXAMINATION FORM
PDF template
A comprehensive medical screening form for college athletes to assess health conditions and potential risks before sports participation.
See template
See template
WAIVER FORM
PDF template
A legal form allowing corporate officers, directors, general partners, and LLC managing members to opt out of workers' compensation insurance coverage in California.
See template
See template
I Voted Sticker Contest
PDF template
A contest for York County students in grades K-12 to design an official 'I Voted!' sticker for local elections.
See template
See template
Harford Mutual Insurance Group Agency Portal Terms Of Use
PDF template
Legal terms governing access and use of Harford Mutual Insurance Group's agency web portal for agents and users.
See template
See template
Program Health And Waiver Form
PDF template
A comprehensive health and emergency contact form for program participants to provide medical information and consent for field station activities.
See template
See template
Medicare Advantage Plan Enrollment Form
PDF template
Enrollment form for MassHealth Standard members over 65 to join a Medicare Advantage Plan
See template
See template
CCCC Medical Sonography Program Volunteer Informed Consent
PDF template
Consent form for volunteer scan models participating in medical sonography student training at Central Carolina Community College.
See template
See template
Student Activity Travel General Release And Waiver Of Liability
PDF template
Legal document releasing Calhoun Community College from liability during student activity travel events.
See template
See template
Emergency InformationUpdate Form
PDF template
A comprehensive form for collecting child's emergency contact, medical, and parental information for YMCA child care programs
See template
See template
Liability Waiver And Release Form (Minor Child)
PDF template
A legal document releasing the Chesterfield County Fair from liability for minor children participating in volunteer activities at the fairgrounds.
See template
See template
New Patient Intake Patient Medical History
PDF template
Comprehensive medical intake form for new patients collecting detailed personal and health information.
See template
See template
Certificate Of Insurance
PDF template
Insurance documentation for residential contractors and remodelers in Minnesota, certifying general liability and property damage coverage.
See template
See template
Certificate Of Insurance Covering General Liability And Property Damage Liability Insurance Coverage
PDF template
Official document certifying insurance coverage for construction contractors in Minnesota, meeting state statutory requirements for liability insurance.
See template
See template
Pediatric Care Management Referral Form
PDF template
A comprehensive referral form for children aged 0-20 years to access care management and coordination services.
See template
See template
Volunteer Form
PDF template
A comprehensive form for individuals interested in volunteering, collecting personal information and including liability waivers and consent agreements.
See template
See template
MEDICAL HISTORY FORM
PDF template
Comprehensive form for collecting patient personal information, medical history, lifestyle details, and emergency contacts.
See template
See template
Covered California For Small Business Change Request Form For Employers
PDF template
A form for employers to request changes to their Covered California small business health insurance coverage, including ownership, address, and plan modifications.
See template
See template
Cottonwood Crossing Summer Institute Health Information Form
PDF template
A comprehensive medical form for student participation in summer institute activities, collecting health insurance, medical history, and emergency treatment authorization.
See template
See template
Personal Vehicle Travel Liability And Insurance Form
PDF template
A liability release form for students using personal vehicles for university-sponsored off-campus activities
See template
See template
Addendum To Sports Radio 810 WHB Letter Of Agreement
PDF template
An agreement between Union Broadcasting and the City of Overland Park for radio sponsorship of the Overland Park Soccer Complex.
See template
See template
CDC 50.42A Adult HIV Confidential Case Report
PDF template
Comprehensive medical reporting form for documenting HIV cases for patients over 13 years of age, used by health departments and CDC for surveillance purposes.
See template
See template
Authorization For Release Of Information
PDF template
A form authorizing the Federal Motor Carrier Safety Administration to disclose medical records related to a commercial vehicle operator's medical exemption application.
See template
See template
Commonwealth Of Dominica Physical Examination Report
PDF template
A comprehensive medical screening form for seafarers detailing personal and medical history
See template
See template
Pre Employment Medical Form
PDF template
Comprehensive medical assessment form for pre-employment screening including medical history, vital signs, and tuberculosis screening.
See template
See template
COVID 19 VACCINE CONSENT FORM
PDF template
Comprehensive consent form for receiving COVID-19 vaccination, collecting patient medical information and screening for potential vaccine contraindications.
See template
See template
CDPHP Co Pay Reimbursement Form
PDF template
Form for employees to submit medical co-pay expenses for reimbursement through Hudson Valley Community College's healthcare program.
See template
See template
Celiac Disease Diagnostic Testing Requisition Form
PDF template
Medical form for ordering celiac disease diagnostic tests, including patient and prescriber information and insurance details.
See template
See template
Exhibitor Appointed Contractor Form
PDF template
Form for exhibitors to authorize independent contractors for services at Calgary Expo 2024, with specific requirements and restrictions.
See template
See template
Climbing Escalade Canada Disciplinary Action Form
PDF template
Official form documenting disciplinary actions taken against competitors or team officials during a climbing competition.
See template
See template
PATIENT REGISTRATION MEDICAL HISTORY FORM
PDF template
Comprehensive medical registration form for patient intake, collecting personal, contact, and insurance information for medical services.
See template
See template
VCU RCDI G CENC External Concussion Diagnostic Interview
PDF template
A medical interview form for documenting potential concussive events and detailed injury information
See template
See template
Patient Referral Form
PDF template
A comprehensive healthcare referral document for patient intake, medical assessment, and service selection.
See template
See template
2017 SAFETY INCENTIVE PROGRAM
PDF template
A comprehensive safety program guide for insurance fund members focusing on workplace safety, health, and wellness efforts.
See template
See template
APPLICATION FOR DISABILITY BENEFIT
PDF template
Application form for disability benefits from the Central States, Southeast and Southwest Areas Pension Fund for eligible participants.
See template
See template
MEDICAL RELEASE FORM
PDF template
A legal form allowing medical treatment for a minor in the absence of a parent or guardian, including consent for medical procedures and documentation of medical history.
See template
See template
Certificate Of Insurance
PDF template
Insurance certification document required for obtaining a pesticide operator licence in Newfoundland and Labrador.
See template
See template
ContractorS, ArchitectS AndOr EngineerS Certificate Of Insurance Form
PDF template
A formal document certifying insurance coverage details for a construction or design project with multiple insurance companies.
See template
See template
Certificate Of Insurance Form For ContractorS Architects AndOr EngineerS
PDF template
A certificate of insurance detailing coverage for contractors, architects, and engineers for a specific project.
See template
See template
Certificate Of Liability Insurance
PDF template
A standard insurance document that provides information about liability insurance coverage without conferring specific rights to the certificate holder.
See template
See template
ContractorS Certificate Of Workers Compensation Insurance (Form 61A)
PDF template
A form for contractors to provide details about their workers' compensation insurance status and business information for compliance purposes in Virginia.
See template
See template
Certification Application Form
PDF template
Application form for obtaining professional certification in a sports-related field with multiple certification type options.
See template
See template
Emergency Exam Cancellation Form
PDF template
Form for clinical research professionals to request fee waiver for exam cancellations due to emergencies or extenuating circumstances.
See template
See template
Certification Of Need And Waiver Of Liability (Prescription Delivery)
PDF template
A form for patients without transportation to receive prescription medication delivery, including liability release and risk assumption.
See template
See template
Vehicle Accident Report
PDF template
A comprehensive form for documenting details of a vehicle accident involving non-state-owned vehicles used in cooperative extension service activities.
See template
See template
MEDICAL FORM
PDF template
Confidential medical history form for collecting patient personal and health information for medical examination purposes.
See template
See template
Daily Waiver Form
PDF template
Comprehensive waiver form for participants of Wilmette Park District Fitness Center, covering injury risks, medical treatment, and photography consent.
See template
See template
Consent Form Checklist For Reliance On External IRBs
PDF template
Guidance for UCLA investigators creating site-specific consent forms when relying on external Institutional Review Board (IRB) approval.
See template
See template
Incident Report Form
PDF template
A comprehensive form for documenting injuries and incidents at CrossFit facilities, used for risk management and insurance purposes.
See template
See template
Candia Farmers Market Accident Waiver And Release Of Liability Form
PDF template
Legal document releasing Candia Farmers Market from liability for potential accidents or injuries during market participation.
See template
See template
CG 20 40 12 19 Commercial General Liability Endorsement
PDF template
Insurance endorsement that automatically adds additional insureds for parties involved in construction contracts, specifically for completed operations liability.
See template
See template
Amendment Of Insured Contract Definition
PDF template
Insurance policy endorsement modifying the definition of 'insured contract' in a commercial general liability coverage part.
See template
See template
OCCUPATIONAL MEDICAL HISTORY AND EXAMINATION FORM
PDF template
A comprehensive medical examination form for U.S. Coast Guard employees covering personal and occupational health information and potential workplace exposures.
See template
See template
ElitePac General Liability Extension Endorsement
PDF template
A comprehensive summary of additional coverages and modifications for a commercial general liability insurance policy.
See template
See template
Colorado Golf Hall Of Fame Induction Form (724)
PDF template
A comprehensive nomination form for inducting individuals into the Colorado Golf Hall of Fame across multiple categories of contribution to golf.
See template
See template
International Group Travel Release
PDF template
Legal release document for participants in international group travel programs, outlining risks and liability waivers for Claremont Graduate University programs.
See template
See template
MEDICAL INFORMATION AND RELEASE FORM
PDF template
A comprehensive medical form for participants in Hartwick College Challenge Programs, collecting health information and liability acknowledgment.
See template
See template
CHAMP Assessment Medical History Form
PDF template
Comprehensive medical history form for fitness assessment program, collecting health and exercise background information from participants.
See template
See template
GROUP POLICY CHANGE FORM
PDF template
A form for employees to request changes to their group insurance policy details and dependent status.
See template
See template
Change Of Address Form
PDF template
Form for United States Bowling Congress (USBC) members to update their contact information and mailing address.
See template
See template
Change Of Contractor Form
PDF template
Instructions and form for changing contractors on a building permit in Southwest Ranches, Florida, with requirements for licensing, insurance, and notification.
See template
See template
2020 States 4 H OB Medical Form (Non Japan)
PDF template
Medical evaluation form for chaperones participating in a cross-cultural exchange program, assessing health status and medical conditions.
See template
See template
Charter License Agreement
PDF template
A licensing document for charter boat operators using Port of Newport recreational marina facilities, detailing vessel and operator information.
See template
See template
Release Of Liability, Acknowledgement Of Risk And Acceptance Of Responsibility
PDF template
Legal document waiving liability for risks associated with participating in a Community Corrections Chase event.
See template
See template
Checklist For Business Visa
PDF template
A comprehensive checklist of documents and requirements for obtaining a business visa for travel to Schengen countries.
See template
See template
Cherry Hill Counseling New Client Information Packet
PDF template
Comprehensive new client forms for mental health counseling services, including medical history, insurance, and privacy documentation.
See template
See template
NEW PATIENT INTAKE FORM
PDF template
Comprehensive form for collecting new patient personal, contact, and medical information for a medical practice.
See template
See template
Health Care Provider Exam Form
PDF template
A comprehensive medical examination form for tracking patient vaccinations, health status, and provider details.
See template
See template
Child Care General Health Examination Form
PDF template
A health examination form for children entering child care programs, documenting their general health status and medical information.
See template
See template
Child Care General Health Examination Form
PDF template
A medical form documenting a child's health status and conditions for child care program enrollment.
See template
See template
Child Care General Health Examination Form
PDF template
A medical form documenting a child's health status and conditions for child care enrollment.
See template
See template
Child Comprehensive Medical Release Permission Form
PDF template
Medical release and permission form for children participating in parish or diocesan activities, capturing health information, emergency contacts, and medical history.
See template
See template
Application For Child Life Internship
PDF template
Application guidelines and requirements for internship positions at Children's Hospitals and Clinics of Minnesota's Child Life Department.
See template
See template
Child Patient Intake Form
PDF template
Comprehensive intake form for children with cancer, collecting patient and family information for Rock Cancer Care services.
See template
See template
Child Registration Form
PDF template
A comprehensive form for registering a child, collecting personal and insurance information for medical or childcare purposes.
See template
See template
MEDICAL And LIABILITIES RELEASE FORM
PDF template
A comprehensive form for medical information and liability release for children participating in church activities and programs.
See template
See template
MEDICAL HISTORY CHILD
PDF template
Comprehensive medical history questionnaire for collecting pediatric health information and previous medical conditions.
See template
See template
Calvary Baptist Church ChildrenS Ministry Participant Permission Medical Release
PDF template
A comprehensive permission and medical release form for children participating in Calvary Baptist Church ministry activities during 2024.
See template
See template
Child Travelling Alone Legal Form
PDF template
Legal form for parents/guardians authorizing solo travel for 16-17 year old participants in CISV international programs with medical consent and release provisions.
See template
See template
Health Information Form
PDF template
Confidential health information form for participants in an international research program between Alabama A&M University and Nanjing Forestry University.
See template
See template
STUDENT HEALTH FORM
PDF template
Comprehensive health form for students to provide medical information and health status to an educational institution
See template
See template
Department Of RadiologyImaging Services Pre Scheduling Evaluation Form
PDF template
Medical form used by physicians to request and evaluate imaging services, including patient details and medical history for CT or MRI scans.
See template
See template
CLIENT REQUISITION FORM
PDF template
A comprehensive medical test requisition form for various health diagnostics including inflammation, lipids, metabolic, and other specialized tests.
See template
See template
5185 3 Choosing The Legal Form For Your New Business
PDF template
A guide to selecting the appropriate legal structure for a new business, discussing different ownership and liability options.
See template
See template
Insurance FAQ
PDF template
Comprehensive overview of liability insurance coverage provided by the Sports Field Management Association (SFMA) for chapter officers, directors, and events.
See template
See template
Chromebook Optional Insurance Plan
PDF template
Optional insurance plan for Chromebooks at Dexter Community Schools, covering repair or replacement costs for students
See template
See template
Chronic Illness Benefit Application Form 2022
PDF template
Application form for Bankmed members on Essential and Basic Plans to apply for Chronic Illness Benefit coverage.
See template
See template
Chronic Illness Benefit Application Form
PDF template
An application form for patients seeking chronic illness benefits through the Glencore Medical Scheme, detailing submission requirements and contact information.
See template
See template
Remedi Medical Aid Scheme Application Form
PDF template
Application form for patients seeking medical aid coverage through Remedi Medical Aid Scheme, requiring patient and medical professional details.
See template
See template
Malcor Medical Aid Scheme Application Form
PDF template
An application form for joining the Malcor Medical Aid Scheme, requiring patient and medical details.
See template
See template
Chronic Medical Condition Treatment Compliance Form
PDF template
Form documenting a patient's ongoing medical treatment and compliance with care standards for at least 6 months
See template
See template
GreenlandAntarctica Travel Affidavit And Questionaire
PDF template
A comprehensive travel risk assessment and insurance document for individuals traveling to Greenland or Antarctica, requiring detailed travel and health information.
See template
See template
Non Employee IncidentAccident Report
PDF template
A form used to document details of non-employee incidents or accidents, capturing key information about the event, parties involved, and potential damages.
See template
See template
CIEF Membership Form 2019 2020
PDF template
Membership form for competing and non-competing members of a sports or equestrian organization
See template
See template
Cigna Claim Form (Rev. 72015)
PDF template
A comprehensive form for submitting healthcare service reimbursement claims with patient, provider, and payment information.
See template
See template
Cigna Dental Specialty Referral Form
PDF template
A referral form for specialty dental services under Cigna Dental Care, outlining payment guidelines and patient responsibilities.
See template
See template
Medical Claim Form
PDF template
Form for submitting medical claims for fellows, trainees, and patients seeking international health insurance reimbursement.
See template
See template
CIMERLI Solutions Enrollment Form
PDF template
Comprehensive enrollment form for healthcare services, insurance verification, and patient assistance programs offered by CIMERLI Solutions
See template
See template
Veteran Engagement Council Interview Form
PDF template
Interview form for potential Veteran Engagement Council members to assess their interest and availability for research participation.
See template
See template
PHILHEALTH CIRCULAR No. 2018 XXX
PDF template
Official guidelines for PhilHealth Accredited Collecting Agents on using the Electronic Collection Reporting System for premium contribution reporting and remittance.
See template
See template
TEST REQUISITION FORM
PDF template
A laboratory test request form for clinical immunodiagnostic testing with patient and specimen information collection fields.
See template
See template
Application Form Travel Fellowship
PDF template
Application form for academic travel fellowship to support research related to Spanish art and culture.
See template
See template
Claim For Money Or Damages Against The City Of Moreno Valley
PDF template
A legal form for filing monetary claims or damages against the City of Moreno Valley, California.
See template
See template
2021 CIVME Research Grant Program Grant Application Instructions
PDF template
Instructions and guidelines for applying to the Council on International Veterinary Medical Education research grant program.
See template
See template
Employability Assessment Form (PA 1663)
PDF template
A comprehensive guide for healthcare providers on completing the Pennsylvania Medicaid Employability Assessment Form to verify patient health conditions and disability status.
See template
See template
AIA Miami CKLDP Agreement Form
PDF template
Participation agreement for the AIA Miami Leadership Development Program detailing attendance requirements and participant commitments.
See template
See template
Military Medical Intake And Deployment Assessment Form
PDF template
Comprehensive medical assessment form for active duty military personnel covering health status, deployment readiness, and substance abuse screening.
See template
See template
BENEFICIARY CONTACT FORM
PDF template
A comprehensive form for collecting contact and demographic information about Medicare beneficiaries and their representatives.
See template
See template
MEDICAL EXPENSE CLAIM
PDF template
Form for filing medical expense claims with Blue Cross and Blue Shield of Alabama when a healthcare provider does not file a claim directly.
See template
See template
Claims Adjustments And Project Form
PDF template
A form for healthcare providers to request claims adjustments, retractions, or resolution of billing issues with WellSense Health Plan.
See template
See template
Death Claim Discharge Form
PDF template
A discharge form for claiming death benefits from SBI Life Insurance Company, documenting claim details and financial settlement.
See template
See template
Virginia Workers Compensation Commission Claim Form
PDF template
Official form for filing a workers' compensation claim in Virginia, documenting workplace injury details and requesting benefits.
See template
See template
City Of Lawrence Claim Form
PDF template
A legal form for submitting claims for property damage or personal injury against the City of Lawrence, Kansas.
See template
See template
CIEE Claim Form
PDF template
A comprehensive medical claim form for student health insurance reimbursement and documentation of medical conditions or treatments.
See template
See template
Prescription Claim Form
PDF template
A form for submitting prescription reimbursement claims under a Medicare Part D manufacturer patient assistance program
See template
See template
Dental Insurance Claim Form
PDF template
Insurance claim form for submitting dental treatment and patient information for reimbursement or coverage verification.
See template
See template
Claim For Damages To Person Or Property
PDF template
Official form for filing a claim for damages against Riverside County, detailing injury or property damage incidents.
See template
See template
Student Insurance Claim Form
PDF template
Insurance claim form for students to report medical examinations, illnesses, prescriptions, or injuries for insurance coverage.
See template
See template
Claim Form Finder And User Guide
PDF template
Comprehensive guide to help healthcare providers select the appropriate claim form for various submission scenarios and corrections.
See template
See template
Claim Form Finder
PDF template
Comprehensive guide for healthcare providers detailing claim modification forms and processes for Neighborhood Health Plan of Rhode Island.
See template
See template
Details Of Hospital Claim Form Part B
PDF template
A comprehensive medical claim form for documenting patient hospital admission, treatment, and insurance claim details.
See template
See template
National Grid Claim Form
PDF template
Claims form for reporting property damage or personal injury related to National Grid services.
See template
See template
Claim Form ICS Non Medical Expenses
PDF template
A comprehensive claim form for reporting non-medical insurance damages across multiple insurance types including household contents, travel/baggage, liability, and extra costs.
See template
See template
PRADHAN MANTRI SURAKSHA BIMA YOJANA (PMSBY) CLAIM CUM DISCHARGE FORM
PDF template
Official claim form for submitting accidental disability or death claims under the Pradhan Mantri Suraksha Bima Yojana insurance scheme.
See template
See template
VSP Member Reimbursement Form
PDF template
A form for VSP vision care members to request reimbursement for vision-related services and expenses.
See template
See template
Claim Inquiry Form
PDF template
A form for healthcare providers to submit claim-related inquiries to Carelon Behavioral Health regarding claim status, denials, or clarifications.
See template
See template
City Of Columbus Claim Packet
PDF template
Guidance for filing injury or property damage claims against the City of Columbus, including claim submission procedures and legal liability information.
See template
See template
Retiree Claim For Reimbursement
PDF template
A form for retirees to submit healthcare expense reimbursement claims through their health reimbursement arrangement (HRA)
See template
See template
MVP Health Care Claim Reimbursement Form
PDF template
Detailed instructions for MVP Health Care members to submit medical and dental expense reimbursement claims with required documentation.
See template
See template
Claims Reporting Reference Guide
PDF template
A comprehensive guide for reporting and managing various types of insurance claims across different coverage areas.
See template
See template
Certificate Of Insurance And Claims History FAQ
PDF template
Frequently asked questions about obtaining certificates of insurance and claims history from Rush, covering procedures, requirements, and limitations.
See template
See template
CLAIM FORM
PDF template
A comprehensive form for reporting property damage or personal injury claims related to National Grid services or incidents.
See template
See template
Member Reimbursement Form For Medical Claims
PDF template
A form for patients to submit medical claims for reimbursement, detailing patient, subscriber, and provider information.
See template
See template
MOTOR WINDSCREEN AND WINDOW GLASS DAMAGE REPORT FORM
PDF template
Insurance claim form for reporting windscreen and window glass damage to a vehicle under Lion of Kenya Insurance Company's policy.
See template
See template
Revised Claims Inquiry Form Process
PDF template
Guidelines for healthcare providers to submit and resolve claim payment disputes with Partnership HealthPlan of California.
See template
See template
Claim Procedure Note
PDF template
A detailed guide explaining the process for obtaining cashless medical insurance claims through a network hospital and third-party administrator.
See template
See template
Claims Reimbursement Form
PDF template
A comprehensive form for submitting medical claims for reimbursement, used by patients or healthcare providers to request payment for medical services.
See template
See template
Claims Reporting Reference Guide
PDF template
A comprehensive guide for reporting insurance claims across multiple coverage types and managing workplace incidents
See template
See template
Special Olympics Volunteer Consent Form
PDF template
Consent form for volunteers to participate in Special Olympics programs, including personal information usage and privacy agreements.
See template
See template
Student Class Evaluation
PDF template
An evaluation form for students to provide feedback on educational programs and instructors in emergency medical services.
See template
See template
Hermitage Visual Arts School Class Proposal Form
PDF template
A form for instructors to propose and detail a visual arts class at the Hermitage Museum & Gardens Visual Arts School.
See template
See template
CONTRACT INSTRUCTOR PROPOSAL FORM
PDF template
A proposal form for potential contract instructors to submit class and personal details to Pleasant Valley Recreation and Park District.
See template
See template
General Media Release Form
PDF template
A comprehensive form for media use authorization and liability release for The Cutting Edge Classroom's activities.
See template
See template
PacificSource Enrollment Application
PDF template
A comprehensive group health insurance enrollment form for employees and their dependents to select medical and dental coverage.
See template
See template
Patient Information Form
PDF template
Comprehensive patient intake form collecting personal, contact, medical, and insurance information for dermatology services.
See template
See template
NCAA Drug Testing Consent Form
PDF template
Legal document requiring student-athletes to consent to drug testing as part of NCAA athletic participation regulations.
See template
See template
Cancer Claim Form
PDF template
Comprehensive form for filing cancer-related insurance claims, detailing required documentation and submission instructions.
See template
See template
BENEFICIARY CONTACT FORM
PDF template
A form for collecting contact and demographic information for Medicare beneficiaries and their representatives during counseling sessions.
See template
See template
Client Insurance Form
PDF template
Insurance form for collecting client insurance information and authorizing claims submission and payment
See template
See template
Cancer Services Client Intake Form
PDF template
Confidential intake form for cancer patients seeking free services in Erie, Huron, and Ottawa counties in Ohio.
See template
See template
Cancer Services Client Intake Form
PDF template
Comprehensive intake form for cancer patients seeking free support services, collecting personal, medical, and financial information.
See template
See template
Client Endorsement Request Form
PDF template
A form for customers to request changes to their existing insurance policy with Colwood Insurance Services.
See template
See template
CLIMBucknell MEDICAL FORM
PDF template
Medical history and emergency contact form for participants in a university climbing/ropes course activity
See template
See template
Accident Waiver And Release Of Liability
PDF template
A comprehensive legal document releasing event organizers from liability for potential injuries or damages during an athletic event.
See template
See template
CLINICAL BOOKING FORM
PDF template
A form for scheduling telehealth consultations and televisitation events for healthcare professionals.
See template
See template
Behavioral Health Discharge Clinical Form
PDF template
A clinical form for documenting patient discharge details from behavioral health treatment, including care level, residence, and follow-up appointments.
See template
See template
Clinical Incident Report Form 4.3
PDF template
A form documenting details of a clinical incident, including injury, location, witnesses, and actions taken.
See template
See template
Nephrology Laboratory Test Requisition
PDF template
A clinical form for requesting laboratory tests related to complement system and nephrology research at Cincinnati Children's Hospital.
See template
See template
HARKNESS CENTER FOR DANCE INJURIES PATIENT MEDICAL HISTORY FORM
PDF template
Comprehensive medical history form specifically designed for documenting dance-related injuries across multiple body regions.
See template
See template
Clubs Emergency Contact Information
PDF template
School emergency contact and medical information form for recording student and parent contact details and health information.
See template
See template
Notice Of Field Trip And Waiver Of Liability
PDF template
A legal document for students participating in a voluntary field trip, requiring a signed waiver of liability by the participant.
See template
See template
Clubhouse Rental Agreement And Statement Of Indemnity
PDF template
A rental agreement for Heathlake Community Association's clubhouse, outlining terms, fees, and liability conditions for residents.
See template
See template
Clubhouse Rental Agreement
PDF template
A rental agreement for clubhouse facilities detailing rates, policies, and guidelines for residents and non-residents of Seasons Trace community.
See template
See template
Club Sports Informed Consent Form
PDF template
A legal consent and liability release form for students participating in club sports at Connecticut College, acknowledging risks and insurance responsibilities.
See template
See template
Club Sports Travel Form
PDF template
Form for documenting and obtaining approval for club sports team travel, including trip details, contacts, and signatures.
See template
See template
Medical History Form
PDF template
Comprehensive medical history form collecting patient's personal health details, family medical history, and lifestyle information.
See template
See template
OFFER IN COMPROMISE
PDF template
Official form for taxpayers to propose a compromise of tax liabilities with the Hawaii Department of Taxation
See template
See template
Funeral Home Claim Form
PDF template
A claim form for processing funeral service insurance benefits with detailed documentation requirements.
See template
See template
CM 600 WEB Claim Form
PDF template
Insurance claim form for processing death benefits from American Memorial Life Insurance Company or Union Security Insurance Company.
See template
See template
Health And Emergency Contact Form
PDF template
A comprehensive form for collecting student medical history, emergency contact details, and healthcare consent at Central Maine Community College.
See template
See template
PATIENT MEDICAL HISTORY FORM
PDF template
Comprehensive medical history form for collecting patient demographic, family medical history, and personal health information.
See template
See template
Civilian Marksmanship Program Excellence In Competition Match Report Form
PDF template
Form for reporting details of Excellence-in-Competition shooting matches, including competitor information, entry fees, and match circumstances.
See template
See template
Centers For Medicare And Medicaid Services EDI Registration Form
PDF template
A registration form for healthcare providers to establish electronic data interchange (EDI) capabilities with the Centers for Medicare and Medicaid Services.
See template
See template
Centers For Medicare And Medicaid Services EDI Registration Form
PDF template
Form for healthcare providers to register for Electronic Data Interchange (EDI) transactions with Centers for Medicare and Medicaid Services.
See template
See template
Form CMS 116 (0324)
PDF template
Clinical Laboratory Improvement Amendments (CLIA) certification application for health laboratories seeking federal certification.
See template
See template
Volunteer Application Form
PDF template
A comprehensive volunteer application form for the Los Angeles County Department of Parks and Recreation, capturing personal information and volunteer interests.
See template
See template
HEALTH INSURANCE CLAIM FORM
PDF template
Standard medical insurance form for submitting healthcare claims and patient information for reimbursement purposes.
See template
See template
Health Insurance Claim Form
PDF template
Official form for submitting medical insurance claims and capturing patient and insured party information.
See template
See template
Medicare Redetermination Request Form 1st Level Of Appeal
PDF template
Official form for Medicare beneficiaries to request a first-level appeal of a Medicare claim determination.
See template
See template
Medicare Reconsideration Request Form 2nd Level Of Appeal
PDF template
A form for Medicare beneficiaries or providers to request a second-level appeal of a Medicare claim determination.
See template
See template
Privacy Impact Assessment Benefits Coordination And Recovery Center
PDF template
Privacy impact assessment documenting the data collection and processing system for Medicare benefits coordination and recovery processes.
See template
See template
Form CMS L564R297 (0923) Request For Employment Information
PDF template
A form used to verify group health plan coverage for Medicare special enrollment based on current employment.
See template
See template
CMS Model Consent Form For Marketplace Agents And Brokers
PDF template
A model consent form for documenting consumer permission for health insurance agents or brokers to assist with marketplace coverage enrollment.
See template
See template
CMS Model Consent Form For Marketplace Agents And Brokers
PDF template
A model consent form for documenting consumer permission for health insurance agents or brokers to assist with Marketplace coverage enrollment.
See template
See template
CMSP 215 Supplemental Application
PDF template
Application form for individuals seeking medical services coverage through the County Medical Services Program with rights and responsibilities outlined.
See template
See template
Adult Medical History Form
PDF template
Comprehensive medical history form for collecting patient health information, symptoms, and medical conditions.
See template
See template
Infant Medical History Form
PDF template
Comprehensive medical history form for pediatric patients covering medical tests, therapies, medications, developmental milestones, and birth history.
See template
See template
HIRER COLLISION Or DAMAGE REPORT FORM
PDF template
A comprehensive form for documenting details of a vehicle rental accident, including renter, driver, vehicle, and incident information.
See template
See template
CNHS Insurance Requirements Proof Of Health Insurance Form
PDF template
Form for documenting student health insurance coverage for clinical and practicum rotations in the College of Nursing & Health Sciences.
See template
See template
Curriculum Approval Form
PDF template
A comprehensive form for proposing, reviewing, and approving academic program changes at a university.
See template
See template
Conservation Northwest Field Volunteer Waiver Form
PDF template
A legal waiver form for volunteers participating in wildlife monitoring and conservation field work with Conservation Northwest.
See template
See template
Conservation Northwest Field Volunteer Waiver Form
PDF template
A legal waiver form for volunteers participating in wildlife monitoring and outdoor conservation projects with Conservation Northwest.
See template
See template
Club Sports Coach Agreement Form
PDF template
A comprehensive agreement outlining responsibilities and expectations for coaches of club sports at Western Carolina University.
See template
See template
WIAA Bylaws And Rules Of Eligibility
PDF template
Guidelines for high school sports participation during summer months, including restrictions on coach contact and team activities.
See template
See template
Langston University Coaches Evaluation Form
PDF template
A comprehensive evaluation form for assessing university coaches' professional performance, conduct, and development.
See template
See template
SPORT CLUB COACHES MEMBERSHIP FORM
PDF template
Form for coaches to apply for membership and participation in university recreational sports programs with liability waiver and approval process.
See template
See template
STATE SYSTEM OF HIGHER EDUCATION COACHES PERFORMANCE REVIEW AND EVALUATION DOCUMENT
PDF template
A comprehensive performance review document for coaches in the state higher education system, assessing professional responsibilities and overall performance.
See template
See template
COACHING APPLICATION FORM
PDF template
Comprehensive form for individuals seeking to become sports coaches, capturing personal details, sports experience, and background information.
See template
See template
Nomination Form
PDF template
A form for nominating coaches who have demonstrated excellence in sportsmanship, player development, and leadership during the 2021 calendar year.
See template
See template
BOOKING FORM
PDF template
Travel booking form for collecting passenger details and holiday reservation information
See template
See template
COBRADirect Billing Participant Use ONLY ACH Agreement Form
PDF template
Form for authorizing automatic health insurance premium payments via bank account deduction.
See template
See template
Coconino County Volunteer Service Agreement
PDF template
A comprehensive volunteer service agreement that outlines volunteer responsibilities, terms, and participant details for Coconino County.
See template
See template
COVID 19 Code Of Conduct And Waiver Form Addendum
PDF template
Guidelines and requirements for participant forms and safety protocols for Special Olympics Washington during the Summer Season
See template
See template
Medical Release Form
PDF template
A medical consent and release form for student participation in activities, allowing emergency medical treatment with parental authorization.
See template
See template
Commercial Outdoor Fee Based Activity (COFA) Application For Permit
PDF template
Application for commercial fitness and professional services providers to obtain permits for using dedicated city parks and properties
See template
See template
Referral Form
PDF template
A form for healthcare providers to request patient referrals and provide medical background information.
See template
See template
Election To Fellowship Application Form
PDF template
Application form for professionals seeking fellowship status with the Chartered Insurance Institute (CII)
See template
See template
Employee Flexible Spending Account (FSA) Enrollment Form
PDF template
Form for employees to enroll in Flexible Spending Account (FSA) options for healthcare and dependent care expenses.
See template
See template
College Sponsored Related Medical And Travel Form
PDF template
A medical and travel authorization form for students participating in college-sponsored activities with COVID-19 compliance and liability waiver provisions.
See template
See template
Camp Medical Form, College Tennis Exposure Camp
PDF template
Medical form for participants of a college tennis exposure camp, capturing health history and emergency contact information.
See template
See template
COLOGUARD ORDER REQUISITION FORM
PDF template
Medical order form for Cologuard, a stool-based DNA test used for colorectal cancer screening
See template
See template
COLOGUARD ORDER REQUISITION FORM
PDF template
Medical order form for Cologuard, a stool-based DNA test for colorectal cancer screening
See template
See template
Account Information Tax Advantage Wellness Programs
PDF template
Form for establishing a new account for Tax Advantage Wellness Programs with Colonial Life insurance services.
See template
See template
Insurance Claim Processing Instructions
PDF template
Instructions for submitting an insurance claim, including required documentation and processing details for Colonial Life & Accident Insurance Company.
See template
See template
General Service Provider Data Sharing And Confidentiality Agreement
PDF template
Agreement establishing terms for data sharing and confidentiality between Colonial Life Insurance and a service provider for insurance administration services.
See template
See template
New Patient Intake Form
PDF template
Comprehensive medical intake form for new patients to collect personal, contact, and health information for medical providers.
See template
See template
Application For Policy Changes Part 1
PDF template
Insurance policy form for requesting changes such as cash surrender, partial withdrawal, and policy modifications.
See template
See template
AFI PRE AUTHORIZATION FORM FOR HOSPITALIZATION FROM PANEL NON PANEL HOSPITALS
PDF template
A form for obtaining pre-authorization for hospitalization from panel and non-panel hospitals for insurance coverage.
See template
See template
Information Disclosure Consent Form For UN COVID 19 Medical Evacuation (MEDEVAC) Services
PDF template
Consent form for medical information disclosure and liability release for UN COVID-19 medical evacuation services.
See template
See template
NEW PATIENT REGISTRATION FORM
PDF template
Comprehensive form for new patient medical registration, including personal information, medical history, insurance details, and a physician-patient arbitration agreement.
See template
See template
CGL CERTIFICATE OF INSURANCE
PDF template
Official insurance certificate documenting commercial general liability coverage for an insured party with the City of Vancouver
See template
See template
Loss Or Damage Report Form Commercial
PDF template
Insurance claim form for reporting commercial property loss or damage incidents with comprehensive details about the incident and policyholder.
See template
See template
Commercial Surety Bond Application
PDF template
A comprehensive application form for obtaining a commercial surety bond from Lexington National Insurance Corporation, collecting business and personal financial information.
See template
See template
Commission Inquiry Form
PDF template
Form for agents to submit inquiries about commission payments for L.A. Care Covered health insurance policies.
See template
See template
BFA Committee Declaration Form
PDF template
A form for BFA students to declare their faculty committee members at the University of Nevada Reno's Department of Art
See template
See template
NAIC Enterprise Risk Report (Form F) Implementation Guide
PDF template
A guide for preparing and reviewing annual enterprise risk reports for insurance holding company systems as part of NAIC accreditation requirements.
See template
See template
Common Child And Adolescent Psychiatry Application
PDF template
An application form and procedure guide for medical professionals seeking child and adolescent psychiatry residency programs.
See template
See template
ResidencyFellowship Non ERAS Common Application Form
PDF template
Comprehensive application form for medical residency and fellowship candidates seeking placement at the University of Connecticut School of Medicine.
See template
See template
Standardized Application For Pathology Fellowships
PDF template
A comprehensive application form for medical professionals seeking pathology fellowship training in various subspecialties.
See template
See template
Communicable Disease Report For Healthcare Providers
PDF template
A comprehensive medical reporting form for healthcare providers to document communicable disease cases in Arizona.
See template
See template
Marquette University ComMUnity Physical Therapy Clinic Referral Form
PDF template
A referral form for patients seeking physical therapy services at Marquette University's Community Physical Therapy Clinic.
See template
See template
Community Membership Form
PDF template
A medical history and liability waiver form for campus recreation membership at Lees-McRae College, requiring personal and medical information along with a hold harmless agreement.
See template
See template
Community Membership Program Registration Form
PDF template
Registration form for obtaining a community membership at Cuyahoga Community College recreational facilities
See template
See template
Companion Agreement Form Frequently Asked Questions FAQs
PDF template
Guide for companions assisting people with disabilities in Maryland-National Capital Park and Planning Commission programs
See template
See template
COMPANY MOTOR PROPOSAL FORM
PDF template
Insurance proposal form for company vehicle coverage detailing vehicle ownership, use, and driver information.
See template
See template
Comparable Coverage Premium Certification
PDF template
Certification document for insurers offering renewal policies to Texas Windstorm Insurance Association policyholders, detailing coverage and premium requirements.
See template
See template
USA Gymnastics Competition Entry Form
PDF template
Entry form for registering gymnasts at various competition levels for a gymnastics meet.
See template
See template
Jersey Petanque Club Competition Entry Form 2022
PDF template
Annual competition entry form for various Petanque tournaments with different dates, times, and entry costs.
See template
See template
Complaint Form
PDF template
A detailed form for submitting complaints about insurance companies and policy-related issues in Washington state.
See template
See template
Health Care Provider Complaint Form
PDF template
Official form for filing a complaint against a healthcare provider in Florida with detailed information requirements for investigation.
See template
See template
Consumer Complaint Form
PDF template
Official form for filing insurance-related complaints with the Nevada Division of Insurance
See template
See template
ComplaintInquiry Form
PDF template
Official form for filing insurance-related complaints or inquiries with the State of Hawaii Insurance Division.
See template
See template
USDA Program Discrimination Complaint Form Instructions
PDF template
Instructions for filing a discrimination complaint with the United States Department of Agriculture (USDA) regarding program discrimination.
See template
See template
Complaint Report Form
PDF template
Form for reporting patient complaints and potential protected health information disclosure at UW-Milwaukee
See template
See template
The Wellness Plan ComplaintResolution Form
PDF template
A form for documenting patient complaints, concerns, and their resolution within a medical center's wellness plan.
See template
See template
COMPLAINT RESOLUTION FORM
PDF template
A form for customers to submit and document complaints or service issues with Takaful Emarat.
See template
See template
STEPSFORMS TO SEE DR. SENIOR
PDF template
Detailed guidelines for students seeking to schedule and attend a psychiatric appointment with Dr. Senior at Landmark College.
See template
See template
Emergency Contact Form
PDF template
A form for students to provide emergency contact details and medical authorization for University of Detroit Mercy.
See template
See template
Affordable Care Act ACA Compliance Form Filing Submission Worksheet
PDF template
A comprehensive worksheet for insurance providers to submit compliance documentation for ACA-related insurance products and services.
See template
See template
Comprehensive Pain Assessment Form
PDF template
A detailed form for evaluating and documenting a patient's pain characteristics, intensity, and management goals.
See template
See template
IEEE AP SUSNC URSI 2024 EXHIBITORS COMPULSORY INSURANCE FORM
PDF template
Mandatory insurance form for exhibitors at the IEEE AP-S/USNC URSI 2024 conference, detailing insurance coverage requirements and policies.
See template
See template
Authorization For Examination Or Treatment
PDF template
A medical authorization form for workplace-related medical examinations, testing, and treatment with comprehensive patient and service details.
See template
See template
Concussion Incident Form
PDF template
A form for documenting and reporting concussion-related incidents in sports, specifically for Ringette Canada.
See template
See template
Concussion Waiver Form
PDF template
A waiver form requiring student athletes to acknowledge and report concussion symptoms to medical staff.
See template
See template
Concussion Waiver Form
PDF template
A waiver form for student athletes acknowledging their responsibility to report concussion symptoms and potential injuries.
See template
See template
Concussion Waiver Form
PDF template
A waiver form requiring student athletes to acknowledge their responsibility in reporting concussion symptoms and understanding concussion risks.
See template
See template
Montana Newborn Screening Program Condition Nomination Form
PDF template
A form used by healthcare professionals to nominate new medical conditions for inclusion in Montana's newborn screening panel.
See template
See template
Conference Submission Form
PDF template
Form for students to report details and impact of conference attendance at Genesee Community College.
See template
See template
Confidential Medical History Form
PDF template
Comprehensive medical symptoms and conditions checklist for patient intake, covering multiple body systems and health concerns.
See template
See template
An Artistic Discovery Art Competition Exhibit Inventory Form
PDF template
Form for submitting artwork entries for Congressman Bill Posey's FL-8th Congressional District Art Competition with a Space Program theme.
See template
See template
CONSENT INSURANCE FORM
PDF template
A comprehensive form for collecting medical insurance and consent information for a cadet or applicant, including parent/guardian details and insurance policy information.
See template
See template
Participant Consent Form
PDF template
A consent form for participants of a workshop, explaining survey data collection and potential Medicare study participation.
See template
See template
Adult Consent Form
PDF template
A comprehensive medical consent form for adults, collecting personal information and health history details prior to medical treatment or vaccination.
See template
See template
Child Consent Form
PDF template
A comprehensive health screening form for children to assess medical history and vaccination readiness.
See template
See template
Consent Form For Research Participation
PDF template
A comprehensive guide and template for creating a consent form for research participation at Oakland City University.
See template
See template
Parental Consent Form
PDF template
Parental consent and liability waiver form for participation in hockey school activities, including insurance and concussion acknowledgment.
See template
See template
CIAC Background Check Consent Form
PDF template
Consent form for high school sports officials in Connecticut requiring a criminal background check for officiating clearance.
See template
See template
Consent For Publication Form
PDF template
A form granting permission for personal information or medical details to be published in a journal or article while acknowledging potential public exposure.
See template
See template
Minor Athlete General Consent Form
PDF template
A comprehensive consent form for parents/guardians to authorize various in-program activities and training sessions for minor athletes in USA Gymnastics.
See template
See template
Consent To Treat Form
PDF template
Parental consent form for chiropractic evaluation and treatment of a child, with specific limitations on diagnostic scope.
See template
See template
Consent For Treatment
PDF template
Comprehensive patient consent document covering treatment, benefits assignment, privacy practices, and telemedicine consent for Kentucky Cardiology medical services.
See template
See template
Authorization For Medical Treatment Of Child
PDF template
A form allowing school representatives to consent to medical treatment for a student when parents cannot be reached during an emergency.
See template
See template
Providence Mountain Emergency Services Consent To Treat Form
PDF template
Medical release and emergency treatment authorization form for participants in Providence Mountain program from December to May.
See template
See template
Authorization For Medical Treatment Agreement
PDF template
A legal document authorizing medical treatment and insurance payment for elder care services at Horizon Internal Medicine.
See template
See template
Consent To Treat Release Form
PDF template
A form authorizing Woodward School to secure medical treatment for a student in emergency situations when parents cannot be immediately contacted.
See template
See template
USA Hockey National Championships Consent To TreatMedical History Form
PDF template
A comprehensive medical history and consent to treat form for USA Hockey participants, covering emergency contact, medical history, and insurance information.
See template
See template
Authorization Informed Consent
PDF template
Consent form for behavioral health services covering patient authorization, medical record release, and payment agreements.
See template
See template
Consentimiento Para Recibir Tratamiento, Cesin De Beneficios Y Garanta De Pago
PDF template
A Spanish-language medical consent and insurance benefits assignment form for Northwell Health Dental Medicine patients.
See template
See template
CONSENT TO TREAT MINOR CHILDREN
PDF template
A legal form allowing parents or guardians to provide medical treatment consent for a minor child when the parent is not immediately available.
See template
See template
USA Hockey National Championships Consent To TreatMedical History Form
PDF template
Medical consent and history form for USA Hockey participants, allowing medical treatment and collecting health information for emergency purposes.
See template
See template
Consent To Treat Form
PDF template
A legal document allowing medical treatment for patients, including consent for minors and adults, insurance filing, and patient rights.
See template
See template
Consent To Treat Form
PDF template
A medical consent form allowing treatment authorization and insurance filing by a healthcare provider.
See template
See template
Medical Release Form (For Students Under The Age Of 18)
PDF template
A consent form allowing medical treatment for students under 18 when parents/guardians cannot be immediately contacted.
See template
See template
CONSENT, WAIVER, RELEASE AND INDEMNITY AGREEMENT
PDF template
A legal document outlining participant consent, risk assumption, and liability waiver for a university program or activity.
See template
See template
Consent, Waiver, Release And Indemnity Agreement
PDF template
Legal document outlining participant consent, risk assumption, and liability waiver for international medical exchange programs.
See template
See template
Amendment Proposal Form
PDF template
A form for proposing amendments to VM-00 Exposure Draft related to principle-based valuation reserve requirements.
See template
See template
Pathology Consult Request Form
PDF template
A form for requesting pathology consultation and case review between medical institutions.
See template
See template
Individual Products Independent Contractor Form
PDF template
Form for adding or updating independent insurance agents as 1099 contractors for a contracted agency
See template
See template
NAIC Funded Consumer Representative Travel Expense Reimbursement Policy
PDF template
Policy detailing travel expense reimbursement procedures for NAIC consumer representatives attending national and interim meetings.
See template
See template
2024 NAIC Funded Consumer Representative Travel Expense Reimbursement Policy
PDF template
Guidelines for reimbursing NAIC consumer representatives' travel expenses for national and interim meetings, with up to $5,500 allocated per representative in 2024.
See template
See template
Contact Information And Medical Form
PDF template
A comprehensive medical form collecting participant's personal information, emergency contacts, medical history, and health conditions for University of Maine at Presque Isle program participation.
See template
See template
What Forms Are Required To Process A Contract
PDF template
Comprehensive guide detailing documentation and procedural requirements for contract processing based on contract value thresholds.
See template
See template
Contracted Agreement
PDF template
A contractual agreement outlining patient responsibilities, payment terms, and cancellation policies for healthcare services.
See template
See template
Change Of Contractor Form
PDF template
A form allowing property owners to change contractors for permitted work and release liability for Hillsborough County.
See template
See template
Contractor Frequently Asked Questions
PDF template
Comprehensive overview of contractor licensing requirements and regulations in Hawaii, covering license application process, exemptions, and legal guidelines.
See template
See template
Building Permit Application
PDF template
A document for contractors to apply for a building permit, detailing contractor information and workers' compensation insurance requirements.
See template
See template
Commonwealth Of Virginia Agency Contract Form Addendum To ContractorS Form
PDF template
A legal document that modifies a standard contractor's form for use by a Virginia state agency, with specific terms and limitations of liability.
See template
See template
Diversity Management System (DMS) Submission Documentation
PDF template
A detailed tracking document for contractor submissions, insurance requirements, and project documentation across federal and state projects.
See template
See template
Contract Request Form (CRF)
PDF template
Form for healthcare providers to request a contract and credentialing with Molina Healthcare
See template
See template
Contract Details Register
PDF template
Compilation of multiple IT, services, and procurement contracts with details of suppliers, dates, and values.
See template
See template
Contract Types And Required Documents
PDF template
Comprehensive guide outlining document requirements for different types of consultant agreements and contracts.
See template
See template
McLaren Flint Foundation Contribution Form
PDF template
Fundraising form for making charitable donations to McLaren Flint Foundation with multiple designated giving options.
See template
See template
Annual Controlled Substance Inventory Form
PDF template
A form for tracking and documenting annual physical inventory of controlled substances as required by state and federal regulations.
See template
See template
ING Premier Disability Cancellation Form
PDF template
A form for employees to cancel their ING Premier Short Term Disability insurance policy and associated payroll premium deduction.
See template
See template
Curatorial Opportunity Program (COP) Guidelines
PDF template
Guidelines for independent curators to submit group exhibition proposals for the New Art Center's Main Gallery from September 2018 to May 2019.
See template
See template
New Art Center Curatorial Opportunity Program (COP) Guidelines
PDF template
Guidelines for submitting group exhibition proposals for the New Art Center's Curatorial Opportunity Program, accepting proposals for 6-week exhibitions from September 2019 to May 2020.
See template
See template
Liability Waiver Form
PDF template
A legal document releasing the University of Louisville from liability for participation in the Suzuki Studies Program and acknowledging program policies.
See template
See template
City Of Socorro 2024 Cornhole League Registration
PDF template
Registration form for participating in the City of Socorro's 2024 Cornhole League, including league rules and liability waiver.
See template
See template
Corps Of Cadets Preparticipation Physical Evaluation Medical History
PDF template
Medical history and health evaluation form required for admission to the Texas A&M Corps of Cadets, verifying medical fitness for cadet program participation.
See template
See template
Corrected (Replacement)Voided Claim Request Form
PDF template
A form used to correct or void previously processed healthcare claims with specific submission requirements.
See template
See template
Certificate Of Trust
PDF template
A document used to establish or update trust insurance and annuity policy ownership with Pacific Guardian Life insurance company.
See template
See template
RPCI.GEN.LAB.PATH.Frm.0023.00 Delivery Form
PDF template
A form for tracking and delivering medical laboratory samples between locations.
See template
See template
Waiver Form
PDF template
A comprehensive waiver form for participation in camp activities, requiring participant information and acknowledging potential risks.
See template
See template
Waiver Form
PDF template
A comprehensive waiver document for participants at Covenant Harbor Bible Camp and Retreat Center, covering liability and participation risks.
See template
See template
COVID 19 Case Interview Form
PDF template
A detailed medical form used by the Florida Department of Health to collect information about COVID-19 cases and patient symptoms.
See template
See template
COVID 19 DISABILITY FORM
PDF template
A comprehensive medical information form designed to help healthcare providers understand and support patients with disabilities during COVID-19 related medical treatment.
See template
See template
Medical Information Request Form For COVID 19 Temporary Reasonable Accommodation For Faculty, Admini
PDF template
Form for Fordham University employees to request workplace accommodations related to COVID-19 high-risk medical conditions
See template
See template
COVID 19 OTC Test Reimbursement Form
PDF template
Form for submitting reimbursement claims for personally purchased FDA-approved COVID-19 over-the-counter tests.
See template
See template
COVID 19 Participant Code Of Conduct And Risk Assessment Form
PDF template
Comprehensive guidelines for Special Olympics participants during the COVID-19 pandemic, outlining safety protocols and personal responsibilities.
See template
See template
COVID 19 Participant Code Of Conduct And Risk Assessment Form
PDF template
Comprehensive safety guidelines and risk acknowledgment for Special Olympics participants during the COVID-19 pandemic.
See template
See template
COVID 19 Participant Code Of Conduct And Risk Assessment Form
PDF template
Guidelines for participant safety and risk mitigation during Special Olympics activities during the COVID-19 pandemic.
See template
See template
COVID 19 PERSONAL HEALTH RISK ASSESSMENT FORM
PDF template
A comprehensive form to assess individual health risks and COVID-19 exposure for meeting participation and travel to Italy.
See template
See template
DOH COVID 19 Vaccination Consent Form
PDF template
A comprehensive form for collecting patient information and screening for COVID-19 vaccination eligibility.
See template
See template
COVID 19 SPECIMEN SUBMISSION FORM
PDF template
Form for submitting COVID-19 test specimens to the Massachusetts State Public Health Laboratory for PCR testing.
See template
See template
COVID 19 TESTING PATIENT INTAKE FORM
PDF template
Demographic and medical intake form for COVID-19 testing in compliance with CARES Act reporting requirements.
See template
See template
Communicable Disease Related Hold Harmless, Release, Waiver Of Liability, And Indemnity Agreement
PDF template
Legal document releasing event organizers from liability related to potential communicable disease exposure during an event.
See template
See template
COVID 19 Order Form
PDF template
Medical form for collecting patient information and COVID-19 specimen details for testing purposes.
See template
See template
COVID Vaccine Patient Intake Form 2021
PDF template
Patient intake form for COVID-19 vaccination at Stauffer's Drug Store and Stauffer's LTC Pharmacy, collecting patient information and insurance details.
See template
See template
COVID 19 Release Of Liability Form
PDF template
Release of liability form for Pacific Crest Trail Association volunteers during COVID-19 pandemic, outlining risks and participant responsibilities.
See template
See template
Vaccine Recipient Information And Consent Form
PDF template
A medical consent form for receiving COVID-19 vaccines, capturing patient information and legal authorization for vaccination services.
See template
See template
COVID 19 Vaccine Consent And Waiver Form
PDF template
A legal consent form for receiving the COVID-19 vaccine, detailing risks, acknowledgements, and patient agreements.
See template
See template
PARENTALGUARDIAN, SCOUT, LEADER COVID 19 ACKNOWLEDGEMENT CONSENT WAIVER FORM
PDF template
A waiver form acknowledging COVID-19 risks for scout activities and granting permission for participation during the pandemic.
See template
See template
Work Comp MVA Patient Intake Form
PDF template
Comprehensive medical intake form for documenting patient information, injury details, and insurance details for workers' compensation and motor vehicle accident claims.
See template
See template
NEW PATIENT INTAKE FORM
PDF template
Comprehensive medical intake form for new patients at a women's wellness practice, collecting personal and medical information.
See template
See template
Medical Form For Volunteers
PDF template
A comprehensive medical screening form for volunteers to assess health status and eligibility for participation in Camp Promise/Jett Foundation programs.
See template
See template
Medical Form For Campers
PDF template
A comprehensive medical form for documenting a camper's health status, medical history, and physical examination details for participation in Camp Promise/Jett Foundation programs.
See template
See template
Assurances Of Eligibility Of A Student Under Competent Private Instruction (CPI)
PDF template
A form documenting a student's academic eligibility for interscholastic sports participation based on specific educational requirements.
See template
See template
Driver Proof Of Insurance Form
PDF template
Form for volunteer drivers to document and verify current automobile insurance coverage for Catholic Pro-Life Committee activities.
See template
See template
The UPS Store Shipping Form
PDF template
Shipping instructions and form for artists submitting paintings to the 2018 Renaissance in Pastel exhibition at UConn Stamford Art Gallery.
See template
See template
Center For Pediatric Therapies Volunteer Application Form
PDF template
A comprehensive application form for potential volunteers at the Center for Pediatric Therapies, including medical and contact information.
See template
See template
CRAFFTN Interview Form
PDF template
A confidential medical screening form for assessing substance use and potential risks among adolescents or young adults.
See template
See template
Physical Examination Form
PDF template
Comprehensive medical examination form for assessing physical fitness, likely for occupational certification purposes.
See template
See template
Gymnasium Rental Form
PDF template
A rental form for leasing half of the gymnasium at the Carbondale Recreation & Community Center for non-profit, youth, senior organizations, schools, and government entities.
See template
See template
Creative Earth A COP26 Art Competition Entry Form
PDF template
A competition entry form for young artists to submit artwork related to the future of the planet, organized in connection with COP26.
See template
See template
Patient Medical Intake Form
PDF template
Medical intake and financial responsibility form for orthopedic patient evaluation, specifically for injury-related medical treatment.
See template
See template
Credit Card Authorization Form
PDF template
A form allowing Tranquility Psychiatry and Counseling Services to keep a credit card on file for service payments and outstanding balances.
See template
See template
Credit Card Pre Authorization Form
PDF template
A form authorizing Creekside Counseling + Wellness to charge client's credit card for services, copayments, and fees.
See template
See template
Credit Card Pre Authorization Form
PDF template
Form authorizing Valleycare Gastroenterology Medical Group to charge credit card for patient balances and medical services
See template
See template
Instructions For Credit Life And Health Insurance Experience Reports
PDF template
Detailed instructions for insurance carriers to submit statistical reports on credit life and health insurance cases in Maryland.
See template
See template
CreditRefund Request Form
PDF template
A form for participants to request credit or refund for YMCA programs with specific policy guidelines.
See template
See template
CRESEMBA Support Solutions Enrollment Form
PDF template
A comprehensive enrollment form for patients seeking support and prescription assistance for CRESEMBA medication through Astellas Patient Assistance Program.
See template
See template
Clinical Research Education Training Program (CRETP) Application Student Evaluation Form
PDF template
A form used to evaluate student characteristics and potential for participation in a clinical research training program.
See template
See template
PhysicianS Mammography Evaluation Form
PDF template
Detailed assessment form for evaluating mammography image quality and technical standards.
See template
See template
DMMA Critical Incident Form
PDF template
A comprehensive form for documenting and reporting critical incidents involving healthcare members or patients.
See template
See template
Informed Consent Self Assessment Form
PDF template
An electronically fillable PDF version of the Informed Consent Self-Assessment tool to help study teams evaluate their informed consent process.
See template
See template
CLINICAL GENETICS PROGRAM REFERRAL FORM (GENERALPRENATAL)
PDF template
A medical referral form for genetic consultation and testing services, used by healthcare providers to submit patient referrals for genetic assessment.
See template
See template
Classified Senate Collegial Consultation Committee Survey Form
PDF template
A survey form for committee members to provide feedback on their committee's productivity, representation, and value
See template
See template
Colonie Soccer Club Scholarship Application Form
PDF template
A scholarship application form for youth soccer players who need financial assistance with registration fees for the Colonie Soccer Club.
See template
See template
Hepatitis C Virus (HCV) Treatment Procedure
PDF template
Montana Department of Corrections clinical procedure for monitoring and treating Hepatitis C Virus among offenders in secure care facilities.
See template
See template
Membership Form
PDF template
Form for individuals seeking membership to the NDSU Wellness Center, including sponsorship and personal information sections.
See template
See template
Cranleigh School Equestrian Centre Block Booking Form
PDF template
A form for parents and guardians to book riding lessons at Cranleigh School Equestrian Centre and confirm existing registration details.
See template
See template
Cranleigh School Equestrian Centre Booking Form
PDF template
Booking and registration form for riders at Cranleigh School Equestrian Centre, capturing participant and emergency contact details.
See template
See template
Committee For Specialist International Medical Graduate Education (CSIMGE) Area Of Need Ongoing Asse
PDF template
Comprehensive evaluation form for assessing international medical graduates' clinical performance, professional skills, and competencies in a medical setting.
See template
See template
Employer Support Declaration Form
PDF template
A form documenting employer support for an international medical graduate's pathway to fellowship with the Royal Australian and New Zealand College of Psychiatrists (RANZCP)
See template
See template
Required Consent For Release Of Information
PDF template
A consent form for releasing a child's medical, mental health, and treatment information for intensive mental health services coordination in New York City.
See template
See template
Certificate (Policy) Service Request Form
PDF template
A form for requesting various insurance contract services such as withdrawal, surrender, ownership assignment, or duplicate contract issuance.
See template
See template
Flight Attendant Optional Short Term Disability (OSTD)
PDF template
An optional short-term disability insurance program for flight attendants that provides income protection during periods of disability between paid sick time and long-term disability benefits.
See template
See template
Waiver Of Liability, Assumption Of Risk, And Indemnity Agreement
PDF template
Legal document waiving liability for participation in University of California community service transportation program.
See template
See template
Colorado State University Pueblo Event ParticipationMedical Form
PDF template
Comprehensive medical form for capturing participant health information, emergency contacts, and medical history for Colorado State University Pueblo events.
See template
See template
Colorado State University Sport Club Style Guide
PDF template
A comprehensive style guide detailing branding, uniform, and apparel requirements for Colorado State University sport clubs.
See template
See template
Grace Period Extension Agreement
PDF template
An agreement allowing insurance customers additional time to pay premiums during the COVID-19 pandemic without plan termination.
See template
See template
Circulating Tumor Cell Core Laboratory Requisition Form
PDF template
A requisition form for submitting samples to the Circulating Tumor Cell Core Laboratory for enumeration and profile analysis.
See template
See template
CTE Hospital Occupations Internship Class Application Form
PDF template
Application for high school students to participate in a medical internship program at UCI Medical Center, involving job shadowing and clinical skills training.
See template
See template
CT, MRI And MRA Order Pre Authorization Form
PDF template
A comprehensive form for ordering CT, MRI, and MRA medical imaging exams with detailed patient and clinical information requirements.
See template
See template
CPT Codes List
PDF template
Comprehensive list of Current Procedural Terminology (CPT) codes for various CT and diagnostic imaging procedures.
See template
See template
Nebraska Career Student Organization Medical Release Form
PDF template
A medical consent and emergency contact form for student organization members, allowing medical treatment authorization in parent/guardian's absence.
See template
See template
Cub Scout Activity Waiver Form
PDF template
A waiver form for youth and adult participation in Cub Scout activities, addressing medical and safety requirements.
See template
See template
Cultural Arts Handbook
PDF template
A handbook detailing the Champaign Park District's facilities, operations, and policies for cultural arts programs.
See template
See template
Cultural Product District Program Guidelines
PDF template
Provides tax exemptions for original art sales and tax credits for historic property rehabilitation within designated cultural districts in Louisiana.
See template
See template
Attending Physician Statement
PDF template
Medical documentation form used to assess patient's medical condition and ability to work for disability evaluation purposes.
See template
See template
CUNY Release Agreement For Activities In A Destination Under A Travel Warning
PDF template
A legal document outlining risk assumptions and compliance requirements for CUNY travelers going to destinations with travel warnings or advisories.
See template
See template
SHORT TERM DISABILITY CLAIM FORM
PDF template
Form for employees to file a claim for short-term disability benefits, including personal and employment details.
See template
See template
University Undergraduate Curriculum Committee Curricular Proposal Form Guide
PDF template
A comprehensive guide and form for proposing curricular changes, new programs, and course modifications at the university level.
See template
See template
Certification Course CMBP Designation
PDF template
A comprehensive training program covering medical billing fundamentals, insurance types, claims processing, and medical office forms.
See template
See template
Scholarship ApplicationRegistration Form
PDF template
A form for students to apply for art class scholarships based on financial need and family income.
See template
See template
Participant Consumption Of Alcohol Information And Waiver Form
PDF template
A form outlining alcohol consumption guidelines and restrictions for adult participants in Champaign-Urbana Special Recreation activities.
See template
See template
Custom EnrollmentApplication Certification Instructions
PDF template
A compliance checklist for customized enrollment forms to ensure regulatory requirements are met before submission.
See template
See template
Custom EnrollmentApplication Certification Instructions
PDF template
Instructions and checklist for ensuring compliance of customized enrollment forms prior to submission to regulatory authorities.
See template
See template
Customer Accessibility Feedback Form
PDF template
A form designed to collect customer feedback about service accessibility and satisfaction at Heartland Farm Mutual Insurance Inc.
See template
See template
REFERRAL FORM B Specialist
PDF template
A medical referral form used by Citrus Valley Physicians Group to request specialist services and track patient referrals.
See template
See template
Prescription Claim Form
PDF template
A form for submitting prescription reimbursement claims under a Medicare Part D manufacturer patient assistance program.
See template
See template
Prescription Reimbursement Claim Form
PDF template
A form for submitting prescription medication reimbursement claims, including patient and pharmacy information, insurance details, and claim reasons.
See template
See template
Prescription Reimbursement Claim Form
PDF template
A form for submitting prescription medication reimbursement claims, used to process pharmacy expense reimbursements.
See template
See template
CVS Caremark Prescription Benefits Guide
PDF template
A guide providing six strategies for saving money and time on prescription medications through CVS Caremark's pharmacy benefits program.
See template
See template
Accident Waiver, Release Of Liability Informed Consent Form
PDF template
Legal document waiving liability for participants in activities at the Colonial Williamsburg Musket Range.
See template
See template
Accident Waiver, Release Of Liability Informed Consent Form
PDF template
Legal document waiving liability for participants in activities at the Colonial Williamsburg Musket Range.
See template
See template
Patient Registration Form
PDF template
A comprehensive medical intake form for collecting patient personal and insurance details for healthcare services.
See template
See template
General Consent For Treatment
PDF template
A consent form allowing medical treatment for minor patients at The C. W. Williams Community Health Center, including medical and dental procedures.
See template
See template
CAREER EXPLORATIONS 2024 REGISTRATION AND EMERGENCYMEDICAL RELEASE FORM
PDF template
Registration form for high school students to participate in a two-day career exploration program at Johnson & Wales University campus.
See template
See template
MODEL INDIVIDUAL ENROLLMENT REQUEST FORM TO ENROLL IN A MEDICARE ADVANTAGE PLAN (PART C)
PDF template
Official form for individuals with Medicare who want to enroll in a Medicare Advantage Plan, outlining eligibility and enrollment periods.
See template
See template
Special Olympics Iowa Bike Safety Inspection Form
PDF template
A form used to inspect and certify bicycle safety for Special Olympics Iowa cycling competition participants.
See template
See template
Cycling UKS Risk Assessment Guide
PDF template
A comprehensive risk assessment guide for cycling events, detailing potential hazards and control measures for rider safety.
See template
See template
Application For Appointment In Cytopathology Fellowship Program
PDF template
Application form for medical professionals seeking a fellowship in cytopathology at the University of Massachusetts Medical School/UMass Memorial Health Care.
See template
See template
Pathology Requisition Cytology
PDF template
Medical form for collecting patient cytology test information, clinical history, and diagnostic details for gynecological testing.
See template
See template
Consent For The Medical Treatment Of A Minor
PDF template
A consent form authorizing medical treatment for a minor student at Sam Houston State University Health Center with payment responsibility details.
See template
See template
MOTOR ACCIDENT REPORT FORM
PDF template
Comprehensive form for reporting motor vehicle accidents, documenting incident details, vehicle information, and driver statements.
See template
See template
STATE OF LOUISIANA DRIVER AUTHORIZATION FORM
PDF template
Official form for authorizing state employees to drive vehicles on state business and documenting driving credentials and insurance compliance.
See template
See template
Request For Records Disposition Authority
PDF template
Official document detailing records disposition for Commissioned Corps Officers in the U.S. Department of Health and Human Services.
See template
See template
Medical Form Requirements
PDF template
Comprehensive guide for medical form requirements for Boy Scouts of America camps and activities in Colorado.
See template
See template
MEMBER REIMBURSEMENT DENTAL CLAIM FORM
PDF template
A form for members to request reimbursement for out-of-network dental services from their insurance provider.
See template
See template
Damage Report Form
PDF template
A form for reporting and documenting insurance damage claims with contact and incident details.
See template
See template
Damage Report Form
PDF template
A detailed form documenting damage incidents at a cemetery, including damage details, witnesses, police reports, and potential insurance claims.
See template
See template
Damage Report Form
PDF template
A form documenting damage to cemetery property, stones, or monuments, including details of the incident and potential repair process.
See template
See template
MEDICAL INQUIRY FORM IN RESPONSE TO AN ACCOMMODATION REQUEST
PDF template
A medical form used to assess an employee's disability status and potential need for workplace accommodations under the Americans with Disabilities Act (ADA).
See template
See template
PARKING ACCOMMODATION STATEMENT OF MEDICAL NECESSITY
PDF template
Medical certification form for employees requesting parking accommodations due to disability or medical limitations
See template
See template
New Provider Data Form
PDF template
Comprehensive registration form for medical providers to submit personal and professional information for onboarding with CHS Medical Group.
See template
See template
New Provider Data Form
PDF template
Comprehensive form for medical providers to submit personal and professional information for registration with CHS Medical Group.
See template
See template
Bartlett Park District Registration Form
PDF template
Registration form for park district programs with participant information, payment details, and liability waiver.
See template
See template
Direct Reimbursement Claim Form
PDF template
A form for requesting reimbursement from Davis Vision for out-of-network vision services and eyewear expenses.
See template
See template
SSM Health Davis Duehr Dean Eye Care Referral Form
PDF template
Medical referral form for patients needing eye care services at SSM Davis Duehr Dean Eye Care clinic, used to transmit patient and clinical information.
See template
See template
All FUR Fun Stay Play Dog Care Service Agreement Form
PDF template
A service agreement for dog daycare and boarding that outlines responsibilities, health certifications, and liability waivers for pet owners.
See template
See template
Dayspace Studio Rental Agreement
PDF template
A comprehensive rental agreement for studio equipment outlining terms, conditions, responsibilities, and risks for equipment rental from Day Space Studio.
See template
See template
DB 450 Notice And Proof Of Claim For Disability Benefits
PDF template
Instructions for filing a disability benefits claim in New York State, detailing submission requirements and process for employees and recently unemployed individuals.
See template
See template
Client Interview Form Defense Base Act
PDF template
A comprehensive form for collecting client information related to workplace injuries under the Defense Base Act
See template
See template
Interpreter Evaluation Form
PDF template
A comprehensive form to evaluate the performance and skills of medical interpreters across multiple dimensions of communication and professionalism.
See template
See template
New York State Disability Benefits Rights Statement
PDF template
Informational document outlining disability benefits rights for employees in New York State under Section 229 of the Disability and Paid Family Leave Benefits Law.
See template
See template
DC 54 Complaint Form
PDF template
Instructional guide for filing a complaint related to Temporary Disability Insurance or Prepaid Healthcare issues in Hawaii.
See template
See template
Emergency Consent Form
PDF template
A medical consent form that allows parents or guardians to provide advance authorization for emergency medical treatment of a child.
See template
See template
RETIRED LAW ENFORCEMENT OFFICER IDENTIFICATION CARD
PDF template
Liability waiver for retired law enforcement officers seeking to carry a concealed firearm under LEOSA provisions.
See template
See template
Emergency Medical Release
PDF template
A comprehensive medical release form for participants, collecting emergency contact, health, and treatment authorization information for minors.
See template
See template
Adult Patient Intake Form
PDF template
A comprehensive form for collecting patient medical history, personal information, and health details for treatment planning.
See template
See template
Dekalb County Athletic Participation Consent Form
PDF template
Parental consent form for students participating in inter-scholastic athletics and sports clubs in DeKalb County School District.
See template
See template
DCTD Tumor Repository International Shipping Form
PDF template
A form for shipping tumor repository samples internationally, used by researchers to request and document biological material shipments.
See template
See template
Uniform Consultation Referral Form
PDF template
A comprehensive form for healthcare providers to refer patients to consultants, detailing patient, provider, and referral information.
See template
See template
Some Early Thoughts On Liability Standards For Online Providers Of Legal Services
PDF template
An academic article exploring potential legal liability issues for online legal service providers and the intersection of technology and legal institutions.
See template
See template
REQUEST FOR ARMED FORCES PARTICIPATION IN PUBLIC EVENTS (NON AVIATION)
PDF template
A form used to request Armed Forces participation in public events, including musical units, troops, color guards, and exhibits.
See template
See template
DD Form 2807 2 Medical Prescreen Of Medical History Report
PDF template
A form used by military recruiters to pre-screen medical history of potential military service applicants for the United States Armed Forces or Coast Guard.
See template
See template
DD FORM 2876 3, TRICARE PRIME ENROLLMENT, DISENROLLMENT, AND PRIMARY CARE MANAGER (PCM) CHANGE FORM
PDF template
Official Department of Defense form for enrolling, disenrolling, or changing primary care managers in the TRICARE Prime healthcare program.
See template
See template
DD FORM 2876 TRICARE PRIME ENROLLMENT, DISENROLLMENT, AND PRIMARY CARE MANAGER (PCM) CHANGE FORM
PDF template
A Department of Defense form for enrolling, disenrolling, or changing primary care managers in the TRICARE Prime healthcare program.
See template
See template
Delta Dental Of Colorado Enrollment Form
PDF template
Form for enrolling in Delta Dental insurance coverage, including employee and dependent information.
See template
See template
Delta Dental Enrollment Form
PDF template
Enrollment form for obtaining dental insurance coverage through Delta Dental of Massachusetts
See template
See template
Claim For Disability Insurance (DI) Benefits
PDF template
Authorization form for releasing medical information to process a disability insurance claim with the California Employment Development Department (EDD).
See template
See template
DEA Order Form 222
PDF template
Official form for ordering Schedule I and II controlled substances from authorized suppliers, requiring detailed tracking and record-keeping.
See template
See template
Death Benefit Application Form
PDF template
A form for Fiji Bank & Finance Sector Employees Union members to apply for death benefits for themselves or eligible family members.
See template
See template
DECA ICDC 2023 Registration Guide
PDF template
Official registration and permission form for DECA conference attendance, including medical authorization and conduct agreement.
See template
See template
Diver Medical Questionnaire Additional Declarations COVID 19
PDF template
A medical questionnaire and health declaration form for divers to assess fitness and COVID-19 risk prior to participating in diving activities.
See template
See template
Declaration Form Process
PDF template
Detailed instructions for World Aquatics Members to submit and download Declaration Forms through the GMS platform.
See template
See template
Decode Duchenne Test Requisition Form
PDF template
A comprehensive genetic testing requisition form for patients with suspected or confirmed Duchenne or Becker muscular dystrophy
See template
See template
Decrease Election Form For Supplemental Life Insurance
PDF template
A form for active state employees to reduce their supplemental life insurance coverage in prescribed increments.
See template
See template
Payroll Deduction Cancellation Form
PDF template
Form for employees to cancel various payroll deductions for insurance, benefits, and voluntary contributions.
See template
See template
License Agreement For Diabetes Empowerment Education Program
PDF template
A licensing agreement between the University of Illinois and a licensee for the use and distribution of the Diabetes Empowerment Education Program
See template
See template
Participant Agreement, Release And Assumption Of Risk
PDF template
Legal waiver and risk assumption document for participants in trampoline and interactive activities, specifically for participants under 19 years old.
See template
See template
BIRTH TO TWENTY DELIVERY FORM
PDF template
Comprehensive medical form documenting pregnancy and childbirth details for medical research and tracking.
See template
See template
Specialty Care Referral Form
PDF template
A form for referring patients to dental specialists with patient, enrollee, and referral details.
See template
See template
Dental Claim Form
PDF template
A standardized form for submitting dental treatment and insurance claim information to Delta Dental of Illinois.
See template
See template
Dental Claim Form
PDF template
A standardized form for submitting dental insurance claims, tracking patient treatment, and requesting predetermination or preauthorization.
See template
See template
Delta Dental EnrollmentChange Form
PDF template
A comprehensive form for enrolling in or modifying dental insurance coverage with Delta Dental plans
See template
See template
Delta Dental Of Minnesota Membership Enrollment Form
PDF template
Membership enrollment form for Delta Dental insurance coverage, allowing employees to select dental plan options and enroll dependents.
See template
See template
ENROLLMENT FORM
PDF template
Dental insurance enrollment form for University of Tennessee Health Science Center (UTHSC) student plan.
See template
See template
Demand For Documents Letter
PDF template
A letter requesting legal documentation, potentially related to debt collection or insurance matters, with guidance on proper letter composition and legal considerations.
See template
See template
Patient Intake Form
PDF template
Comprehensive patient registration form collecting personal, contact, and insurance information for medical practice.
See template
See template
Demographics And Insurance Form Surgery Registration
PDF template
Comprehensive patient intake form for surgical procedures, collecting patient demographics, insurance, and medical contact information.
See template
See template
Dental Claim Form
PDF template
Standard form for submitting dental treatment and insurance claim details for reimbursement or predetermination.
See template
See template
ADA Dental Claim Form Instructions
PDF template
Comprehensive instructions for completing the ADA Dental Claim Form, including general instructions, coordination of benefits, and National Provider Identifier requirements.
See template
See template
DENTAL CONE BEAM CT REFERRAL FORM
PDF template
A medical referral form for dental cone beam CT imaging studies with patient and physician information collection.
See template
See template
Delta Dental Of Wisconsin EnrollmentChangeWaiver Form Dental
PDF template
A form for enrolling in, changing, or waiving dental insurance coverage through an employer's group plan with Delta Dental of Wisconsin.
See template
See template
COBRA Dental Insurance EnrollmentWaiver Form
PDF template
A form for employees to enroll in or waive dental insurance coverage, with options for adding or dropping dependent coverage under COBRA.
See template
See template
Dental Insurance EnrollmentWaiver Form
PDF template
A comprehensive form for employees to enroll or waive dental insurance coverage, including personal and dependent information.
See template
See template
Employee Enrollment Form
PDF template
Comprehensive form for employee insurance enrollment with personal information and coverage details.
See template
See template
Proof Of School Dental Examination Form
PDF template
Official form documenting student dental health examination for Illinois school children in specific grade levels as required by state law.
See template
See template
Dental Examination Waiver Form
PDF template
A form for parents/guardians to request a waiver from required dental examination for school-enrolled children in Illinois.
See template
See template
Dental Insurance EnrollmentChange Form
PDF template
A form for employees to enroll in or modify dental insurance coverage, including dependent information and policy details.
See template
See template
WCTC Dental Hygiene Clinic MEDICAL HISTORY FORM
PDF template
Comprehensive medical history form for patients at a dental hygiene clinic, collecting personal information and medical conditions.
See template
See template
Dental Hygiene Consent Form
PDF template
A comprehensive consent form outlining patient expectations, treatment policies, and administrative guidelines for dental services.
See template
See template
Dental Insurance Form
PDF template
A comprehensive form for collecting patient and insurance details for dental insurance claims.
See template
See template
Dental Waiver Form
PDF template
A form allowing civil service staff to waive enrollment in Genesee Community College's group dental insurance plan.
See template
See template
PATIENT MEDICAL HISTORY FORM
PDF template
A comprehensive medical and dental history form for patient intake, collecting personal health information and current medical status.
See template
See template
Dental Medical Release Form Template
PDF template
A template form for patients to authorize medical information release and consent for dental treatment.
See template
See template
Kentucky Dental ScreeningExamination Form For School Entry
PDF template
A mandatory dental health screening form for children entering public school in Kentucky, documenting dental health status and examination details.
See template
See template
Dental Claim Form
PDF template
A comprehensive form for filing dental insurance claims, collecting patient and insurance information.
See template
See template
DentalVision Enrollment Form
PDF template
Detailed guide for completing a dental and vision insurance enrollment form with step-by-step instructions.
See template
See template
Patient Referral Form
PDF template
A comprehensive medical and dental referral form for patient intake and specialist consultation at Boston Children's Hospital dental services.
See template
See template
Medical History Form
PDF template
Comprehensive medical history form collecting personal health information, medical background, and current health status.
See template
See template
DepartureTransfer Out CHECKLIST
PDF template
A comprehensive checklist for international students preparing to leave their current location, covering health insurance, student accounts, housing, and financial matters.
See template
See template
DependantS Pension Application Form
PDF template
A form for Nestl European Pension Fund members to nominate a financial dependent to receive pension benefits in the event of the member's death.
See template
See template
Dependent Audit Form
PDF template
A form for employees to verify and update dependent insurance coverage information and personal details.
See template
See template
Departmental Software Order Form
PDF template
A form for ordering and tracking software licenses and media for Virginia Polytechnic Institute and State University departments.
See template
See template
DepartmentProgram Transfer Request Form
PDF template
Form for students requesting transfer between departments or programs within the Rollins School of Public Health.
See template
See template
Dermatology Medical History
PDF template
Comprehensive medical history form for dermatology patients to document health conditions, medications, and allergies.
See template
See template
DERMATOLOGY MEDICAL HISTORY FORM
PDF template
Comprehensive medical history form for dermatology patients to document existing health conditions, medications, and potential skin-related medical concerns.
See template
See template
Dermatopathology Requisition Form
PDF template
Medical form for submitting wet or fresh tissue specimens for dermatopathology analysis and diagnostic testing.
See template
See template
Designation Of Beneficiary And Emergency Contact Form
PDF template
A form for designating beneficiaries and emergency contacts for funds owed by the International Atomic Energy Agency (IAEA)
See template
See template
Designee Registration Form
PDF template
A registration form for third-party entities interacting with Illinois Shines program end-use customers, establishing transparency and program participation requirements.
See template
See template
DESIGN FRINGE REGISTRATION INFO PACK
PDF template
Registration information for a design exhibition showcasing works by Australian-based artists and designers at all career stages.
See template
See template
Des Plaines Park District Waiver Form
PDF template
Waiver and release form for sports team participants to acknowledge and accept potential risks associated with participation.
See template
See template
Shipping Assessment Form
PDF template
A comprehensive form for assessing and documenting shipments of various materials to and from Weill Cornell Medicine, requiring detailed information about shipping contents and requirements.
See template
See template
CONSENT FORM CONFIDENTIAL HUMAN IMMUNODEFICIENCY VIRUS (HIV) TEST Non Health Care Settings
PDF template
Official consent form for HIV testing in non-healthcare settings, documenting informed consent and explaining testing procedures.
See template
See template
REFERRAL FOR CONSULT OR PROCEDURE
PDF template
Medical referral form for patients seeking consultation or procedures at Stanford Health Care's Digestive Health and Liver Clinic
See template
See template
Patient Medical History Form
PDF template
Comprehensive medical history form for collecting patient personal information, contact details, and health status.
See template
See template
Type 2 Diabetes Risk Assessment Form
PDF template
A screening tool to evaluate an individual's risk factors for developing type 2 diabetes through a points-based assessment.
See template
See template
Request For Diagnostic Imaging
PDF template
Medical form for requesting and scheduling diagnostic imaging procedures such as X-Ray, Ultrasound, CT, and Nuclear Medicine.
See template
See template
NWU2014 04 01 Participant Contact Form Data Dictionary
PDF template
A data dictionary for documenting participant contact form variables and metadata for a research study.
See template
See template
MDA2016 08 02 Study Specimen Shipping Form Blood Data Dictionary
PDF template
A data dictionary detailing the variables and specifications for a blood specimen shipping form used in a medical study.
See template
See template
MDA2014 04 01 Specimen Shipping Form Tissue Data Dictionary
PDF template
A comprehensive data dictionary for tracking and recording specimen shipping information for tissue samples across multiple medical institutions.
See template
See template
Student Record Card 6
PDF template
A health record and immunization documentation form required for student enrollment in Montgomery County Public Schools in Maryland.
See template
See template
Stanford Health Care Referral For Consult Or Procedure
PDF template
A medical referral document for patients seeking consultation or procedures at Stanford Digestive Health and Liver Clinic.
See template
See template
MASTER SERVICES AGREEMENT
PDF template
Legal agreement governing use of Digital 55's website, services, and platform with terms of service and liability limitations.
See template
See template
FEMME PHYSIOCARE PATIENT INTAKE FORM
PDF template
Comprehensive patient intake form for physiotherapy services with personal information, insurance, and consent sections.
See template
See template
DIGITAL SLIDE ORDER REQUEST FORM
PDF template
A form for requesting digital slide scanning services at UCLA with options for magnification, scanner type, and image delivery method.
See template
See template
UDENYCA Solutions Enrollment Form
PDF template
Enrollment form for patients seeking information about UDENYCA medication and insurance verification services.
See template
See template
DIRECT ACCESS PATIENT ATTESTATION AND MEDICAL RELEASE FORM
PDF template
A form for patients seeking physical therapy care, documenting current medical care status and providing medical record release consent.
See template
See template
Athlete Registration Form, Athlete Release Form Athlete Medical Forms
PDF template
Detailed guide for completing and submitting athlete registration and medical documentation for participation.
See template
See template
Liability And Insurance Form Instructions
PDF template
Comprehensive instructions for electronically filling out and submitting a liability and insurance form across different devices and platforms.
See template
See template
Molina Healthcare Of California Direct Referral To Specialist
PDF template
A referral form for Molina Healthcare members to receive specialized medical services within their network of contracted specialists.
See template
See template
VCHCP PCP DIRECT REFERRAL FORM
PDF template
A medical referral form for primary care physicians to refer patients to contracted specialists within the Ventura County Health Care Plan network.
See template
See template
DIS 101C V7 EMPLOYEE STATEMENT DISABILITY CLAIM FORM
PDF template
A comprehensive form for employees to file a disability claim for short-term or long-term disability benefits.
See template
See template
SUPPLEMENTAL DISABILITY CLAIM FORM
PDF template
Claim form for submitting a disability benefit request for IUOE Local 132 Health and Welfare Fund participants
See template
See template
Group Disability Claim Filing Instructions
PDF template
Instructions for filing a disability insurance claim with American Fidelity Assurance Company, detailing the required steps and documentation.
See template
See template
Disability Health Welfare Hours Claim Form
PDF template
A form for carpenters to claim disability health and welfare hours due to illness or injury, requiring participant and physician statements.
See template
See template
Disability Coverage Claim Form
PDF template
Insurance claim form for filing a disability coverage claim with American Heritage Life Insurance Company.
See template
See template
Disability Claim Form
PDF template
A comprehensive form for submitting a disability insurance claim, detailing the policyholder's medical condition and disability status.
See template
See template
Delta Pilots Mutual Aid Disability Claim Form
PDF template
Disability claim form for Delta pilots to request benefits and authorize medical information release and payment processing.
See template
See template
Short Term Disability Claim Form
PDF template
A comprehensive form for employees to file a claim for short-term disability benefits, requiring input from the employee, employer, and attending physician.
See template
See template
Disability Claim Form Instructions
PDF template
Comprehensive instructions for filing a disability insurance claim with sections for physician, claimant, and employer statements.
See template
See template
New York State NOTICE AND PROOF OF CLAIM FOR DISABILITY BENEFITS
PDF template
Official New York State form for filing a disability benefits claim, to be used by employees who became disabled while employed or within four weeks of employment termination.
See template
See template
MetLife Disability Insurance Guide
PDF template
A comprehensive guide for reporting disability claims and absence procedures through MetLife insurance.
See template
See template
Disability Claim Form
PDF template
A comprehensive form for filing a disability claim with medical and employment details for Teamsters Joint Council No. 83 members.
See template
See template
Disability Claim Form
PDF template
A comprehensive form for filing a disability claim through the Teamsters Joint Council No. 83 of Virginia Health & Welfare and Pension Funds.
See template
See template
Disability Claim Form
PDF template
A comprehensive form for filing a disability claim with the Teamsters Joint Council No. 83 of Virginia Health & Welfare and Pension Funds.
See template
See template
Continuing Disability Claim Form
PDF template
A comprehensive form for filing a disability insurance claim covering various types of disability and patient information
See template
See template
N 648 Medical Certification For Disability Exceptions
PDF template
Guidelines for medical professionals assessing disability exceptions for refugees seeking U.S. citizenship, focusing on comprehensive and culturally sensitive evaluation methods.
See template
See template
Disability Application Glossary Of Terms
PDF template
A comprehensive guide defining key terms and requirements for disability retirement applications for public employees in Massachusetts.
See template
See template
Short Term Disability Reporting Form
PDF template
A reporting form for employees to document short-term disability leave and absence from work due to illness or non-work related injury.
See template
See template
Supplementary Disability Claim Form
PDF template
A form used to submit disability claims, requiring details from both the claimant and attending physician about an employee's inability to work.
See template
See template
SI 11268 Your Disability Benefit Claim
PDF template
Application packet for submitting a long-term disability benefits claim, including instructions for completing required forms.
See template
See template
Adapted Physical Education Program Medical Form
PDF template
Medical form documenting student's disability, exercise limitations, and physical capabilities for adapted physical education program participation.
See template
See template
Disabled Dependent Authorization Form
PDF template
Insurance form for documenting dependent status, eligibility, and coverage details for a disabled dependent under 26 years old.
See template
See template
How To File A Claim For Weekly Disability Benefits
PDF template
Comprehensive guide for filing a disability benefits claim, including required documentation and medical certification requirements.
See template
See template
Discharge Form
PDF template
A form used to document patient discharge from a healthcare facility with multiple completion options.
See template
See template
Discharge And Follow Up Recommendations
PDF template
Guidelines for healthcare personnel on discharge and follow-up care for patients who have experienced assault, including medical and mental health considerations.
See template
See template
DISCHARGE PLANNING INPATIENT STANDARDS
PDF template
A comprehensive protocol detailing the procedures and responsibilities for patient discharge from an inpatient healthcare facility.
See template
See template
Pediatric Discharge Summary Template
PDF template
A comprehensive template and instructions for creating a pediatric patient discharge summary with detailed guidelines for documentation.
See template
See template
Discussion Period Request Form
PDF template
Form for healthcare providers to request a review of a claim determination and provide additional supporting documentation within a 30-day period.
See template
See template
International Medical History Form
PDF template
Comprehensive medical form for collecting personal health information, emergency contacts, and medical history for international travel purposes.
See template
See template
International Medical History Form
PDF template
Comprehensive medical history and emergency contact form for international travelers to ensure safety and medical preparedness.
See template
See template
Distinctive Americas Holiday Booking Form
PDF template
A comprehensive travel booking form for reserving holidays with Distinctive Americas, including personal details, travel insurance, and payment information.
See template
See template
MLML AAUS Diving Medical Form
PDF template
Medical examination form for assessing fitness of scientific divers, detailing potential disqualifying medical conditions for diving certification.
See template
See template
DIVING MEDICAL HISTORY FORM
PDF template
A comprehensive medical history form designed to assess an individual's fitness and health risks for participating in scuba diving activities.
See template
See template
UM Diver Proof Of Insurance Form
PDF template
Form requiring proof of medical insurance coverage for potential scuba diving accidents and hyperbaric oxygen therapy
See template
See template
UM Diver Proof Of Insurance Form
PDF template
A form requiring divers to prove they have medical insurance coverage for potential scuba diving accidents involving hyperbaric oxygen therapy.
See template
See template
Diversity Drives Us Art Competition Entry Form
PDF template
Application form for artists to submit artwork for the PSTA Diversity Art Competition, exploring themes of diversity and inclusion.
See template
See template
Guidelines For Maintaining An Equipment Inventory
PDF template
Comprehensive guidelines for managing and tracking equipment owned by a PEF Division, including insurance coverage, custodianship, and inventory tracking.
See template
See template
Guidelines For Maintaining An Equipment Inventory
PDF template
Comprehensive guidelines for managing and tracking equipment owned by a PEF Division, including insurance coverage, custodianship, and inventory tracking.
See template
See template
Claims Reporting Procedure Manual
PDF template
Comprehensive guide for reporting and managing various types of claims for state-owned property, vehicles, and liability incidents in Alaska.
See template
See template
DIY Docs
PDF template
An online legal document creation and storage tool provided by ARAG for employees to generate and manage legal documents independently.
See template
See template
DIZZINESS BALANCE MEDICAL HISTORY QUESTIONNAIRE
PDF template
Comprehensive medical questionnaire for patients experiencing dizziness, balance issues, and related symptoms
See template
See template
Payroll Deduction Agreement
PDF template
Agreement for Texas A&M University employees to authorize payroll deductions for Recreation Sports memberships and locker rentals
See template
See template
NC Medicaid Hospice Prior Approval Authorization Form
PDF template
A form for healthcare providers to request prior authorization for Medicaid hospice benefits for patients entering a new benefit period.
See template
See template
CCNCCA Enrollment Form
PDF template
Enrollment form for healthcare program participation, allowing individuals to enroll multiple people and select primary care providers.
See template
See template
Denver Mac Repair Service Agreement
PDF template
Service agreement outlining repair procedures, liability, and customer responsibilities for Mac computer repair services.
See template
See template
Individual Volunteer Registration AgreementTime Record
PDF template
Agreement for volunteers to register and track service time with the Department of Natural Resources, including liability waiver and image consent.
See template
See template
Referral
PDF template
A comprehensive medical referral document for tracking patient information and transfer of care between healthcare providers.
See template
See template
DoctorS Signature Form
PDF template
A comprehensive medical form for documenting a camper's health information, medical history, medications, and physician details.
See template
See template
Organizational Hold Harmless And Indemnity Agreement
PDF template
Legal document that provides liability protection for Boy Scouts of America against claims from non-BSA scouting groups and organizations.
See template
See template
Minor (Under 18) Participant Form
PDF template
Registration and liability waiver form for minors participating in sports activities at Accelerate Sports complex.
See template
See template
Non THPRD Personal AidCaregiver Notification
PDF template
Form for notifying Tualatin Hills Park & Recreation District about a non-THPRD personal aid attending a program with a patron who may need assistance.
See template
See template
The 1st Annual Ridgecrest Regional Hospital Dodgeball Tournament 2017 Waiver Form
PDF template
Legal waiver for participants in the Ridgecrest Regional Hospital Dodgeball Tournament, releasing the hospital from liability for potential injuries.
See template
See template
Authorization For The Release Of Health Information And Confidential HIV Related Information DOH 255
PDF template
A form for releasing general health and HIV-related information to single or multiple healthcare providers with specific guidelines for usage.
See template
See template
Authorization For Use Or Disclosure Of Protected Health Information (PHI)
PDF template
A legal form allowing authorized use and disclosure of an individual's protected health information by the Hawaii State Department of Health.
See template
See template
DOH COVID 19 Vaccination Consent Form
PDF template
A comprehensive form for capturing patient information and screening for COVID-19 vaccination eligibility and potential health risks.
See template
See template
Proposal Form Domestic Maid (Lite)
PDF template
Insurance proposal form for obtaining domestic maid insurance coverage in Singapore.
See template
See template
Domestic Maid (Lite) Proposal Form
PDF template
Insurance proposal form for domestic maid coverage in Singapore, detailing proposer and maid particulars.
See template
See template
Good Fit Domestic Partner Affidavit
PDF template
A form for active and retired employees to add or terminate domestic partner and dependent coverage for various insurance plans.
See template
See template
RELEASE INDEMNIFICATION FOR DOMESTIC TRAVEL FORM
PDF template
A legal document for releasing liability and indemnifying the university for domestic student travel activities.
See template
See template
INFORMED CONSENT TO DONATE EMBRYOSWAIVER OF LIABILITY
PDF template
Legal document for donating cryopreserved embryos to the National Embryo Donation Center for reproductive purposes.
See template
See template
Do Not File Insurance Waiver Form
PDF template
A document allowing patients to request that Oklahoma State University Medicine not file an insurance claim for a specific date of service.
See template
See template
EducationalAcademic Travel Pre Authorization Form For Out Of Province Travel
PDF template
A pre-approval form for faculty, clinical associates, and trainees to document and obtain approval for out-of-province travel related to educational or academic purposes.
See template
See template
Driver Services Release Form
PDF template
A legal document for releasing liability related to a vehicular accident, allowing a releasor to waive claims against a released party.
See template
See template
Application, Liability Release And Rental Agreement Form
PDF template
A liability release and rental application form for using the Glen Echo Town Hall meeting room, including details about event, attendance, and sponsorship requirements.
See template
See template
TESTING REQUISITION FORM
PDF template
Specialized medical form for flow cytometry testing of blood and bone marrow specimens for various hematological conditions.
See template
See template
Job Displacement Insurance A Policy Typology
PDF template
A research paper examining policy approaches for insuring workers against earnings losses from unemployment and job displacement.
See template
See template
Master Services Agreement
PDF template
A comprehensive service agreement between the City of Seattle Department of Parks & Recreation and the Associated Recreation Council defining their mutual responsibilities and operational guidelines.
See template
See template
Disability Benefit Application Instructions
PDF template
Comprehensive instructions for submitting a disability benefit application, including eligibility requirements and submission guidelines.
See template
See template
Driver Medical History Form
PDF template
Medical history and physical examination form for taxi and limousine drivers to assess fitness for operating a motor vehicle.
See template
See template
Motor Vehicle Accident Report Form
PDF template
Confidential report form for documenting details of a motor vehicle accident involving injury, death, or property damage over $1,000.
See template
See template
Chapter 133 General Medical Provisions Health Care Provider Billing Procedures
PDF template
Regulatory document outlining electronic and paper billing procedures for health care providers in workers' compensation and insurance contexts.
See template
See template
Chapter 133. General Medical Provisions Subchapter B. Health Care Provider Billing Procedures
PDF template
Regulatory document specifying required electronic and paper billing formats for healthcare providers in workers' compensation and insurance contexts.
See template
See template
Artist ApplicationAgreement
PDF template
A legal document for artist participation in Buttonwood Art Space activities, including a waiver of liability and hold harmless agreement.
See template
See template
Indemnity Data CallReporting Contact Form
PDF template
Form for insurance affiliates to designate primary data reporting contacts for NCCI Group Codes.
See template
See template
STATE OF LOUISIANA DRIVER AUTHORIZATION FORM
PDF template
Annual form for authorizing state employees to drive vehicles on state business and verifying driving credentials
See template
See template
Driver Insurance Form Field Trips And Athletics
PDF template
A form for parents/guardians to complete insurance and driving history information for school-related transportation and field trips.
See template
See template
DriverForm Rev12.2016 VOLUNTEEREMPLOYEE DRIVER FORM
PDF template
A form for collecting driver information, vehicle details, insurance coverage, and driving history for volunteers and employees who drive vehicles.
See template
See template
Medical Certification Form New Driver Applicant
PDF template
Medical certification document required for new taxi and livery vehicle drivers in New York City to verify physical fitness for driving.
See template
See template
New Drivers Of University Vehicles
PDF template
Form for collecting driver information and authorization for new drivers of university vehicles, specifically for golf carts or low-speed electric vehicles.
See template
See template
DriverS Accident Reporting Packet
PDF template
Comprehensive guide for handling vehicle accidents involving University of California vehicles, providing step-by-step instructions for reporting and managing post-accident procedures.
See template
See template
CIBC Insurance DriveSmart Program Terms And Conditions
PDF template
Policy terms and conditions for CIBC Insurance DriveSmart telematics driving program with Certas Direct Insurance Company.
See template
See template
Integrative Medicine Intake Form
PDF template
Comprehensive medical intake form for patients seeking integrative medicine services, collecting medical history, current health concerns, and personal health information.
See template
See template
Medical Drop Off Consent Form
PDF template
A consent form for veterinary medical services and pet drop-off, including pet health status and treatment authorization.
See template
See template
Drug Testing Consent NCAA Division III
PDF template
Consent form for NCAA Division III student-athletes agreeing to drug testing and understanding potential consequences of positive tests.
See template
See template
Drug Testing Consent Form
PDF template
A comprehensive consent form for drug testing administered by the Manila Health Department Public Health Laboratory for various purposes.
See template
See template
Form 10 3f Drug Testing Consent NCAA Division III
PDF template
A mandatory consent form for NCAA Division III student-athletes to agree to drug testing and understand associated consequences.
See template
See template
BP 5131.61 Student Athlete Drug Testing
PDF template
A school district policy establishing a drug testing program for student athletes to promote health, safety, and deterrence of substance abuse.
See template
See template
UMKC Substance Abuse Education And Testing Program
PDF template
A comprehensive policy outlining substance abuse education, testing, and consequences for student-athletes at the University of Missouri-Kansas City.
See template
See template
University Of West Alabama Athletic Department Drug Testing Policy
PDF template
A comprehensive drug testing and education policy for student-athletes at the University of West Alabama, designed to ensure a safe and drug-free athletic environment.
See template
See template
Medical Examination Form
PDF template
Comprehensive medical examination form documenting patient's physical condition, vision, hearing, and overall health status.
See template
See template
Installment Agreement
PDF template
Official form for resolving driver's license reinstatement through an installment payment plan with specific procedural requirements.
See template
See template
Medical Examination For Immigrant Or Refugee Applicant (DS 2053)
PDF template
Comprehensive guide for panel physicians completing medical examinations for immigrant and refugee applicants, detailing required assessments and evaluation process.
See template
See template
Student Insurance Claim Form
PDF template
A comprehensive insurance claim form for students to report medical examinations, illnesses, prescriptions, or injuries for insurance coverage.
See template
See template
USEF Dressage Sport Horse Breeding HandlerAssistant Handler Entry Release Form
PDF template
Official form for handlers and assistant handlers participating in USEF dressage sport horse breeding competitions, outlining participation agreements and requirements.
See template
See template
Direct Deposit Enrollment Authorization Form
PDF template
Authorization form for electronic benefit payments through direct deposit for Social Services programs in North Carolina.
See template
See template
Registration Form
PDF template
Registration form for participants to sign up for park district programs with personal and payment information.
See template
See template
Change Of Information Form
PDF template
A form for patients to update their personal, contact, insurance, and payment information with Double Talk Therapy, PLLC.
See template
See template
Informed Consent For Fitness Assessment
PDF template
Consent document for participating in a comprehensive fitness assessment conducted by exercise physiology students at the College of St. Scholastica during the City of Duluth Health Fair.
See template
See template
Durable Power Of Attorney
PDF template
A form allowing employees to designate an attorney-in-fact to conduct insurance-related transactions with the Employees Group Insurance Division (EGID).
See template
See template
Workers Compensation Complaint Form
PDF template
Official form for filing a complaint related to workers' compensation violations in Texas, detailing alleged system participant infractions.
See template
See template
DyAnsys Brief Proposal Form
PDF template
A comprehensive form for researchers seeking project support and equipment loan from DyAnsys, including project details and research objectives.
See template
See template
Employee Benefit Enrollment Form
PDF template
A comprehensive form for employees to select and enroll in medical, dental, and vision benefit plans.
See template
See template
2022 WEDGE RESIDENCY Application Form
PDF template
An application form for artists and practitioners seeking a research residency in Vancouver, focused on exploring specific topics or histories related to the city.
See template
See template
Certification Of Trust
PDF template
A form for certifying trust details when a trust is the owner of an American Equity annuity contract.
See template
See template
Declaration For Testamentary Deposit (Multiple Grantors), Form 720009
PDF template
Federal document detailing FDIC forms used to collect information about depositors and deposit ownership for failed financial institutions.
See template
See template
Workers Compensation Commission Self Insurance Program Application
PDF template
Comprehensive application guide for employers seeking self-insurance status for workers' compensation in Maryland.
See template
See template
Exhibitor Appointed Contractor Form
PDF template
Form detailing requirements and guidelines for third-party contractors working at Gulf Coast Conference (GCC) event.
See template
See template
Barcelona Portal Industry Booking Form
PDF template
Booking form for sponsorship and exhibition options at the EACTS 34th Annual Meeting virtual event in October 2020.
See template
See template
Assumption Of The Risk, Release Waiver Of Liability
PDF template
Liability waiver for participants in a research program, acknowledging risks and providing emergency consent.
See template
See template
EASA PROGRAM DISCHARGE FORM
PDF template
A form used to document client discharge details from the EASA program, including reasons for discharge and transition information.
See template
See template
Patient Medical History
PDF template
Comprehensive medical history form for capturing patient personal information, health status, medical history, and patient rights.
See template
See template
INITIAL DISABILITY CLAIM FORM
PDF template
A comprehensive form for filing disability insurance claims covering various types of disability scenarios with patient and policyholder information.
See template
See template
DENTAL APPLICATION AND POLICY CHANGE
PDF template
A comprehensive form for enrolling in or modifying dental insurance coverage, including options for new employees, open enrollment, COBRA, and membership changes.
See template
See template
PELHAM SCHOOL DISTRICT POLICY EBBB ACCIDENT REPORTS
PDF template
Comprehensive policy detailing requirements for reporting accidents involving students or employees in school settings, including notification procedures and documentation guidelines.
See template
See template
Accident Reporting
PDF template
Policy outlining procedures for reporting accidents involving students or employees at school or school-sponsored activities.
See template
See template
Sponsorship Exhibition Booking Form
PDF template
Booking form for sponsorship and exhibition opportunities at the European Breast Cancer Conference (EBCC)
See template
See template
Claim Form
PDF template
A comprehensive form for submitting claims for various flexible spending and healthcare reimbursement accounts.
See template
See template
North Carolina Workers Compensation Electronic Billing And Payment Companion Guide
PDF template
A companion guide for electronic billing and payment processes in North Carolina's workers' compensation system, based on national electronic billing standards.
See template
See template
Volunteer Field Trip Waiver Form
PDF template
A waiver form for volunteers participating in activities with the East Bay Regional Park District, covering liability, medical consent, and photo permissions.
See template
See template
EasyCare Cancellation Form
PDF template
Form for cancelling vehicle protection or GAP coverage contract with specific documentation requirements.
See template
See template
Elk County Catholic High School Building Usage Form
PDF template
A form for external groups to request use of school facilities, including details about event, facilities, and insurance requirements.
See template
See template
Claims Submission Form
PDF template
A form authorizing healthcare providers to submit and exchange personal information for insurance claims processing and benefits administration.
See template
See template
Electronic Transmission Authorization And Consent Form
PDF template
A form authorizing electronic submission and exchange of personal health information for insurance claims processing and administration.
See template
See template
ECU Leased Equipment Policy Change Form
PDF template
A form for documenting changes to leased equipment at East Carolina University, including equipment details, location, and lease information.
See template
See template
ECU Leased Equipment Policy Change Form
PDF template
A form for documenting changes to leased equipment at East Carolina University, including equipment details, location, and lease information.
See template
See template
ECU School Of Dental Medicine Referral Form
PDF template
A comprehensive referral form for dental patients requiring specialized medical or dental services at East Carolina University School of Dental Medicine.
See template
See template
NCAAR Drug Testing Program, 1999 2000
PDF template
Comprehensive drug testing program for student-athletes to ensure fair competition and athlete health and safety.
See template
See template
EDI Application Form
PDF template
Application form for healthcare providers to submit electronic Medicare claims and receive electronic remittances through the Electronic Data Interchange (EDI) system.
See template
See template
DDE Enrollment Form
PDF template
Form for healthcare providers to enroll in Direct Data Entry system and request access credentials for Medicare claims processing.
See template
See template
Montana Conduent EDI Provider Enrollment Form
PDF template
A form for healthcare providers to enroll in electronic data exchange and authorize billing agent/clearinghouse transactions in Montana.
See template
See template
Employee Request For Accommodation
PDF template
A form for employees to request workplace accommodations related to disabilities or medical conditions.
See template
See template
Medical Reserve Corps Volunteer Application
PDF template
Application form for volunteers interested in joining the Medical Reserve Corps for public health emergency support
See template
See template
Traveler Health And Medical Information
PDF template
A comprehensive guide for group leaders to collect and manage travelers' medical information and health considerations during travel programs.
See template
See template
Emergency Family Medical Leave Request Form
PDF template
Detailed guidance for employees on completing timesheets and tracking Emergency Family and Medical Leave (EFML) usage and compensation.
See template
See template
Extended Health Care Claim Form
PDF template
A comprehensive form for submitting medical and health care expense claims to an insurance provider, requiring detailed personal and coverage information.
See template
See template
PeriodontalImplant Referral Form
PDF template
Medical referral form for periodontal and dental implant services with patient and examination details.
See template
See template
STUDENT MEDICAL HISTORY
PDF template
Comprehensive medical history form for students, covering various health aspects and potential medical conditions.
See template
See template
Electronic Communications Requirements
PDF template
Document outlining electronic communication services and requirements between Western National Insurance Group and its agencies for policy information transmission and business communications.
See template
See template
EFT And ERA Electronic Funds Transfer And Electronic Remittance Advice Transactions Basics
PDF template
A comprehensive overview of Electronic Funds Transfer (EFT) and Electronic Remittance Advice (ERA) transactions in healthcare payment systems.
See template
See template
IAIABC Electronic Partnering Agreement
PDF template
A document establishing guidelines and expectations for electronic data exchange between trading partners in industrial accident and workers' compensation domains.
See template
See template
2021 2022 Elementary School Request Form
PDF template
A form for schools to request Junior Achievement educational programs for elementary grade levels
See template
See template
Lehigh University Athletic Eligibility Requirements
PDF template
Comprehensive guidelines for student-athletes at Lehigh University covering medical, NCAA, academic, and financial aid requirements for participation in intercollegiate athletics.
See template
See template
Early Learning Scholarships Invoice Form SFY2024
PDF template
Invoice form for early childhood education programs serving Early Learning Scholarships Pathway I award recipient children to submit payment for eligible service expenses.
See template
See template
Camp Registration Form
PDF template
Official registration form for children's summer camp programs offered by the City of Los Angeles Department of Recreation and Parks.
See template
See template
Active Directory And Email Access Request Form
PDF template
Form for requesting and authorizing Active Directory and email system access for faculty, staff, and consultants
See template
See template
EMERGENCY CARE AND CONTACT FORM
PDF template
A school form for collecting student medical information, emergency contacts, and parental authorization for medical care.
See template
See template
Emergency Contact Health Form
PDF template
Health and emergency contact form for participants in Lake County Forest Preserve programs, including medical information and treatment authorization.
See template
See template
Emergency Contact Form
PDF template
A form for collecting personal health details and emergency contact information for club or organizational trips.
See template
See template
Emergency Contact Parental Consent Form
PDF template
A comprehensive form for collecting emergency contact, medical, and consent information for children in care.
See template
See template
Emergency Contact Form
PDF template
A form for collecting emergency contact and medical information for volunteers participating in disaster response activities.
See template
See template
Emergency Contact Form
PDF template
A comprehensive form for collecting student emergency contact details, medical information, and guardian contact information for school records.
See template
See template
Student Emergency And Release Form
PDF template
Confidential form for collecting student medical information, emergency contacts, and special needs details for Howell Mountain Elementary School District.
See template
See template
Emergency Contact Vendor Form
PDF template
Form for collecting emergency contact details and medical information for vendors and booth operators.
See template
See template
Emergency Contact Information Form
PDF template
A document for collecting employee emergency contact details and medical information for use in urgent situations.
See template
See template
Health Office Emergency Contact Form
PDF template
A comprehensive form collecting student contact, medical, and insurance information for school emergency purposes.
See template
See template
Hickory Hill Member Family Emergency Contact Form
PDF template
A form for collecting emergency contact information and medical authorization for family members at a club or organization.
See template
See template
EMERGENCY CONTACT FORM
PDF template
A form for collecting personal, emergency contact, and medical information for students in case of emergency situations.
See template
See template
Emergency Contact Form
PDF template
A comprehensive form for recording family contacts, medical care providers, and insurance details for emergency reference.
See template
See template
Emergency Information
PDF template
A comprehensive emergency contact and medical information form for students participating in university activities.
See template
See template
Emergency Medical Form For Pre Clinical And Clinical Placements
PDF template
A form for clinical and pre-clinical teacher candidates to provide emergency medical and contact information for placement purposes.
See template
See template
PADRE PIO ACADEMY EMERGENCY MEDICAL FORM
PDF template
A medical form for collecting student emergency contact and treatment authorization information for Padre Pio Academy.
See template
See template
Emergency Medical Form
PDF template
A comprehensive form for collecting student medical information and emergency contact details with parental consent for medical treatment.
See template
See template
Emergency Medical Treatment Form
PDF template
A comprehensive medical information form for emergency medical treatment and patient details, designed to be posted on a refrigerator for quick access.
See template
See template
Emergency Medical Form
PDF template
Form for updating student emergency contact, insurance, and athletic participation information for school records.
See template
See template
EmergencyMedical Release Authorization Form
PDF template
A form authorizing school staff to seek medical treatment for a child in case of emergency and acknowledging parental responsibility for medical expenses.
See template
See template
EmergencyMedical Release Authorization Form
PDF template
Authorization form allowing school staff to seek medical treatment for a child in emergency situations with parental consent.
See template
See template
Emergency Medical Release Form
PDF template
A form granting permission for emergency medical treatment for a minor at Pats Peak Ski Area, authorizing medical care in case of illness or injury.
See template
See template
Emergency Medical Release Form
PDF template
A comprehensive medical form for collecting health information and emergency contact details for participants in adaptive or therapeutic horseback riding programs.
See template
See template
Emergency Medical Release Form
PDF template
A form authorizing school officials to consent to medical treatment for a minor in case parents/guardians cannot be reached.
See template
See template
DUTCHESS COMMUNITY COLLEGE EMERGENCY MEDICAL FORM
PDF template
A consent form allowing medical treatment for a child during a summer program, with parental emergency contact authorization.
See template
See template
Clauses To Emergency Use Agreement
PDF template
Legal document outlining terms and conditions for emergency service provision between City of Dripping Springs/ESD #6 and a vendor during emergency situations.
See template
See template
EmergencyMedical Authorization Waiver Form For Minor Participants
PDF template
A form authorizing emergency medical treatment and waiving liability for minor participants in a Ferris State University camp or program.
See template
See template
Emeriti Reimbursement Benefit Claim Form
PDF template
Instructions for submitting healthcare reimbursement claims through Rx debit card, online portal, or paper submission.
See template
See template
EMERGENCY MEDICAL FORM
PDF template
A form for parents to authorize emergency medical treatment for students and provide critical medical contact and health information.
See template
See template
EMFG Venue Check List
PDF template
Comprehensive checklist of required documents and steps for preparing an event venue at a fairgrounds facility.
See template
See template
EMG ORDER FORM
PDF template
Medical referral form for ordering electromyography studies to diagnose nerve and muscle conditions.
See template
See template
Health Insurance Claim Form
PDF template
Standard health insurance claim form for submitting patient and insurance information for medical reimbursement and processing.
See template
See template
EMPLOYEE EMERGENCY CONTACT FORM
PDF template
A comprehensive form for collecting employee personal and emergency contact details for human resources purposes.
See template
See template
Employee Emergency Medical Form
PDF template
Confidential form for collecting employee emergency contact details, medical conditions, and treatment consent.
See template
See template
ENROLLMENT, CHANGE, CANCELLATION, OR OPT OUT EMPLOYEES ONLY HEALTH AND WELFARE PLANS
PDF template
A form for Lawrence Livermore National Security employees to enroll, change, cancel, or opt out of health and welfare benefit plans.
See template
See template
ENROLLMENT FORM FOR GROUP INSURANCE
PDF template
A comprehensive form for enrolling in group insurance benefits, capturing employee and dependent information, coverage selections, and authorization.
See template
See template
Virginia Tech Employee Software Sales Order Form
PDF template
Order form for Virginia Tech employees to purchase software and technology accessories at discounted rates.
See template
See template
M NCPPC Benefits EnrollmentChange Form
PDF template
Form for employees to enroll in or modify benefits, including medical, dental, and prescription plans.
See template
See template
Eye Care Insurance Enrollment Form
PDF template
A comprehensive form for employees to enroll in or modify eye care insurance coverage for themselves and dependents.
See template
See template
New Patient Intake Form
PDF template
Comprehensive medical form for collecting new patient health history, chronic conditions, surgical history, medications, and family medical background.
See template
See template
Employer Error Institution Process
PDF template
Guidelines for handling employer errors in employee insurance enrollment, detailing steps for institutions and employees to correct coverage issues.
See template
See template
University Recreation Employment Application
PDF template
Job application form for students seeking employment at the University Recreation Student Recreation Center in various positions like lifeguard, ropes course, and intramural officiating.
See template
See template
Recreation And Parks Child Care Division Employment Application
PDF template
A comprehensive employment application for child care positions with the Recreation and Parks Child Care Division.
See template
See template
APPLICATION FOR EMPLOYMENT
PDF template
Comprehensive employment application form for job seekers applying to La Rabida Children's Hospital.
See template
See template
Employment Application
PDF template
A job application form for employment opportunities with the City of Antioch Recreation Department.
See template
See template
Application For Employment
PDF template
Employment application form for Logan County Health Services with instructions for completing the document electronically or manually.
See template
See template
Rutgers Recreation Employment Application
PDF template
Employment application for students seeking positions at Rutgers University Recreation facilities and programs.
See template
See template
GIC Employment Status Change Form
PDF template
A form for documenting changes in employment status, leave of absence, and associated health insurance coverage elections.
See template
See template
2023 EMRA RenewalSurvey Form
PDF template
Form for renewing and surveying emergency medical transport agency licenses in Oklahoma, with two renewal options for 2024 and 2025.
See template
See template
CENTER FOR EARLY EDUCATION AND CARE STAFF EMERGENCY CONTACT FORM
PDF template
A form for collecting emergency contact and medical information for staff members of an early education center.
See template
See template
Request For Consultation
PDF template
A medical consultation request form for electron microscopy services, used to collect patient medical history, diagnostic information, and study details.
See template
See template
EMS Payment Plan Form No Penalty No Interest
PDF template
A form for establishing an extended payment arrangement for ambulance billing with the City of Houston
See template
See template
Out Of Network Vision Services Claim Form
PDF template
A form for submitting out-of-network vision service claims with instructions for online or mail submission.
See template
See template
NEW PATIENT INTAKE FORM
PDF template
A comprehensive medical history form for new patients, capturing personal information, medical history, and current health concerns.
See template
See template
License Agreement Between International Floorball Federation And Eurosport SA
PDF template
A licensing agreement granting Eurosport SA broadcasting rights for Floorball Championships
See template
See template
Endocrinology Submission Form
PDF template
Comprehensive form for submitting veterinary endocrine and hormone function test samples with detailed diagnostic testing options.
See template
See template
REFERRAL FORM
PDF template
A medical referral form for endocrinology patients, specifically focused on thyroid-related diagnoses and consultations.
See template
See template
New Patient Intake Form
PDF template
Comprehensive medical intake form for new patients at the UCSF Endometriosis Center, focusing on pain assessment and reproductive health.
See template
See template
Architects And Engineers Professional Liability Insurance Application
PDF template
An insurance application form for architects and engineers to obtain professional liability coverage.
See template
See template
Authorization And Consent To Treatment
PDF template
A comprehensive document outlining patient consent for medical treatment, insurance benefits assignment, and payment responsibilities.
See template
See template
Financial Assistance Application
PDF template
A comprehensive form for patients to provide financial details and income verification for potential medical financial assistance.
See template
See template
Youth Programs Mandatory Forms
PDF template
Comprehensive legal document for youth program participation, covering travel, risk, and liability waivers for participants or their guardians.
See template
See template
Home Health Referral Form
PDF template
A comprehensive form for referring patients to home health services, capturing patient information, medical orders, and healthcare practitioner details.
See template
See template
Enhanced Dental Benefits Enrollment Form
PDF template
A self-enrollment form for additional dental coverage for members with specific medical conditions through Blue Cross Blue Shield of Massachusetts.
See template
See template
ENJAYMO Patient Solutions Enrollment Form
PDF template
Comprehensive patient enrollment form for ENJAYMO patient assistance program, collecting personal and insurance information.
See template
See template
VEHICLE INSPECTION FORM
PDF template
A comprehensive form for documenting vehicle condition and existing damage for insurance purposes.
See template
See template
Enrichment Program Proposal
PDF template
A form for submitting proposed educational enrichment programs to Rochester Community Schools for review and potential approval.
See template
See template
Enrollment Change Waiver Group Insurance Form
PDF template
Insurance enrollment form for adding or changing group dental and eye care coverage for employees and their dependents.
See template
See template
Continuing Consent To Treatment And Authorization To Release Information
PDF template
A consent form allowing medical treatment for a minor student and authorizing release of medical information to insurance services.
See template
See template
Northern California Carpenter Funds Enrollment Form
PDF template
Form for enrolling or updating records with the Northern California Carpenter Funds, including health plan selection and participant information.
See template
See template
SISC Flex Plan Enrollment Form
PDF template
Employee enrollment form for health care, limited purpose, and dependent care flexible spending accounts with benefit election options.
See template
See template
Delta Dental Of Rhode Island Enrollment Form
PDF template
An enrollment form for Delta Dental insurance coverage in Rhode Island, used to add or modify dental insurance coverage for individuals and families.
See template
See template
Vision Service Plan EnrollmentChange Form
PDF template
Form for employees of Fallbrook Elementary School District to enroll or modify vision insurance coverage for themselves and dependents.
See template
See template
Application And Change Form For Delta Dental Individual And Family
PDF template
A comprehensive dental insurance enrollment form for individual and family coverage with personal and dependent information sections.
See template
See template
Superior Dental Care Employee Enrollment Form
PDF template
Form for employees to enroll in dental and vision insurance benefits through Superior Dental Care.
See template
See template
ENROLLMENT FORM
PDF template
A comprehensive form for enrolling in insurance coverage and adding spouse and dependent information for IBEW Local 26 members.
See template
See template
ENROLLMENT FORM GL.2017.010
PDF template
A comprehensive employee insurance enrollment form for selecting life and AD&D coverage options for employees and dependents.
See template
See template
Enrollment Transfer Request Form
PDF template
A form for veterans to transfer their medical enrollment between VA healthcare facilities, capturing personal and contact information.
See template
See template
ENROLLMENT FORM NATIONAL ELEVATOR INDUSTRY BENEFIT PLANS
PDF template
An enrollment form for employees of the National Elevator Industry to enroll in benefit plans and update personal and dependent information.
See template
See template
Electronic Consent Contact Form
PDF template
A consent form allowing patients to receive medical communications via email, SMS, and phone for allergy treatment updates and appointment reminders.
See template
See template
VEHICLE INSPECTION FORM
PDF template
Insurance form for documenting existing vehicle damage during policy inspection or claim process.
See template
See template
Patient Intake Form
PDF template
Comprehensive form for collecting patient personal, contact, medical, and insurance information for healthcare providers.
See template
See template
Strathbungo Spring Fling Art Competition Entry Form
PDF template
Entry form for children aged 5-8 years to participate in a local art competition with parental permission required.
See template
See template
BVASA 2024 November Tournament Entry Form
PDF template
Tournament event for BVASA members to participate in competitive and enjoyable badminton matches over a weekend in November.
See template
See template
BVASA 2024 November Tournament Entry Form
PDF template
Tournament event for BVASA members to participate in competitive and enjoyable badminton matches over a weekend in November.
See template
See template
LUCY IN SPACE CONTEST ENTRY FORM WITH PARENTAL CONSENT
PDF template
A creative contest for middle and high school students to engage with space exploration and NASA's Lucy Mission through art and writing.
See template
See template
Health History Examination Form South Carolina Envirothon Program
PDF template
Comprehensive health and emergency contact form for documenting medical information and insurance details for program participants.
See template
See template
Release Of Liability, Promise Not To Sue, Assumption Of Risk And Agreement To Pay Claims
PDF template
A legal document that releases a university from liability for potential injuries or damages during an activity or related travel.
See template
See template
Youth Sports Medical History Form
PDF template
A comprehensive medical history form for youth sports participants, requiring detailed health information and medical practitioner verification.
See template
See template
Consulting Physician Compliance Form
PDF template
A comprehensive medical form for evaluating patient mental capacity and terminal disease status by consulting and attending physicians.
See template
See template
Episodic Medical Form
PDF template
A comprehensive medical intake form for students to document current health issues and medical history at Ramapo College's Health Services.
See template
See template
Emerging Printmakers Residency Application Form
PDF template
Application form for artists seeking a residency program at Print Arts Northwest for emerging printmakers.
See template
See template
Equipment Agreement Form
PDF template
Form for borrowing equipment from KC STEM Alliance, outlining rental terms, liability, and borrower responsibilities.
See template
See template
Equipment Booking Form And Hire Agreement
PDF template
A form for requesting and hiring equipment from Uralla Shire Council with terms and conditions for equipment use.
See template
See template
Club OwnedLeased Equipment Form
PDF template
A form for documenting recreational club equipment details including vehicle/equipment specifications and tracking information.
See template
See template
Outdoor Adventure Equipment Rental Agreement Form
PDF template
A rental agreement for outdoor adventure equipment provided by the University of Akron's Student Recreation and Wellness Services.
See template
See template
Accident Waiver, Release Of Liability And IndemnityHold Harmless Agreement For The Use Of Loaned Equ
PDF template
Legal document releasing White Lake Community Library from liability when borrowing and using library equipment
See template
See template
Waiver And Release Agreement
PDF template
A document allowing student photography and releasing the school district from liability for potential harm or damages.
See template
See template
Equitable Distribution Inventory Affidavit
PDF template
Legal document for disclosing assets and liabilities during divorce proceedings in North Carolina's district court system.
See template
See template
ERaf Request Form
PDF template
A form used by specialists to request an electronic Request for Authorization Form (eRAF) from Primary Care Providers for specialty care.
See template
See template
ERM 14 FormConfidential Request For Ownership Information
PDF template
A confidential form for reporting changes in business ownership, legal entity status, or organizational structure for workers compensation insurance purposes.
See template
See template
Applied Behavior Analysis (ABA) Clinical Service Request Form
PDF template
A form for requesting clinical services related to Applied Behavior Analysis treatment, used by Blue Cross Blue Shield of Texas for initial or concurrent treatment requests.
See template
See template
RETIREE INSURANCE ENROLLMENT FORM
PDF template
A form for Texas Employees Retirement System retirees to enroll in insurance and provide Medicare information
See template
See template
License Agreement
PDF template
A license agreement for artists submitting artwork to the Into the Pixel art exhibition, granting non-exclusive usage rights to the Entertainment Software Association.
See template
See template
2012 OPERS Prescription Plan Guide
PDF template
Guide for OPERS health care plan participants explaining prescription drug coverage options for Medicare-eligible members
See template
See template
Getting Started With Home Delivery From Express Scripts Pharmacy
PDF template
Comprehensive guide for managing prescription home delivery services through Express Scripts online platform and mobile app.
See template
See template
ESPEN RESEARCH FELLOWSHIPS 2020 APPLICATION FORM
PDF template
Application form for research fellowship funding from ESPEN, with detailed requirements for applicants and project details.
See template
See template
ESRD Incident Or Accident Report Form
PDF template
A detailed reporting form for documenting critical incidents or accidents in healthcare facilities, especially for End-Stage Renal Disease (ESRD) centers.
See template
See template
Community Grant Application Form
PDF template
A comprehensive application form for non-profit organizations seeking community grant funding for various programs and events in Estevan, Saskatchewan.
See template
See template
MEDICAL HISTORY FORM
PDF template
A comprehensive medical history form for patients aged 12 and older, used in combination with a referral form and unique reference number (URN).
See template
See template
SBA Event Participation Form
PDF template
A form for documenting participant details and expenses for an SBA event with required documentation for reimbursement.
See template
See template
Event Expense Reimbursement Form
PDF template
Form for reimbursing event expenses for approved sporting events at fire stations, with a $500 annual benefit maximum.
See template
See template
Event ParticipationRegistration Form
PDF template
A form for student organizations to document event details, participants, and obtain approval for campus activities.
See template
See template
Event Proposal Form
PDF template
A comprehensive form for military personnel to propose and plan squadron recreational and social events with detailed funding and activity breakdowns.
See template
See template
Events, Programs Special Projects Proposal Form
PDF template
A comprehensive form for submitting event, program, or project proposals at Seattle University School of Law with detailed guidelines and requirements.
See template
See template
Ski Area Release Agreement
PDF template
Legal document waiving liability for ski-related activities at Lake Louise Ski Area, covering potential injuries and property damage.
See template
See template
Park Space Event Use Inquiry
PDF template
Form for requesting permission to host an event in Henderson County parks and recreational spaces.
See template
See template
Waiver Form
PDF template
A legal document providing consent and releasing liability for participation in a St. Jude Children's Research Hospital event.
See template
See template
Piercing Consent Release Form
PDF template
Legal document providing informed consent for body piercing procedures, detailing risks and patient acknowledgments.
See template
See template
Parental Permission For A Minor To Participate In Research
PDF template
A consent form for parents to allow their high school junior to participate in a research study about student opinions on school start times.
See template
See template
Release Of All Claims
PDF template
Legal release form for participants of a community garden, acknowledging risks and waiving liability for potential accidents or injuries.
See template
See template
MEDICAL BENEFITS SUBSCRIBER CLAIM FORM
PDF template
A comprehensive medical insurance claim form for submitting healthcare reimbursement or coverage information.
See template
See template
Exchange Privilege Application
PDF template
A form for requesting policy exchanges between term life insurance policies without requiring evidence of insurability.
See template
See template
Southwestern Community College District Excursion Liability Release Agreement Form
PDF template
A liability release form for students participating in off-campus activities or field trips sponsored by Southwestern Community College District.
See template
See template
Primary Care EXERCISE CLINIC REFERRAL
PDF template
A medical referral form for patients seeking exercise physiology services, documenting health conditions and exercise participation eligibility.
See template
See template
Exercise Waiver And Release Form
PDF template
A legal document releasing fitness facilities or trainers from liability for potential injuries during exercise activities.
See template
See template
Major League Baseball Properties, Inc. License Agreement
PDF template
A license agreement granting rights to use Major League Baseball trademarks, logos, and likenesses for specified products and purposes.
See template
See template
Master Services Agreement
PDF template
An agreement between Chartis International and MMR Information Systems for providing electronic medical record storage services to insurance customers.
See template
See template
Catholic Identity Commitment Agreement
PDF template
Agreement defining the preservation of Catholic identity and ethical guidelines in the transfer of Catholic Medical Center's healthcare facilities to HCA.
See template
See template
Simple Inquiry Form
PDF template
A form for documenting basic contact inquiries and program-related interactions.
See template
See template
Exhibit Agreement And Inventory Form
PDF template
A form detailing terms and conditions for displaying exhibits in Hunter Library, including exhibitor responsibilities and liability waivers.
See template
See template
Washoe County Liability Property Loss Report Form
PDF template
A comprehensive form for reporting personal injuries, property damage, and county property losses in Washoe County.
See template
See template
Exhibition Inventory Form
PDF template
Document for tracking artwork details, lender information, and exhibition logistics for Murray State University art exhibitions.
See template
See template
Exhibition Loan Inventory Form
PDF template
A form for documenting artwork details for loan to an exhibition, including artwork specifications and valuation.
See template
See template
Notification Of Intent To Use Exhibitor Appointed Contractor
PDF template
Form for exhibitors to notify event management about using a non-official service contractor for an event
See template
See template
Liability Waiver Form
PDF template
A liability waiver form for exhibitors at conferences or events at the Hyatt Regency Newport, requiring insurance documentation and releasing Hyatt from potential claims.
See template
See template
G Adventures Confidential Medical Form
PDF template
A confidential medical form for travelers with pre-existing medical conditions to assess fitness for expedition travel.
See template
See template
Emergency ResponsePublic Safety Worker Incident Report Form
PDF template
A form for emergency response and public safety workers to document workplace exposure incidents and medical referral details.
See template
See template
Hazardous Exposure To Blood And Other Body Fluids
PDF template
Guidelines for managing accidental contact with human blood or body fluids in workplace and educational settings, including immediate response steps and responsibilities.
See template
See template
Exposure Incident Investigation Form
PDF template
A detailed form for documenting and investigating workplace exposure incidents, including route of exposure, materials involved, and prevention recommendations.
See template
See template
Form B Exposure Incident Report Form
PDF template
A form documenting potential medical exposure incidents for students during clinical training or placement.
See template
See template
Texas City ISD Extended Leave Request Form
PDF template
A form for employees to request extended leave with medical certification, to be submitted to Human Resources.
See template
See template
External Collaborator Requisition Form
PDF template
A form for documenting and tracking tissue sample shipments to the Human Tissue Resource Center at the University of Chicago.
See template
See template
Instructions For Application To Sell UnitedHealthcare Products
PDF template
Comprehensive guide for external producers seeking authorization to sell UnitedHealthcare insurance products and become appointed agents.
See template
See template
Laser Eye Examination Form
PDF template
Medical form for documenting laser user eye examination and medical history related to laser exposure risks.
See template
See template
Out Of Network Vision Services Claim Form
PDF template
A claim form for submitting out-of-network vision services reimbursement to First American Administrators for EyeMed Vision Care plans.
See template
See template
EnrollmentChange Form
PDF template
A form for enrolling or changing employee and family insurance coverage with Fidelity Security Life Insurance Company.
See template
See template
EnrollmentChange Form
PDF template
Insurance enrollment and change form for employees and their family members, underwritten by Fidelity Security Life Insurance Company.
See template
See template
Out Of Network Claim Form
PDF template
A form for EyeMed Vision Care members to submit claims for out-of-network vision care services and receive reimbursement.
See template
See template
CCP Prior Authorization Request Form
PDF template
A form for healthcare providers to submit prior authorization requests for medical services or treatments through Texas Medicaid Health and Human Services.
See template
See template
OTHER INSURANCE FORM
PDF template
A form for collecting details about additional insurance coverage for a Medicaid client
See template
See template
Employer Health Insurance Verification Individual Follow Up Health Insurance Information
PDF template
A form for employers to verify health insurance benefits offered to employees and their families for BadgerCare Plus applicants.
See template
See template
LEAP Testing Service Sample Submission Form
PDF template
A form for submitting test samples to LEAP Testing Service for various scientific and medical testing purposes.
See template
See template
Consent For Sterilization Completion Instructions
PDF template
Detailed instructions for completing a mandatory consent form for sterilization procedures under Wisconsin's ForwardHealth program.
See template
See template
PDP Prescription Reimbursement Request Form
PDF template
A form for members to request reimbursement for prescription medications purchased at retail cost when standard prescription drug coverage was not used.
See template
See template
All Of Us Research Program Sample Consent Form
PDF template
A consent form for participating in a large-scale health research program funded by the U.S. government to collect health data from 1 million participants.
See template
See template
Medical Dental Time Loss Claim Form
PDF template
A comprehensive medical claim form for employees and dependents to submit healthcare and time loss claims.
See template
See template
Dual Option Enrollment Form
PDF template
An enrollment form for dental insurance coverage through Transport Workers Union, Local 100, allowing members to select dental plans and add dependents.
See template
See template
F245 145 000 Travel Reimbursement Request
PDF template
A form for workers to request travel expense reimbursement related to workers' compensation medical visits, treatments, or vocational services.
See template
See template
General Provider Billing Manual
PDF template
Comprehensive guide for healthcare providers on billing procedures for workers' compensation and crime victims services in Washington state.
See template
See template
Puget Sound Benefits Trust Short Term Disability Claim Form
PDF template
A comprehensive form for employees to file a short-term disability claim, requiring details from the employee, employer, and attending physician.
See template
See template
F262 024 000 Claims Suppression Complaint Form
PDF template
A form for reporting potential claims suppression by employers in workers' compensation cases.
See template
See template
Medical Dental Vision Prescription Weekly Disability Claim Form
PDF template
Comprehensive claim form for medical, dental, vision, prescription, and weekly disability benefits for NW Plumbers & Pipefitters Health Fund members.
See template
See template
Enrollment Form F33
PDF template
Comprehensive enrollment form for employees to register dependents and update personal information for benefit plans
See template
See template
Form 433 H
PDF template
Internal Revenue Service form for requesting an installment agreement for tax liabilities over $50,000 or unpayable within 72 months.
See template
See template
Disability Claim Form
PDF template
A comprehensive form for submitting a disability insurance claim, covering coverage information, work schedule, and earnings details.
See template
See template
Western Metal Industry Pension Fund Pre Retirement Death Application
PDF template
A form for surviving spouses to apply for pension benefits after the death of a participant in the Western Metal Industry Pension Fund.
See template
See template
Comprehensive Medical Examination Checklist
PDF template
A medical examination checklist for pilots seeking to operate small aircraft under BasicMed regulations in lieu of a third-class FAA medical certificate.
See template
See template
Huntsville Public Library Standard Rental Agreement Form
PDF template
A comprehensive form for renting rooms and facilities at the Huntsville Public Library, including event details, insurance requirements, and payment information.
See template
See template
FCPRD Program Refund Policy
PDF template
Detailed guidelines for program fee refunds and emergency warning procedures in Fayette County Parks and Recreation areas.
See template
See template
Facility Rental Application
PDF template
Application for renting park district facilities including rooms, pavilions, fields, and courts with pricing and rental details.
See template
See template
Owen County Family YMCA Room Rental Application Form
PDF template
Application and liability waiver for renting rooms at the Owen County Family YMCA, including rental terms and liability release.
See template
See template
Facilities Rental Agreement
PDF template
Rental agreement for reserving community facilities such as pavilions and recreation halls in Stephenville for events.
See template
See template
Facility Request Contacts
PDF template
Directory of contact information and reservation details for various campus facilities including academic, athletic, and recreational spaces.
See template
See template
Domestic Academic Student Travel Waiver Form
PDF template
A legal waiver document for students participating in academic field trips or off-campus activities, outlining risk assumptions, medical consent, and vehicle use conditions.
See template
See template
FACULTY LEAVE AND CLINIC CANCELLATION FORM
PDF template
A form for faculty members to request leave, vacation, or clinic cancellations in the Division of Endocrinology and Metabolism.
See template
See template
Faculty Leave And Clinic Cancellation Form
PDF template
A form for faculty members to request leave, cancel clinics, and arrange coverage in the Division of Endocrinology and Metabolism.
See template
See template
UNIVERSITY OF PUGET SOUND FACULTY LEAVE REQUEST FORM
PDF template
A comprehensive form for faculty members to request various types of leave, including medical, family, parental, and extended leaves.
See template
See template
Exhibitor Appointed Contractors (EACs)Third Party Contractor Guidelines
PDF template
Comprehensive guidelines for exhibitors using third-party contractors for booth installation, dismantling, and services at a trade show event.
See template
See template
Westtown Township Health And Fitness Registration And Insurance Form
PDF template
Registration form for fitness programs with health history and medical information collection
See template
See template
Fall 2016 Afterschool Registration
PDF template
Registration form for afterschool programs with details on enrollment, payment, and policies for the Fall 2016 semester.
See template
See template
Community Gallery Proposal Form
PDF template
Application form for non-profit organizations seeking to exhibit artwork in a community gallery space
See template
See template
Employee Medical Or Family Leave Of Absence Request Form
PDF template
A form for employees to request medical or family leave, indicating type and reason for absence
See template
See template
Family And Medical Leave Request Form
PDF template
A comprehensive form for employees to request unpaid family and medical leave under federal FMLA guidelines, detailing leave entitlements and notice requirements.
See template
See template
Family And Medical Leave (FML) Reference Chart
PDF template
Comprehensive reference guide for family and medical leave policies covering federal and California leave regulations for employees.
See template
See template
Family Camp Medical Form
PDF template
Medical form for capturing health details and emergency contact information for families attending a camp
See template
See template
Family Contact Form
PDF template
Form for collecting comprehensive contact and insurance details for a client's family members and guardians.
See template
See template
Park Approval Form
PDF template
Documentation for local BSA council's approval of camping sites, verifying safety, facilities, and program standards for Cub Scout pack camping.
See template
See template
FAMILY EMERGENCY CONTACT FORM
PDF template
A comprehensive document listing essential emergency contacts and insurance information for family disaster preparedness.
See template
See template
Family Emergency Plan
PDF template
A comprehensive document for recording family medical details, emergency contacts, and critical health information for emergency preparedness.
See template
See template
NECAIBEW Family Medical Care Plan Family Enrollment Form
PDF template
An enrollment form for employees to enroll in the NECA/IBEW Family Medical Care Plan, including personal, spousal, and dependent information.
See template
See template
YMCA OF ORANGE COUNTY Family Guides (Program Registration)
PDF template
Registration form for the YMCA Family Guides Program in Orange County, allowing families to sign up for program membership and events.
See template
See template
Family Medical History Form
PDF template
A comprehensive form for documenting family medical history across multiple health conditions and genetic risks.
See template
See template
Michigan Department Of Natural Resources Annual Family Membership Application
PDF template
Annual family membership application for the Michigan Department of Natural Resources Outdoor Adventure Center, allowing up to five family members free admission for one year.
See template
See template
Family Or Medical Leave Request Form
PDF template
A form for employees to request medical or family leave, including documentation of leave type and duration.
See template
See template
Degree Evaluation Program Assessment Form
PDF template
A form for students to request evaluation of their academic program, course completion, and potential degree program changes.
See template
See template
New Medical Form Consent Form FAQ
PDF template
Explanation of changes to Special Olympics Illinois medical documentation requirements including new Medical Form and Consent Form procedures.
See template
See template
FAQs About Affordable Care Act Implementation Part 31, Mental Health Parity Implementation, And Wome
PDF template
Frequently Asked Questions regarding implementation of market reform provisions in healthcare, covering preventive services, mental health parity, and women's health rights.
See template
See template
FAQs About Affordable Care Act Implementation Part 31, Mental Health Parity Implementation, And Wome
PDF template
Guidance document providing frequently asked questions about preventive services coverage under the Affordable Care Act, Mental Health Parity Act, and Women's Health and Cancer Rights Act.
See template
See template
FAQs CVS Caremark Pharmacy Transition
PDF template
Frequently asked questions about prescription drug benefits transition from Medco to CVS Caremark for PERS Select/Choice/Care members.
See template
See template
Farm Emergency Contact Form
PDF template
A comprehensive emergency contact and insurance information form for farm operations, listing critical emergency and support service contacts.
See template
See template
Farm Emergency Contact Form
PDF template
Comprehensive form for documenting emergency contacts, insurance policies, and critical service providers for a farm operation.
See template
See template
FAX REFERRAL FORM
PDF template
A medical referral form for patients seeking low vision rehabilitation services in Colorado.
See template
See template
Urogynecology New Patient Intake Form
PDF template
Comprehensive medical intake form for urogynecology patients to document urinary and bowel symptoms, medical history, and patient goals.
See template
See template
Cancellation Form
PDF template
A form for subscribers to cancel their health or dental insurance coverage with Farm Bureau Health Plans.
See template
See template
Retiree Enrollment Form
PDF template
Enrollment form for Fulton County retirees to select health and dental plan coverage options and update personal information.
See template
See template
INCLUSA CLAIM FORM
PDF template
A claim form for submitting healthcare service claims to Inclusa Family Care through WPS Health Insurance.
See template
See template
BioDynamic Manual Therapy, LLC Patient Questionnaire
PDF template
Comprehensive medical intake form for collecting patient health history, current symptoms, and personal health details
See template
See template
Claim For Dismemberment Benefits
PDF template
A federal employee insurance claim form for documenting loss of limb or eyesight benefits under the Federal Employees' Group Life Insurance Program.
See template
See template
OWCP 92 Uniform Billing Form
PDF template
Guidelines for submitting medical service bills for federal employees under compensation programs related to work-related injuries and occupational illnesses.
See template
See template
Feedback Form
PDF template
A form for collecting customer feedback about the Upper Valley Aquatic Center's services and facilities.
See template
See template
Example Of Fellowship Application Form
PDF template
A comprehensive application form for fellowship candidates in preventive cardiology or related medical disciplines.
See template
See template
MSKCCWeill Cornell Procedural Dermatology Fellowship Application
PDF template
Application form for fellowship in Procedural Dermatology at Memorial Sloan-Kettering Cancer Center and Weill Cornell Medical Center.
See template
See template
MSKCCWeill Cornell Procedural Dermatology Fellowship Application
PDF template
Application form for a procedural dermatology fellowship at Memorial Sloan-Kettering Cancer Center and Weill Cornell Medicine.
See template
See template
CIRSE Fellowship Information And Application
PDF template
Comprehensive guidelines for physicians and scientists seeking CIRSE Fellowship status in interventional radiology and cardiovascular imaging.
See template
See template
Standardized Application For Pathology Fellowships
PDF template
Comprehensive application form for pathology fellowship candidates covering personal details, education, and fellowship preferences.
See template
See template
NATIONAL FLOOD INSURANCE PROGRAM PUBLICATIONS ORDER FORM
PDF template
Order form for free publications from the National Flood Insurance Program covering flood insurance resources and materials.
See template
See template
Patient Intake Form
PDF template
Comprehensive intake form for collecting patient personal, contact, and medical background information with emphasis on privacy and demographic details.
See template
See template
Health Benefits Claim Form
PDF template
A comprehensive form for submitting health insurance benefits claims, including patient and insurance information.
See template
See template
Nebraska FFA Association Medical Release Form
PDF template
A comprehensive medical consent and emergency contact form for FFA members, allowing parental consent for medical treatment and providing essential health information.
See template
See template
ACCIDENT WAIVER AND RELEASE OF LIABILITY FORM
PDF template
A comprehensive legal document that releases liability for participants in various group activities and events.
See template
See template
FHNO Indus Institutional Fellowship (FIIF) Application Form 2024
PDF template
Application form for medical professionals seeking to apply for the FHNO Indus Institutional Fellowship for the 2024 batch.
See template
See template
Fora Health Residential Referral Form
PDF template
Comprehensive referral form for admitting patients into Fora Health's residential treatment program with detailed guidelines and requirements.
See template
See template
Preparticipation Physical Evaluation Medical History Form
PDF template
Comprehensive medical history form for students participating in sports, requiring detailed health information and medical evaluation
See template
See template
Medical History Form
PDF template
Comprehensive medical history and health screening form for student-athletes to assess fitness for sports participation
See template
See template
Our Faireld Village Ideas And Colouring Competition
PDF template
A community engagement competition inviting residents to submit ideas and participate in a colouring contest for Fairfield Village.
See template
See template
Carbondale Parks And Recreation Town Park Athletic Field, Tennis Or Pickleball Court, Bike Skate P
PDF template
Permit for private or commercial reservations of Town Park facilities including open spaces, pavilions, athletic fields, and recreational areas.
See template
See template
MultidayRecurring Field Rental Agreement
PDF template
Comprehensive rental agreement detailing rules, payment, scheduling, and requirements for field usage at Ford Park.
See template
See template
2024 Athletic Field Rental Application Agreement
PDF template
Application for renting athletic fields in the Borough of Riverdale, including details about field usage and rental requirements.
See template
See template
MIRACOSTA COMMUNITY COLLEGE DISTRICT EXCURSION LIABILITY RELEASE And AGREEMENT
PDF template
A comprehensive form outlining guidelines and requirements for field trip participation at MiraCosta Community College District.
See template
See template
Release Of Liability, Waiver Of Right To Sue, Assumption Of Risk And Agreement To Pay Claims
PDF template
A legal document that releases California State University from liability for potential injuries or damages during an activity or event.
See template
See template
Release Of Liability, Waiver Of Claims, Express Assumption Of Risks, And Hold Harmless Agreement
PDF template
Legal document releasing Florida Atlantic University from liability for potential risks and damages during a field trip.
See template
See template
FIELD TRIPTRANSPORTATION PERMISSION AND WAIVER FORM
PDF template
A legal document granting permission for student participation in a field trip while releasing the school from potential liability.
See template
See template
Adult Tuberculosis (TB) Risk Assessment Questionnaire
PDF template
A medical screening form for assessing tuberculosis risk in adults, required by California Education and Health Codes.
See template
See template
2023 Open Competition Entry Form
PDF template
Entry form for multiple golf competitions at Grantown on Spey Golf Club in 2023, including various open tournaments for men, women, and mixed teams.
See template
See template
UHC WTIA (EnrollCancelWaiverChanges)
PDF template
A comprehensive form for employees to enroll, modify, or cancel health insurance benefits and personal information.
See template
See template
YMCA Camp Independence 2024 Health History And Examination Form
PDF template
Medical form for collecting camper health information and emergency contact details for YMCA summer camp participation.
See template
See template
2022 Redwood Recreation Center Rental Request Form
PDF template
A form for requesting rental space at the Redwood Recreation Center for various events and activities.
See template
See template
Artist Release, Waiver Of Liability Loan Agreement
PDF template
Legal document outlining terms for an artist loaning artwork to the Children's Museum of Oak Ridge for a temporary exhibition.
See template
See template
BUILDER NOMINATION FORM
PDF template
Official nomination form for recognizing builders and contributors to sports achievements in the Bobby Orr Hall of Fame
See template
See template
Companion Agreement Form
PDF template
A form for requesting the use of a companion during participation in Prince George's County Parks and Recreation programs and events.
See template
See template
Patient Demographics Form
PDF template
Comprehensive medical intake form collecting patient personal, contact, insurance, and consent information for healthcare services.
See template
See template
Declaration Of Academic Program
PDF template
Academic form for students to declare their career and technical degree or certification program at ECC.
See template
See template
APPLICATION FOR EMPLOYMENT
PDF template
A comprehensive employment application form for potential job candidates seeking employment with the Port of Port Angeles.
See template
See template
Enrollment Form
PDF template
Comprehensive form for enrolling a child in childcare, collecting personal information, emergency contacts, and health details.
See template
See template
InternExtern Application Packet
PDF template
Application for internship and externship opportunities at Elica Health Centers, focusing on medical, dental, and behavioral health fields.
See template
See template
Facility Rental Agreement
PDF template
A rental agreement for using museum facilities, outlining terms, fees, and liability conditions for event spaces.
See template
See template
APPLICATION AND AGREEMENT FOR USE OF SWIMMING POOLS
PDF template
Application form for renting city swimming pools for events or parties, including permit details and usage fees.
See template
See template
Client Financial Responsibility Agreement
PDF template
A comprehensive agreement outlining financial responsibilities and payment terms for clients receiving services from The Wellness Centre.
See template
See template
Humboldt County Referral Initiative Referral Form
PDF template
A comprehensive medical referral form for transferring patient information between healthcare providers with multiple referral type options.
See template
See template
Volunteer Orientation
PDF template
A comprehensive orientation document for college students interested in volunteering at a physical therapy clinic to gain healthcare experience and learn about the profession.
See template
See template
HONOURARY MEMBER NOMINATION FORM
PDF template
A form used to nominate individuals for honorary membership in the Bobby Orr Hall of Fame, requiring detailed personal and nomination information.
See template
See template
ASHN North American Championship 2009 Hotel Audit Form
PDF template
Form for recording team hotel accommodations and guest details for sports championship event
See template
See template
ClaimIncident Report Form
PDF template
A comprehensive form for documenting insurance claims, liability incidents, and property damage details.
See template
See template
Volunteer Indemnity Agreement
PDF template
Legal document indemnifying Bay Cliff Health Camp against liability for volunteer injuries or losses during camp activities.
See template
See template
PRODUCER AGREEMENT
PDF template
A legal agreement between KIS Surety Bonds, LLC and an independent insurance producer defining their business relationship and operational responsibilities.
See template
See template
Patient Medical History And Symptoms Form
PDF template
A detailed medical intake form capturing patient demographics, ethnicity, race, symptoms, and previous diagnostic studies and treatments.
See template
See template
Massachusetts Collaborative Behavioral Health Level Of Care Request Form
PDF template
A comprehensive form for requesting behavioral health services and documenting patient clinical information for insurance and treatment purposes.
See template
See template
Medical Report Health Statement And Immunizations For 2023 2024
PDF template
Medical form for documenting student health status and required immunizations for St. Paul's School enrollment
See template
See template
Medical Freeze Request Form
PDF template
A form for requesting a temporary freeze on a membership due to medical reasons with specific conditions and documentation requirements.
See template
See template
MEDICAL HISTORY FORM
PDF template
Comprehensive medical history form for capturing patient health information, medical conditions, lifestyle factors, and current health concerns.
See template
See template
Medical Information Form
PDF template
A comprehensive medical form for students to provide health information, medication details, and parental consent for school medical procedures.
See template
See template
2024 25 PermissionWaiver Emergency Information Form Minor
PDF template
A comprehensive form for minor participants to provide emergency contact information and release liability for church activities
See template
See template
NEW CLIENT INFORMATION PAYMENT AGREEMENT
PDF template
A veterinary hospital intake form for new clients to provide personal and pet information along with payment terms.
See template
See template
New Patient Intake Form
PDF template
Comprehensive intake form for new patients seeking cosmetic procedures, collecting personal information and medical history.
See template
See template
FILLABLE ORDER FORM FOR SFP 7 17 CURRICULUM AND MATERIALS
PDF template
Order form for purchasing Strengthening Families Program curriculum materials and resources for the 7-17 age group.
See template
See template
Osteopathy Patient Intake Form
PDF template
Comprehensive medical intake form for osteopathic patient assessment and medical history documentation.
See template
See template
Participant Declaration Form
PDF template
A formal document for organizations to declare their commitment, contributions, and compliance for a collaborative project.
See template
See template
Patient Information For Appointment Booking
PDF template
A comprehensive patient intake form for medical appointment booking at Peninsula Gastroenterology, collecting personal and medical contact details.
See template
See template
PATIENT REFERRAL FORM
PDF template
A comprehensive form for referring veterinary patients to specialized veterinary services and departments.
See template
See template
Patient Registration Form
PDF template
Comprehensive medical intake form for collecting patient personal information, emergency contact details, insurance information, and health history.
See template
See template
Pharmacy Payment Plan Agreement
PDF template
Payment agreement form for managing pharmacy account balances and establishing payment schedules for outstanding medical charges.
See template
See template
Arizona JKA 2024 Summer Payson Camp Waiver Form
PDF template
Legal document releasing liability for participation in martial arts training and activities, acknowledging inherent risks of physical injury.
See template
See template
PATIENT INTAKE FORM
PDF template
Comprehensive medical form for collecting patient health history, contact information, and medical background details.
See template
See template
Patient Discharge Form
PDF template
A standardized form for documenting patient discharge details, treatment status, and medical recommendations.
See template
See template
Portage Pool Booking Request Form
PDF template
Form for requesting and booking facility rentals at Portage Pool, including pricing details for various pool spaces and services.
See template
See template
Santee Recreation Registration Form
PDF template
Registration form for participants to sign up for recreation activities in the City of Santee, including personal and medical information.
See template
See template
Sports Participant Waiver Form
PDF template
Legal waiver for participants in sports activities, releasing the organization from liability for potential injuries or damages.
See template
See template
Immunization Consent Form
PDF template
A comprehensive form for collecting patient demographic, insurance, and consent information for immunization services.
See template
See template
Waiver Form
PDF template
A liability waiver form for user groups utilizing School District No. 5 (Southeast Kootenay) properties and facilities.
See template
See template
CLARK COUNTY SCHOOL DISTRICT VOLUNTEER WAIVER AND RELEASE
PDF template
Legal document releasing Clark County School District from liability for volunteer activities and potential risks during service.
See template
See template
Membership Form
PDF template
Application form for joining the Woodbridge Pickleball Club, a non-profit organization dedicated to pickleball recreation and competitive play.
See template
See template
Annual Report Form For Administrators
PDF template
Annual reporting form for insurance administrators holding a certificate of authority under Texas Insurance Code Chapter 4151
See template
See template
Dental Patient Information Form
PDF template
Comprehensive form for collecting patient personal, dental, and insurance information for dental services.
See template
See template
Kentucky FAIR Plan Reinsurance Association Homeowner Manual
PDF template
Comprehensive manual for homeowner insurance policies and guidelines issued by the Kentucky FAIR Plan Reinsurance Association.
See template
See template
Healthcare Forms Catalog
PDF template
Comprehensive list of medical forms and clinical documentation used across various healthcare departments and specialties.
See template
See template
Paths To Health NM Tools For Healthier Living Referral Form
PDF template
A referral form for participants to join Paths to Health NM health programs with provider contact information.
See template
See template
Contract Types And Required Documents
PDF template
Guidelines for required documentation for different types of consultant agreements based on contractor status and licensing
See template
See template
Financial Aid Request Form Redding Park Recreation
PDF template
A document outlining the process for requesting financial aid for local park and recreation programs in Redding, Connecticut.
See template
See template
Financial Assistance Application Form
PDF template
A confidential form for patients seeking financial assistance, requiring detailed personal and income information for healthcare services.
See template
See template
Financial Assistance Evaluation
PDF template
Application form to help patients determine eligibility for free or discounted healthcare services and public assistance programs.
See template
See template
City Of Duluth Parks Recreation Fee Assistance Application
PDF template
Application for Duluth residents to receive financial assistance for recreation program fees based on income and eligibility criteria.
See template
See template
Suburban Urologic Associates Financial Policy
PDF template
Detailed financial policy outlining insurance, payment, and billing procedures for a urology medical practice.
See template
See template
Type 2 Diabetes Risk Assessment Form
PDF template
A comprehensive questionnaire to assess an individual's risk of developing type 2 diabetes within the next 10 years.
See template
See template
FinlandS Response To Questionnaire On Social Protection Of Older Persons
PDF template
Comprehensive document detailing Finland's legal framework for pension and social protection systems for older persons, covering national and employment-based pension schemes.
See template
See template
First Book Liability And Media Release Form
PDF template
A legal document providing liability waiver and media release for participants in First Book events, particularly for minors.
See template
See template
SAFE SPORT INCIDENT REPORT FORM
PDF template
A form for reporting various types of misconduct within First Tee organization, including child abuse, harassment, and other inappropriate behaviors.
See template
See template
First Time Appointment Billing Form
PDF template
A billing form for documenting client details, service type, and appointment information for a first-time healthcare consultation.
See template
See template
Fisher House Of The Emerald Coast, Inc. Edible Art Cake Decorating Contest General Competition And
PDF template
Competition guidelines for an annual cake decorating contest with a superhero theme, hosted by Fisher House of the Emerald Coast.
See template
See template
Fitness Center Use Agreement And Release Of Liability
PDF template
Legal document outlining liability release and risk assumption for using a fitness center facility in Walnut Creek, California.
See template
See template
Shepherd Village Fitness Centre Information Form
PDF template
Comprehensive guide for membership, fees, and usage of the Shepherd Village Fitness Centre for residents, staff, and community members.
See template
See template
Fitness Class Registration Form
PDF template
Registration form for various fitness classes offered by Fermilab including abs, muscle toning, and yoga classes
See template
See template
Fitness Class Registration Form
PDF template
Registration form for fitness classes at Fermilab including abs, muscle toning, and yoga classes with session details and pricing.
See template
See template
FITNESS INSTRUCTORPERSONAL TRAINER Insurance Program And Enrollment Form
PDF template
Insurance program designed for U.S.-based fitness instructors providing coverage for personal training and exercise activities.
See template
See template
Management Benefits Fund (MBF) Health And Fitness Reimbursement Program Claim Form
PDF template
A form for MBF members to claim reimbursement for health and fitness expenses for themselves and their spouse/domestic partner.
See template
See template
HealthFitness Center Reimbursement Form
PDF template
A form for Capital Health Plan members to request reimbursement for health and fitness center memberships up to $150 per family or member.
See template
See template
Fitness Benefit Coverage Form Instructions
PDF template
Instructions and form for members to request reimbursement for fitness-related expenses through their health plan
See template
See template
Fitness Studio Membership Form
PDF template
A membership form for joining the Wood Dale Park District Fitness Studio with membership options and liability waiver.
See template
See template
Group Fitness Pass Student Billing Form
PDF template
A form for students to purchase an unlimited semester group fitness class pass charged to their student bill.
See template
See template
Group Fitness Pass Student Billing Form
PDF template
Form for students to purchase unlimited access to group fitness classes with billing through student account
See template
See template
Standard Immunization Requirements For Admission To U.S. Schools
PDF template
A comprehensive medical form documenting vaccination history and requirements for students entering U.S. schools or programs
See template
See template
Reimbursement Form For Flexible Spending Account (FSA)
PDF template
Form for employees to request reimbursement for healthcare and dependent care expenses through a Flexible Spending Account.
See template
See template
MEDICAL FLEX REIMBURSEMENT FORM
PDF template
A form for employees to request reimbursement for medical and dental expenses through a flexible spending account program.
See template
See template
MINORS ONLY FLOWRIDER ARBITRATION AGREEMENT
PDF template
Legal document outlining risks and arbitration terms for minors participating in the FlowRider water amusement ride.
See template
See template
Privacy Impact Assessment For Federal Long Term Care Insurance Program (FLTCIP) System
PDF template
Assessment of privacy considerations for the Federal Long Term Care Insurance Program's system that manages insurance enrollment and claims for federal employees and uniformed service members.
See template
See template
FLUOROSCOPY AND INTERVENTIONAL REQUISITION
PDF template
Comprehensive form for requesting medical imaging procedures, capturing patient details, medical history, and clinical information.
See template
See template
Flu Vaccine Form
PDF template
A comprehensive form for patient consent and medical screening prior to receiving a flu vaccine.
See template
See template
Fly Tying Competition Entry Form 202324
PDF template
Official entry form for submitting fly tying competition entries with publication consent requirements.
See template
See template
Informed Consent To Tattoo Procedure
PDF template
A legal form for documenting informed consent and required patron information before receiving a tattoo procedure in Wisconsin.
See template
See template
TEST REQUISITION FORM
PDF template
Medical test requisition form for transplant patient diagnostic testing with comprehensive patient and billing information collection.
See template
See template
Form FMC 67 Ocean Transportation Intermediary (OTI) Insurance Form
PDF template
Insurance form certifying financial responsibility for ocean transportation intermediaries under the Shipping Act of 1984.
See template
See template
Hospital Discharge Plan For Tuberculosis Patients
PDF template
Comprehensive discharge planning document for patients being treated for tuberculosis, including medical details and follow-up instructions.
See template
See template
FMLA Leave Request Form
PDF template
A form for employees to request Family and Medical Leave Act (FMLA) leave, outlining eligibility requirements and leave types.
See template
See template
Requisition For Laboratory Supplies
PDF template
A form for requesting laboratory media, collection kits, supplies, laboratory forms, and reagents from Sacramento County Public Health Laboratory.
See template
See template
Employee FMLA Leave Request
PDF template
Form for employees to request job-protected leave under the Family and Medical Leave Act (FMLA) for various family and medical reasons.
See template
See template
FMLA LEAVE REQUEST FORM
PDF template
A comprehensive form for employees to request leave under the Family and Medical Leave Act for various personal and family medical situations.
See template
See template
FMLA Leave Request Form
PDF template
A form for Harnett County employees to request Family and Medical Leave Act (FMLA) protected leave for various qualifying reasons.
See template
See template
Family And Medical Leave Request
PDF template
Employee form for requesting job-protected medical or family leave under the Family and Medical Leave Act (FMLA)
See template
See template
FAMILY OR MEDICAL LEAVE REQUEST FORM
PDF template
A form for employees to request family or medical leave for various personal and family health-related reasons.
See template
See template
FMLA LEAVE REQUEST FORM
PDF template
A form for employees to request leave under the Family and Medical Leave Act for various personal and family health-related reasons.
See template
See template
HR FMLAOFLA Leave Request
PDF template
A comprehensive form for employees to request leave under Family and Medical Leave Act (FMLA) and Oregon Family Leave Act (OFLA)
See template
See template
Family And Medical Leave (FML)Paid Parental Leave (PPL) Request Form
PDF template
A form for employees to request family and medical leave or paid parental leave, including various qualifying reasons for absence.
See template
See template
Family And Medical Leave Request
PDF template
Request form for employees seeking job-protected leave under the Family and Medical Leave Act (FMLA) for medical or family reasons.
See template
See template
FARTHEST NORTH PICKLEBALL CLUB MEMBERSHIP FORM
PDF template
Membership registration form for the Farthest North Pickleball Club with liability waiver and annual dues information.
See template
See template
FOOD POLICY WAIVER OF LIABILITY FORM
PDF template
A form for event organizers to acknowledge responsibility for food preparation, safety, and liability when catering non-university events.
See template
See template
NHDP Form 133 Foot Evaluation
PDF template
Comprehensive medical form for assessing foot condition, nerve function, sensation, and risk categorization.
See template
See template
FOOT Medical And Insurance Form
PDF template
Medical and insurance form for participants in the Yale First-Year Outdoor Orientation Trips (FOOT) program, collecting health and emergency contact information.
See template
See template
Accident Waiver And Release Of Liability Form
PDF template
Legal document releasing St. Vincent de Paul from liability for potential injuries during charity walk/run event
See template
See template
FORAY CHECK INCHECK OUT FORM
PDF template
Waiver and check-in form for participants in mycological society mushroom forays, capturing participant details and liability release.
See template
See template
Student Travel Profile General Liability Waiver
PDF template
A comprehensive waiver and medical procedure document for students participating in a mission trip, covering liability release and medical emergency protocols.
See template
See template
Application For Foreign Travel (TAPP 3 03)
PDF template
Official form for U.S. Soccer teams requesting international travel authorization for tournaments or games
See template
See template
International Travel Waiver Form
PDF template
A consent form allowing parent/guardian permission for a minor to participate in an international travel event, including liability release and emergency medical consent.
See template
See template
Foreign Travel Insurance Guidelines For STUDENTS
PDF template
Guidelines for foreign travel insurance coverage for California State University students traveling domestically or internationally.
See template
See template
Foresight Carrier Screen Requisition Form
PDF template
A medical form for requesting genetic carrier screening, collecting patient and clinic information, and processing billing details.
See template
See template
TxDOT Form 1560 Certificate Of Insurance
PDF template
An official form for contractors to provide proof of required insurance coverage for TxDOT contracts.
See template
See template
2024 25 CONSENT TO TREAT FORM
PDF template
A form providing parental consent for sports medicine services for minor athletes participating in interscholastic activities.
See template
See template
LASER DEVICE REGISTRATION FORM
PDF template
Official form for registering laser devices with the Florida Department of Health Bureau of Radiation Control.
See template
See template
NEW PATIENT INSURANCE AND OFFICE POLICIES CONSENT FORM
PDF template
A comprehensive form for collecting patient personal, insurance, and medical history information for dental office registration.
See template
See template
Expenditure Approval Form 201
PDF template
A form for South Carolina fire departments to request approval for utilizing local Firemen's Inspection Fund expenses
See template
See template
PGA Professional Golf Management Program Application
PDF template
An application form for individuals seeking to join the PGA Professional Golf Management Program, outlining pre-requisites, documentation requirements, and eligibility criteria.
See template
See template
Form 245b (I) British Skydiving Display Risk Assessment Form
PDF template
A comprehensive risk assessment form for skydiving display teams to evaluate potential hazards and safety measures.
See template
See template
Form 245b (I) British Skydiving Display Risk Assessment Form
PDF template
A comprehensive risk assessment form for evaluating safety and potential hazards in skydiving display activities.
See template
See template
Form 274A
PDF template
Entry form for British Skydiving sporting competitions, covering various accuracy landing events and skill levels.
See template
See template
FORM 28C
PDF template
A North Carolina Industrial Commission form for reporting workers' compensation settlement details and payments.
See template
See template
Johnson Wales University Health Services Requirements
PDF template
Comprehensive health documentation and vaccination requirements for new students enrolling at Johnson & Wales University
See template
See template
Form 350 Emergency Medical Service Provider Exposure Report Form
PDF template
A form to document exposure to blood and body fluids for emergency medical service providers, tracking details of potential occupational health incidents.
See template
See template
HFM Study Form 607 Mailing Blood To NIDDK DNA Repository Form
PDF template
A form for mailing blood samples to the NIDDK DNA Repository with specific shipping and tracking instructions.
See template
See template
Form 6.4.2.2 Rev. D Service Request Form
PDF template
A form for submitting medical devices for service or repair, requiring verification of decontamination and cleaning.
See template
See template
Acceptance Of Site Specific Health And Safety Plan (SSHASP) Form
PDF template
Internal form for documenting compliance and acceptance of a contractor's site-specific health and safety plan by an NJSDA Field Compliance Inspector.
See template
See template
Report Of Job Injury Or Illness
PDF template
A form for workers to report work-related injuries or illnesses to their employer and SAIF Corporation.
See template
See template
Adult Recreation Programs Release, Indemnification Medical Form
PDF template
Legal release and assumption of risk form for adult participants in Bainbridge Island Metropolitan Park & Recreation District programs.
See template
See template
UAB Department Of Obstetrics And Gynecology Presentation Evaluation Form
PDF template
A form for evaluating the effectiveness of presentations within the UAB Obstetrics and Gynecology department.
See template
See template
Medical Claim Form
PDF template
A comprehensive form for submitting medical claims and patient information to Anthem Blue Cross and Blue Shield insurance plan.
See template
See template
OBGYN Formative Feedback Form
PDF template
A comprehensive evaluation form for tracking medical student performance in OBGYN clinical rotation, covering multiple professional and clinical competencies.
See template
See template
Health Exam Form B
PDF template
A medical form for student athletes to obtain health clearance for participation in school athletic activities in Utah.
See template
See template
Credit Card Pre Authorization ACH Pre Authorization Form
PDF template
A form allowing patients to pre-authorize credit card or bank account charges for medical services and outstanding balances.
See template
See template
Medical ControlPhysician Contact Hour Attendance Form
PDF template
Tracking form for medical personnel to document attendance and details of training sessions for emergency medical services.
See template
See template
Form C Student Waiver Form
PDF template
A legal document outlining conditions and medical treatment provisions for students performing services at Rutgers University.
See template
See template
Accident Report Form
PDF template
Comprehensive form for documenting details of a vehicle accident involving a mini-bus, including vehicle information, witness details, and incident description.
See template
See template
Informed Risk Insurance Form For Allied Health Students
PDF template
A form documenting student awareness of potential infectious disease risks in clinical settings and insurance requirements for Allied Health students.
See template
See template
ART APP SUBMISSION FORM
PDF template
A form for students to submit artwork or app concepts for a university challenge competition.
See template
See template
FMLA LEAVE REQUEST FORM
PDF template
A form for employees to request family or medical leave, documenting leave details and employee information.
See template
See template
Physical Examination Form
PDF template
Medical form for students at American School of Warsaw to document health status and medical clearance for school attendance and sports participation.
See template
See template
FORM K FIELD TRIP LIABILITY WAIVER FOR ADULTS
PDF template
Legal waiver form for adult participants on field trips, releasing liability for the diocese and associated organizations.
See template
See template
Medical History Form
PDF template
Required medical history form for students living on campus or participating in sports, documenting health conditions and physical readiness.
See template
See template
Nebraska FBLA Medical Release Form
PDF template
A medical release and emergency contact form for Future Business Leaders of America (FBLA) chapter members during events or activities.
See template
See template
Nebraska FBLA Medical Release Form
PDF template
Medical consent and emergency information form for FBLA chapter members, providing authorization for medical treatment and contact details.
See template
See template
NEW PATIENT INTAKE FORM
PDF template
Comprehensive medical form for collecting new patient personal, contact, and demographic information for healthcare providers.
See template
See template
Form PF 1 A Annual Report For Prepaid Funeral Benefits And Funds
PDF template
Annual report form for funeral homes to verify prepaid funeral contract details and compliance with regulatory requirements.
See template
See template
Physical Examination
PDF template
A comprehensive medical examination form for girls participating in multi-day trips, documenting health status and medical clearance.
See template
See template
Professional Liability Insurance Declaration Form
PDF template
A form for healthcare professionals to confirm their professional liability insurance coverage for the 2024-2025 period.
See template
See template
Patient Registration
PDF template
A comprehensive medical patient registration form for collecting personal, contact, and insurance information for a dental practice.
See template
See template
Prescription Drug Reimbursement Coordination Of Benefits Claim Form
PDF template
A form for submitting prescription drug reimbursement claims with details about medication, pharmacy, and patient information.
See template
See template
Add Insurance Form
PDF template
A form used to add payer information to the Community Practice Services database for insurance and billing purposes.
See template
See template
Patient Intake Form
PDF template
Comprehensive medical intake form for collecting patient personal and health information prior to medical treatment.
See template
See template
SERVICE REQUEST FORM
PDF template
A healthcare service request form for Medi-Cal, Healthy Families, and Medicare prior authorization submissions.
See template
See template
Keenan Insurance Scholarship Application
PDF template
A scholarship application for students pursuing insurance, risk management, financial services, or benefits-related education
See template
See template
Recreation Parks Scholarship Application
PDF template
Application for financial assistance for recreational program participation, targeting low-income families with children.
See template
See template
Financial Agreement Appointment Reminders
PDF template
A comprehensive financial agreement outlining patient payment responsibilities, insurance billing, and appointment policies for counseling services.
See template
See template
Patient Intake Form
PDF template
Comprehensive medical intake form for collecting patient personal and health information for medical treatment purposes.
See template
See template
Change Address
PDF template
Guide for employees to update personal information and manage insurance-related documentation
See template
See template
OBSTETRICAL Service Request Form
PDF template
Medical service request and authorization form for obstetrical services, used for processing healthcare claims and approvals
See template
See template
ACORD Forms Added Or Updated In AMS360 2016 R2
PDF template
Comprehensive list of ACORD insurance forms added or updated in the AMS360 2016 R2 software release.
See template
See template
Health Care Personnel (HCP) Baseline Individual TB Risk Assessment
PDF template
A screening form to evaluate tuberculosis risk factors for healthcare personnel
See template
See template
PRESCRIPTION ORDER FORM
PDF template
A form for obtaining physician authorization for reimbursement of healthcare products and services requiring medical prescription.
See template
See template
Transfer Request Form
PDF template
A form for requesting transfer of patient medical records to a new healthcare provider or facility.
See template
See template
RESIDENCY APPLICATION FORM UDA 2023
PDF template
Application form for artistic residency program with comprehensive project submission requirements.
See template
See template
AiR Goyki 3 Residency Application Form
PDF template
Application form for artists seeking a residency program at Goyki 3, requiring project proposal, portfolio, and CV submission.
See template
See template
FORTIFIED Roof Designation Requirement FORTIFIED HomeHigh Wind ROOFING COMPLIANCE FORM
PDF template
A form for documenting roof installation and compliance with FORTIFIED Home high wind roofing standards.
See template
See template
Health Care Program For Children In Foster Care (HCPCFC) Foster Care Medical (Specialty) Contact For
PDF template
A form for healthcare providers to document medical services and assessments for children in the foster care system.
See template
See template
Foster Provider Liability Insurance Incident Report Form
PDF template
A comprehensive form for reporting incidents involving foster care providers, documenting details of potential insurance claims and liability events.
See template
See template
Contribution Form
PDF template
A charitable donation form for contributing to various healthcare-related funds and programs at Stormont Vail Foundation.
See template
See template
Laboratory Requisition Form
PDF template
A comprehensive laboratory form for collecting patient blood samples and requesting various medical tests.
See template
See template
Faith Pharmacy New Patient Intake Form
PDF template
Comprehensive medical intake form for new patients at Faith Pharmacy, collecting personal, insurance, and medical information.
See template
See template
Florida Petroleum Liability Restoration Insurance Program Claim
PDF template
Florida state form for reporting petroleum storage tank discharges and claiming liability restoration insurance under Section 376.3072.
See template
See template
PATIENT INTAKE FORM
PDF template
Comprehensive medical history and current health status form for patient therapy intake and medical assessment.
See template
See template
Free Medical Clinic Volunteer Application
PDF template
Application form for volunteers interested in working at a free medical clinic, requiring background checks and professional license verification.
See template
See template
4th Annual Fremont County Fine Art Exhibit Application
PDF template
Application for local artists in Fremont County to participate in an annual fine art exhibition at Robert A. Peck Gallery.
See template
See template
Inmate Medication Information Form
PDF template
A comprehensive medical form capturing medication history, psychiatric treatment details, and contact information for incarcerated individuals.
See template
See template
Patient Registration Form
PDF template
A comprehensive patient intake and dental insurance information form for a dental practice in Lancaster, Ohio.
See template
See template
NEW PATIENT INTAKE FORM
PDF template
A comprehensive form for new pharmacy patients to provide contact, medical, and medication preferences.
See template
See template
Volunteer Form Release Of Claims
PDF template
Legal release form for volunteers participating in activities with Friends of the Blue Ridge Parkway, covering volunteer responsibilities and liability waivers.
See template
See template
Consent For COVID 19 Immunization
PDF template
A consent form for COVID-19 immunization at Alberta Health Services, to be used when a parent or alternate decision-maker cannot be present with the person being immunized.
See template
See template
Amprion Clinical Laboratory Test Requisition Form
PDF template
Laboratory test request form for collecting patient information, test details, and diagnostic information for Amprion Clinical Laboratory.
See template
See template
Amprion Clinical Laboratory Test Requisition Form
PDF template
Medical laboratory test request form for collecting patient, billing, and diagnostic information for laboratory testing.
See template
See template
Medical Reimbursement Form
PDF template
A comprehensive checklist for submitting medical reimbursement claims to Mass General Brigham Health Plan, detailing required documentation and submission process.
See template
See template
Incident Report Form
PDF template
A comprehensive form used to report serious incidents, breaches, injuries, or emergencies within an organization or chapter.
See template
See template
VendorExhibitorThird Party Entity Agreement Form
PDF template
A contractual agreement outlining terms and conditions for vendors, exhibitors, and third-party entities conducting business on Auburn University campus.
See template
See template
EMS DUTY OFFICER Provider Feedback Form
PDF template
A form used by Montgomery County Fire and Rescue Services to document and evaluate emergency medical service provider performance and incident details.
See template
See template
Dependent Care And Health Care Reimbursement Claim Form
PDF template
Form for submitting claims for dependent care and health care expenses under a flexible spending account benefit plan.
See template
See template
Flexible Spending Account Claim Form
PDF template
A form for employees to request reimbursement for healthcare and dependent care expenses through a Flexible Spending Account.
See template
See template
Healthcare FSA Expense Claims
PDF template
A form for submitting unreimbursed medical expenses for reimbursement through a Flexible Spending Account (FSA)
See template
See template
Health And Dependent Day Care Reimbursement Form
PDF template
Form for submitting health care and dependent day care expense claims under a Section 125 Cafeteria Plan for reimbursement.
See template
See template
Reimbursement Of Orthodontic Expenses
PDF template
Detailed guidelines for reimbursing orthodontic expenses, explaining IRS guidelines and requirements for monthly service reimbursements.
See template
See template
Text, E Booking E Mail Consent Form
PDF template
Patient consent form outlining risks and conditions for electronic communication with healthcare providers.
See template
See template
Fraser Street Medical Clinic New Patient Registration Form
PDF template
Comprehensive medical intake form for new patients collecting personal information, medical history, and current health symptoms.
See template
See template
Virginia Tech Employee Software Sales Order Form
PDF template
A form for Virginia Tech employees to purchase software licenses and technology accessories at discounted rates.
See template
See template
CareDx Transplant Test Requisition Form
PDF template
Medical form for ordering transplant-related diagnostic testing with patient and clinical information details
See template
See template
CareDx Lung Transplant Test Requisition Form
PDF template
Medical form for ordering diagnostic testing for lung transplant patients, used to track patient information and test requirements.
See template
See template
Discharge Form
PDF template
A comprehensive form for tracking patient discharge details, follow-up care, and medical conditions in a healthcare setting.
See template
See template
Funeral Benefit Application Form
PDF template
Application form for claiming funeral benefits through the JLT (CSI Member Benefits) Discretionary Trust
See template
See template
Funeral Home Reimbursement Form
PDF template
Form for reimbursing funeral homes for additional costs associated with preparing and reconstructing organ, tissue, or eye donors for family viewing.
See template
See template
MEDICAL HISTORY FORM
PDF template
Comprehensive form for collecting patient personal information, medical history, and dental visit details
See template
See template
Pre Authorization Form
PDF template
Medical form for patients seeking insurance pre-authorization for hospital treatment, documenting patient and medical details for insurance approval.
See template
See template
Rental Checklist
PDF template
A comprehensive checklist for renting the Fairmount Water Works venue, outlining required steps, documentation, and payment procedures.
See template
See template
Exhibitor Appointed Contractor Form
PDF template
A form for exhibitors to declare independent contractors working at the event with required insurance and service details.
See template
See template
Out Of Network Claim Form
PDF template
A comprehensive form for submitting out-of-network vision care claims to EyeMed Vision Care for reimbursement of medical services.
See template
See template
FY13 Annual Report Form
PDF template
Annual report documenting University Information Services (UIS) activities, accomplishments, and strategic alignment for fiscal year 2013.
See template
See template
Maryland Statewide Medical Assistance Transport TransferDischarge Form
PDF template
A county health department form for documenting medical transportation needs and patient transfer details for medical assistance recipients.
See template
See template
Non Tagged Mobile (Transient) Property Inventory FY2023 DOAS Insurance Agreement Renewals
PDF template
Instructions for Kennesaw State University departments to submit an inventory of mobile property for insurance coverage purposes.
See template
See template
Non Tagged Mobile (Transient) Property Inventory FY2022 DOAS Insurance Policy Renewal
PDF template
A document requiring Kennesaw State University departments to provide an accurate inventory of non-tagged mobile property for insurance coverage purposes.
See template
See template
AdVenture Scholarship Request Form For Adult Participants With Disabilities
PDF template
A scholarship request form for adults with disabilities seeking financial assistance for Boise Parks & Recreation programs.
See template
See template
DR 1 Disability Benefit Application
PDF template
A comprehensive form for Ohio Public Employees Retirement System members to apply for disability benefits, requiring detailed personal and physician information.
See template
See template
Patient Interview Form
PDF template
Comprehensive medical intake form for collecting patient demographic, health history, and contact information.
See template
See template
Accident And Claim Reporting Procedure
PDF template
Procedure for reporting accidents and filing insurance claims during dance activities for the Folk Dance Federation of California, South, Inc.
See template
See template
Gannon University Health Examination Form
PDF template
A comprehensive health form required for students to access university health services and on-campus housing at Gannon University.
See template
See template
New Patient Inquiries
PDF template
Comprehensive guide for new patients to register and schedule an appointment with the Geriatric Assessment Program at University of North Texas Health Science Center.
See template
See template
GAPWise Cancellation Request Form
PDF template
A form for cancelling a Guaranteed Asset Protection (GAP) insurance addendum with supporting documentation requirements.
See template
See template
Gastrointestinal Order Form
PDF template
A comprehensive medical order form for managing student's gastrointestinal, feeding, suction, catheterization, and ostomy care needs during the school year.
See template
See template
PATIENT MEDICAL HISTORY FORM
PDF template
Comprehensive medical history form for patients at Gateway ENT to collect personal health information, medical history, and family health background.
See template
See template
Gateway To Nucala Enrollment Form
PDF template
Enrollment form for healthcare providers to prescribe and administer Nucala medication, including prescriber and clinical information.
See template
See template
MedicalEmergency Information And Waiver Of Liability And Parental Consent Form
PDF template
A comprehensive medical information and liability waiver form for participants in Great Bay Rowing activities, collecting emergency contact details and medical history.
See template
See template
FORTIFIED Home Continuous Load Path Form
PDF template
A form documenting the proper installation of continuous load path design elements in a home construction project, verifying structural integrity.
See template
See template
GCAA Form 7 Liability Waiver Form
PDF template
A liability waiver form for student athletes participating in GCAA athletic events, requiring parent or guardian signature.
See template
See template
Authorization Disclosure Of Confidential Information
PDF template
A form authorizing the release of confidential medical information to a specified healthcare facility with patient consent and time-limited authorization.
See template
See template
Global Counseling Patient Intake Form
PDF template
Comprehensive medical intake form for counseling services, collecting patient personal and insurance information.
See template
See template
Property And Casualty Model Rate And Policy Form Law Guideline
PDF template
A comprehensive model law guideline for regulating property and casualty insurance rates, policy forms, and competitive market practices.
See template
See template
Athletic Participation Form KHSAA Form GE04
PDF template
Official form for high school students to obtain parental consent and medical release for athletic participation in Kentucky.
See template
See template
Medical Claim Form
PDF template
Comprehensive guide for completing and submitting medical insurance claims to GEHA, including instructions for in-network and out-of-network claims.
See template
See template
Application Form
PDF template
Multi-purpose application form for volunteer, internship, independent study, and temporary employee positions at University Galleries.
See template
See template
CLAIM FORM
PDF template
Claim form for reporting property loss or damage related to utility operations by Consolidated Edison Company of New York, Inc.
See template
See template
YMAHE Health Assessment Form
PDF template
Comprehensive health assessment form for first-year students requiring medical history, vaccination records, and physical examination details.
See template
See template
Louisiana Department Of Insurance Complaint Report Form
PDF template
A form for filing complaints against insurance companies or agents with the Louisiana Department of Insurance for various insurance-related disputes.
See template
See template
Minor Athlete General Consent Form
PDF template
A consent form for parents/guardians to authorize individual training sessions, athletic training, and other activities for minor athletes while addressing abuse prevention policies.
See template
See template
Certification As To Status Of Licensure Licensed General Contractor
PDF template
Official document certifying a general contractor's license status, insurance coverage, and legal compliance for construction contracts in North Carolina.
See template
See template
Recreational Sports Membership Form
PDF template
Membership registration form for Texas A&M International University Recreational Sports Center for various customer types.
See template
See template
General Liability Insurance For MTNA Affiliated State And Local Associations
PDF template
Comprehensive guide to liability insurance coverage for Music Teachers National Association (MTNA) state and local associations, detailing event coverage and insurance procedures.
See template
See template
General Liability Claim Form
PDF template
A comprehensive form for reporting general liability claims related to Little League activities and incidents.
See template
See template
General Liability Incident Report
PDF template
A state-level form for reporting general liability incidents not involving automobiles, used by Minnesota state agencies.
See template
See template
General Liability Loss Reporting Form
PDF template
A comprehensive form for reporting general liability insurance claims, documenting injuries, property damage, and incident details.
See template
See template
GENERAL LIABILITY PERSONAL INJURY CLAIM FORM
PDF template
A comprehensive form for documenting details of a personal injury claim, including claimant, injured person, incident, and witness information.
See template
See template
Liability Waiver Form Stained Glass Workshop
PDF template
A legal document outlining safety procedures and liability release for participants in stained glass classes at MOCA and SHill Creations Studio.
See template
See template
Bridge To Wellness Wellbeing Program General Medical Form
PDF template
A form for employees to document preventative medical, dental, eye, and dermatology examinations for a workplace wellness program.
See template
See template
WAIVER OF LIABILITY PERMISSION MEDICAL RELEASE FORM
PDF template
A liability waiver and medical release form for students staying overnight in a Mount Holyoke College residence hall, covering medical consent and risk acknowledgment.
See template
See template
GENERAL REFERRAL FORM
PDF template
A comprehensive medical referral form for scheduling various imaging procedures at Cedars-Sinai Medical Center.
See template
See template
General Release And Medical Information Form
PDF template
A comprehensive form for youth program participants covering medical information, emergency contacts, and liability release for recreational activities.
See template
See template
Glenville State University Reasonable Accommodation Medical Verification And Inquiry Form
PDF template
A form for employees to request medical accommodations at Glenville State University, involving medical verification and authorization for information release.
See template
See template
General Test Request
PDF template
A comprehensive medical test request form used for submitting patient specimens and information to Mayo Clinic Laboratories for diagnostic testing.
See template
See template
Prior Authorization Form
PDF template
A form for healthcare providers to request prior authorization for prescription medications through Express Scripts.
See template
See template
Partners HealthCare System Research Consent Form
PDF template
A comprehensive consent form template for medical research studies detailing participant rights and study participation guidelines.
See template
See template
New ProgramInitiative Proposal Form
PDF template
A comprehensive form for proposing new academic programs or initiatives with detailed evaluation criteria and implementation planning.
See template
See template
General Risk Assessment Form For Coaches And Run Leaders
PDF template
A comprehensive risk assessment document for athletic activities covering potential hazards and mitigation strategies for coaches and athletes.
See template
See template
GENERAL CLAIM SUBMISSION FORM
PDF template
A comprehensive form for submitting insurance claims with sections for member information, coverage details, and claim specifics.
See template
See template
General Test Requisition
PDF template
A comprehensive medical test requisition form for healthcare providers to submit specimens for laboratory testing, covering various health conditions and tests.
See template
See template
University Health Report
PDF template
Comprehensive health form for Northeastern University students requiring vaccination documentation and personal health information
See template
See template
Vaccine Administration Record (VAR)Informed Consent For Vaccination
PDF template
A comprehensive form for collecting patient information and consent for vaccination at Walgreens.
See template
See template
Duchesne County Volunteer Application Form
PDF template
Application form for individuals interested in volunteering with Duchesne County, including personal information, driver's license details, and legal acknowledgments.
See template
See template
Medical Release, Photo Release, Liability Waiver Form
PDF template
Comprehensive waiver for participants in a construction training program, covering medical risks, property damage, and legal liability.
See template
See template
MEDICAL HISTORY AND RELEASE FORM
PDF template
Medical history and consent form for DeMolay participants under 21 years of age, including health history and liability release.
See template
See template
Physician Referral Form
PDF template
A comprehensive medical referral form for routing patients to various medical specialties at Emory Healthcare.
See template
See template
Scholarship Form For Becoming An Outdoors Woman Workshop
PDF template
A scholarship application form for women interested in attending the Becoming an Outdoors-Woman workshop, targeting students, single parents, and North Dakota residents.
See template
See template
Section 5. Refill Reminder Program Consumer Enrollment Form
PDF template
A form for consumers to enroll in a pharmacy's prescription refill reminder and medication management service.
See template
See template
Pre Authorization For Genomic Testing Form
PDF template
A form for obtaining insurance pre-authorization for genomic testing with required patient and clinical information.
See template
See template
Personal Vehicle Use Form
PDF template
Form documenting employee personal vehicle usage and insurance details for official district business and field trips.
See template
See template
Patient Intake Form
PDF template
Comprehensive patient intake document for healthcare services, collecting personal, contact, and medical information with insurance and consent provisions.
See template
See template
New Patient Intake Form
PDF template
Comprehensive medical intake form for new chiropractic patients, collecting personal information and detailed health history.
See template
See template
Laboratory Specimen Collection Form
PDF template
A detailed form for collecting patient and specimen information for laboratory testing and analysis.
See template
See template
Volunteer Application Form
PDF template
Application form for volunteers interested in participating in the Girls Get Going sports program for youth.
See template
See template
ACCIDENT INFORMATION FORM
PDF template
A comprehensive form for documenting details of a motor vehicle accident, including personal and insurance information.
See template
See template
Employer Notice Of Claim Long Term Disability
PDF template
A comprehensive claim package for employers to submit long-term disability claims for employees, including detailed instructions and employee information sections.
See template
See template
Short Term Disability Claim Form
PDF template
A form for employees to file a claim for short-term disability benefits, documenting medical leave and disability details.
See template
See template
Quartz Medicare Advantage (HMO) Quartz CashCard Reimbursement Form
PDF template
Form for Medicare members to request reimbursement for fitness memberships or medical transportation rides using their Quartz CashCard.
See template
See template
Dental Claim Form
PDF template
A comprehensive form for submitting dental insurance claims, capturing patient, subscriber, and dental service details.
See template
See template
Pre Participation Physical Evaluation History Form
PDF template
Official medical evaluation form for student-athletes participating in Georgia high school sports, detailing medical history and physical examination requirements.
See template
See template
Giant Food Pharmacy Vaccine Informed Consent
PDF template
A comprehensive form for collecting patient information, insurance details, and consent for vaccination at Giant Food Pharmacy.
See template
See template
Gibson Beach Rentals, Inc. Rental Policies
PDF template
Comprehensive rental policies for daily, weekly, and monthly beach rental guests, covering payment terms, cancellation rules, and travel insurance options.
See template
See template
Michigan Gastrointestinal Illness Complaint Interview Form
PDF template
A comprehensive form for documenting and investigating gastrointestinal illness complaints, patient information, and medical details.
See template
See template
Illegal Immigration Reform And Enforcement Act Notice
PDF template
Official document outlining requirements for verifying lawful presence for insurance applications in Georgia.
See template
See template
LSU SVM Gift Contribution Form
PDF template
A form for making financial contributions to support various programs and funds at the LSU School of Veterinary Medicine.
See template
See template
Gift Contribution Form
PDF template
A donation form for contributing to various funds within the Virginia Tech College of Veterinary Medicine
See template
See template
Advancing Access Patient Support Form
PDF template
A comprehensive form for patient information, contact authorization, and insurance details for Gilead medication support programs
See template
See template
Camper Medical Form
PDF template
Medical form for assessing a camper's health status, medical conditions, and fitness for camp participation.
See template
See template
Health And Medical History Form
PDF template
A comprehensive medical history and health information form for American Heritage Girls members, valid for 12 months.
See template
See template
Girl Scouts Health History And Medical Examination Form For Minors
PDF template
Comprehensive medical and health history form for Girl Scout participants to capture essential health information and emergency contact details.
See template
See template
Health History And Medical Examination Form For Minors
PDF template
Comprehensive medical form for collecting health information and medical history for Girl Scouts participants under 18 years old.
See template
See template
City Of Ann Arbor Volunteer Release Waiver Of Liability
PDF template
Legal document outlining liability and risk assumptions for City of Ann Arbor volunteers, detailing participant responsibilities and legal protections.
See template
See template
Gresham Japanese Garden Release, Waiver Of Liability And Indemnity Agreement
PDF template
Legal agreement for renting the Gresham Japanese Garden property, outlining risks and liability limitations for renters.
See template
See template
Request For Benefits ClaimantS Report Of Loss
PDF template
A claim form for filing disability benefits for Glaziers, Architectural Metal and Glass Workers Local Union 1399 members.
See template
See template
Short Term Disability Claim Form Statement Of Employee
PDF template
A comprehensive form for employees to file a short-term disability claim with detailed personal, employment, and medical information.
See template
See template
Long Term Disability Claim Form PhysicianS Statement
PDF template
A comprehensive medical form for submitting a long-term disability insurance claim, requiring detailed patient and medical information.
See template
See template
Commercial General Liability
PDF template
An insurance endorsement modifying commercial general liability policy to provide additional coverage and protections for insureds.
See template
See template
Global Mamas Health Emergency Contact Form
PDF template
A comprehensive medical and contact information form for Global Mamas organization, collecting personal details and health history.
See template
See template
Global Studies Certificate Application Form
PDF template
An application form for students seeking to earn a Global Studies Certificate at their academic institution.
See template
See template
Rental Agreement Form
PDF template
Rental form for airsoft equipment, outlining rental terms, responsibilities, and equipment details.
See template
See template
Rental Agreement Form
PDF template
Rental form for airsoft equipment with terms of responsibility and rental details.
See template
See template
Center For Endocrine Tumors And Disorders Patient Intake Form (Dr Goldfarb)
PDF template
Comprehensive medical intake form for patients with endocrine-related health concerns, collecting personal, medical, and medication history.
See template
See template
Government Claim
PDF template
Official form for filing a claim against state agencies or employees in California, detailing incident information and damages.
See template
See template
OPIC Handbook
PDF template
Comprehensive guide for international investment and political risk insurance provided by the Overseas Private Investment Corporation (OPIC)
See template
See template
PATIENT ENROLLMENT FORM
PDF template
A comprehensive form for collecting patient personal, insurance, and contact information for medical enrollment purposes.
See template
See template
Student Health Insurance Plan Cancellation Form
PDF template
Form for cancelling health insurance coverage for spouse, partner, or dependent students at Washington State University for Spring 2024 semester.
See template
See template
Grade Appeal Form
PDF template
Form for students to request a review of their academic grade at Washington University School of Medicine.
See template
See template
41 Graduate Program Declaration Form
PDF template
A form for students to declare or modify their 4+1 graduate program and undergraduate degree program at Ramapo College.
See template
See template
General Outpatient Referral Form
PDF template
A medical referral form for patients seeking healthcare services at Grady Health System in Atlanta, Georgia.
See template
See template
Certificate Of Insurance On Grain In Licensed Missouri Public Grain Warehouses
PDF template
Official document certifying insurance coverage for grain warehouses in Missouri, demonstrating compliance with state regulations.
See template
See template
Grant Application Form
PDF template
A comprehensive grant application form for funding research and projects at the Mater Hospital Foundation in Dublin, Ireland.
See template
See template
Grant Application Form
PDF template
Comprehensive form for submitting research grant proposals to the International Essential Tremor Foundation (IETF)
See template
See template
Parks, Recreation And Culture Board Grant Application Form
PDF template
A grant application form for community groups seeking funding from the Town of Vermilion Parks, Recreation and Culture Board for local projects and initiatives.
See template
See template
Grateful Patient Contribution Form
PDF template
A form for patients to make tax-deductible contributions to support endodontic research, education, and awareness.
See template
See template
GRMC Foundation Contribution Form
PDF template
A tax-deductible donation form for supporting various fundraising categories at Gila Regional Medical Center Foundation.
See template
See template
Pre Authorisation Form Group Care
PDF template
A medical insurance form for requesting cashless hospitalization, to be filled by the patient and treating doctor
See template
See template
Insurance Information At Retirement
PDF template
Comprehensive guide for Illinois state employees regarding insurance eligibility, coverage, and options at retirement.
See template
See template
Group Policy Change Form
PDF template
A form used to modify group life insurance policy details, including member information, beneficiary changes, and account transfers.
See template
See template
Group Short Term Disability Claim Form
PDF template
A comprehensive form for filing a short-term disability insurance claim with Dearborn National, capturing employee medical and income details.
See template
See template
SCENE75 ENTERTAINMENT CENTER ALL VENUE ACCIDENT WAIVER AND RELEASE OF LIABILITY FORM
PDF template
Legal document releasing Scene75 Entertainment Center from liability for potential accidents or injuries during participation in venue activities.
See template
See template
Working Group Opt In Agreement
PDF template
Agreement for organizations to participate in GS1 Working Groups with intellectual property and participation terms.
See template
See template
G.S. 58 65 40
PDF template
Legal statute governing hospital service corporation contract filing and rate approval requirements with the Commissioner of Insurance.
See template
See template
Blach V. Diaz Verson Supreme Court Of Georgia Decision
PDF template
Supreme Court of Georgia case examining whether an insurance company qualifies as a 'financial institution' under the state's garnishment statute.
See template
See template
GSEF Participation Forms
PDF template
Comprehensive document outlining required forms and checklists for student research projects participating in science fairs.
See template
See template
Tag Along Insurance Form
PDF template
Form for purchasing required Tag-Along Insurance coverage for non-registered children and adults attending Girl Scout troop activities.
See template
See template
Girl Scout Program Site Agreement (Form 700)
PDF template
An online form for Girl Scout program site authorization, with separate versions for standard troops and Juliette scouts.
See template
See template
Graduate Student Request For Program Resignation And Transfer
PDF template
A form for graduate students to resign from one graduate program and transfer to a lesser degree program or certificate within the same discipline.
See template
See template
Intent For International Travel
PDF template
Form for Girl Scout troops to request approval and document details for international travel experiences.
See template
See template
GSS Waiver
PDF template
Legal document releasing UBC Graduate Students Society from liability for potential risks during an event or activity.
See template
See template
Girl Scouts Health History And Medical Examination Form For Minors
PDF template
Comprehensive health history and medical examination form for Girl Scout participants to document medical information and insurance details.
See template
See template
Accident Claim Form
PDF template
Insurance claim form for documenting student accident details and health information authorization
See template
See template
Dental Claim Form
PDF template
Comprehensive form for documenting dental procedures, treatments, and insurance billing details.
See template
See template
Your Guide To Filing A Long Term Disability (LTD) Claim
PDF template
A comprehensive guide for filing a long term disability claim with Guardian, providing step-by-step instructions for completing the required forms and submission process.
See template
See template
Guardian Life Insurance Enrollment Form
PDF template
Insurance enrollment form for University of Massachusetts Medical School employees to select benefits and coverage options.
See template
See template
REQUEST FOR PROPOSALS Oracle Customer Cloud Service (CCS, OUAV, OUTA), Oracle Cloud Infrastructure (
PDF template
Request for competitive proposals for Oracle cloud system managed services and support for Greenville Utilities Commission.
See template
See template
Guest Medical Information Form
PDF template
Confidential medical form for assessing guest fitness and suitability for an Antarctic expedition, collecting comprehensive health history.
See template
See template
Guidance Obtaining Consent From Subjects With Limited English Proficiency
PDF template
Detailed guidance for obtaining informed consent from research subjects with limited English proficiency, covering different interpreter scenarios.
See template
See template
Re Thinking Of Fashion In Research And Artist Collaborating Development For Urban Manufacturing Guid
PDF template
A collaborative research project inviting artists and designers to team up with scientists to reimagine fashion manufacturing processes through innovative technology and sustainable approaches.
See template
See template
Guidelines For Acceptable Documentation
PDF template
Comprehensive guidelines explaining acceptable documentation for medical and personal circumstances affecting academic course completion.
See template
See template
Guidelines For The Individuals Crossing The Customs Border Of The Eurasian Economic Union
PDF template
Official document detailing customs regulations and procedures for individuals crossing borders within the Eurasian Economic Union during the BRICS Sports Games.
See template
See template
Guide To Completing The Patent Application Form (Form No.1)
PDF template
Comprehensive instructions for completing a patent application with details on patent types, fees, and required information for the Intellectual Property Office of Ireland.
See template
See template
Accident Waiver And Release Of Liability
PDF template
Legal document waiving liability for participants in a university athletic event involving physical risks and potential injury.
See template
See template
Reimbursement Form
PDF template
A form for submitting optical service reimbursement claims to General Vision Services by members.
See template
See template
REIMBURSEMENT FORM
PDF template
Form for submitting optical services reimbursement to General Vision Services by members.
See template
See template
Medical History Form
PDF template
A comprehensive form for collecting patient medical history, health details, and emergency contact information for dental service purposes.
See template
See template
COVID 19 CVD Registry Powered By Get With The Guidelines Investigator Initiated Research Proposal Fo
PDF template
A form for researchers to submit investigator-initiated research proposals related to the COVID-19 Cardiovascular Disease Registry by the American Heart Association.
See template
See template
Get With The Guidelines Quality Improvement Research Opportunity
PDF template
Request for research proposals focused on intracerebral hemorrhage (ICH) stroke using Get With The Guidelines data collection.
See template
See template
Permission To Contact For Research
PDF template
A form allowing Gulf War veterans to authorize contact for potential research participation in a biorepository brain bank study.
See template
See template
Reimbursement Request Form
PDF template
A form for members to request reimbursement for eligible healthcare services paid out-of-pocket.
See template
See template
Influenza Sentinel Provider Report Form
PDF template
Comprehensive medical reporting form for tracking influenza cases, patient information, clinical data, and laboratory test results.
See template
See template
PATIENT INTAKE FORM
PDF template
Comprehensive form for collecting patient personal, contact, insurance, and medical information for healthcare providers.
See template
See template
Request For Hospital DischargeTransfer Approval Form (H 804)
PDF template
A medical form for documenting tuberculosis patient discharge, medication regimen, and transfer details for healthcare providers.
See template
See template
2016 Haiti Mission Trip Payroll Deduction Form
PDF template
A form for employees of Morehouse School of Medicine to make a financial contribution to a Haiti Mission Trip through payroll deduction or direct payment.
See template
See template
Town Hall Rental Form
PDF template
Application form for renting the Duluth Township Town Hall, with requirements for event details, insurance, and usage guidelines.
See template
See template
Notification Of Injury
PDF template
Detailed guidelines for submitting medical accident insurance claims, including documentation requirements and claim processing procedures.
See template
See template
University Of Toronto Hand Fellowship Application Form
PDF template
Application form for medical professionals seeking a hand surgery fellowship at the University of Toronto.
See template
See template
XAVIER HAP 2024 Personal Health History
PDF template
A comprehensive medical history form for students, to be completed by parents or guardians before submitting to a medical provider.
See template
See template
Kadena Marina Watercraft Rental Agreement
PDF template
Comprehensive rental agreement for watercraft usage at Kadena Marina, outlining renter responsibilities, safety rules, and liability waivers.
See template
See template
Hardship Refund Request Form
PDF template
Policy detailing conditions and process for students to request tuition refunds due to exceptional medical or family circumstances.
See template
See template
MC Hardware Request
PDF template
A form for requesting computer hardware for Montgomery College employees, with options for remote work and instructional needs.
See template
See template
Harn Museum Of Art Internship Application Form
PDF template
Application form for internship opportunities at the Samuel P. Harn Museum of Art at the University of Florida.
See template
See template
Harn Museum Of Art Internship Application Form Fall Semester 2023
PDF template
Application form for students seeking internship opportunities at the Samuel P. Harn Museum of Art for Fall Semester 2023.
See template
See template
Samuel P. Harn Museum Of Art Intern Application Packet
PDF template
Comprehensive internship application materials for students and professionals interested in museum careers at the Samuel P. Harn Museum of Art.
See template
See template
Wellness Reimbursement Form Instructions
PDF template
Instructions and guidelines for submitting wellness program and fitness reimbursement claims through Harvard Pilgrim Health Care.
See template
See template
Hawaii HIPAA Authorization For Release Of Information
PDF template
A form allowing patients to authorize the release of their personal health information to specified individuals or organizations.
See template
See template
Registration Form
PDF template
Comprehensive intake form for collecting patient personal, contact, insurance, and medical history information for mental health services.
See template
See template
Registration Form
PDF template
Comprehensive registration form for healthcare services, collecting patient demographic, contact, insurance, and medical history information.
See template
See template
H.B. No. 119
PDF template
Legislation addressing manufacturer liability for modified automated motor vehicles and accident reporting requirements in Texas.
See template
See template
REQUEST FOR MEDICAL ELIGIBILITY DETERMINATION
PDF template
A form for assessing an individual's medical care needs and eligibility for healthcare services or facilities.
See template
See template
Record Of Employment
PDF template
A form used by employers to document an employee's job separation for unemployment insurance purposes in New York State.
See template
See template
Hiram College Enrollment Form
PDF template
A comprehensive benefits enrollment form for Hiram College employees covering medical, dental, vision, and supplemental insurance options.
See template
See template
CruzCare Enrollment Cancellation Form
PDF template
Pre-paid access for students waiving UC SHIP, providing on-campus health care visits for acute illness or injury at the Student Health Center.
See template
See template
Health Referral And Coverage Form
PDF template
A comprehensive health referral form capturing patient details, insurance information, and social determinants of health
See template
See template
Provider Enrollment Form
PDF template
Comprehensive form for healthcare providers to enroll and provide professional details for credentialing and practice information.
See template
See template
HEALTHCARE ADVOCATE TOOLS LINKS PHONE NUMBERS
PDF template
Comprehensive guide for AlaskaCare employees and retirees with contact information and resources for health insurance plans and provider networks.
See template
See template
Huntley Community Centre Outdoor Rink Rental Application
PDF template
Rental application for Huntley Community Centre and outdoor rink facilities, including terms of use and liability requirements.
See template
See template
Radiology Exam Order Form
PDF template
A comprehensive form for ordering radiology examinations, collecting patient, provider, and insurance information for medical imaging services.
See template
See template
1500 Health Insurance Claim Form
PDF template
Standard medical claim form used for submitting healthcare insurance reimbursement requests.
See template
See template
Patient Intake Form
PDF template
Comprehensive patient registration form collecting personal, demographic, and healthcare-related information.
See template
See template
OHSU Referral Form
PDF template
A comprehensive medical referral form for patients being referred to various specialty departments at OHSU (Oregon Health & Science University).
See template
See template
Health Care Provider Accommodation Assessment Form
PDF template
A form for employees to request reasonable workplace accommodations by obtaining medical documentation from their healthcare provider.
See template
See template
Health Care Provider Examination Form
PDF template
A comprehensive healthcare provider form for documenting medical examinations, immunization history, and patient assessments.
See template
See template
HCPCS Authorization Form
PDF template
Medical form used for requesting authorization for medical procedures or medications with detailed patient, physician, and treatment information.
See template
See template
Form 4506 Health Care Practitioner Physical Assessment Form
PDF template
Medical assessment form for collecting a resident's comprehensive health history and current medical status for assisted living program admission
See template
See template
Form 4506
PDF template
A detailed medical assessment form for evaluating a resident's health status and medical history for assisted living admission.
See template
See template
Henderson County Parks Recreation Program Proposal Form
PDF template
A comprehensive form for instructors and contractors to propose recreational programs to Henderson County Parks and Recreation department.
See template
See template
Weld HCP Referral Form
PDF template
A comprehensive referral form for healthcare coordination and client information collection in Weld County, Colorado.
See template
See template
ADA Medical Questionnaire
PDF template
Medical questionnaire for employees requesting workplace accommodations under the Americans with Disabilities Act (ADA)
See template
See template
CMS 1500 Claim Filing Instructions
PDF template
Detailed guidelines for completing the CMS-1500 healthcare claim form with specific instructions for each field.
See template
See template
Mandatory Tuberculosis (TB) Risk Assessment Form
PDF template
A comprehensive medical form to assess tuberculosis risk factors and required testing for students, particularly those from high-risk regions or with specific exposure history.
See template
See template
Western Carolina University Base Camp Cullowhee Health And Medical Form
PDF template
A health screening form for participants in outdoor activities, collecting medical history and current health status details for safety purposes.
See template
See template
Health And Temperament Agreement
PDF template
A legal agreement outlining owner responsibilities and liability waivers for dogs attending a dog daycare facility.
See template
See template
SUNY State College Of Optometry Health Assessment
PDF template
Medical immunization and health screening form for SUNY State College of Optometry credentialing purposes.
See template
See template
Health Assessment Form For Compliance With K.S.A. 72 5214
PDF template
A comprehensive health screening form for children entering school, requiring parental consent and medical provider certification.
See template
See template
Tips For Claim Submission
PDF template
Comprehensive guide for submitting healthcare and flexible spending account claims, detailing documentation requirements and eligible expenses.
See template
See template
Tips For Claim Submission
PDF template
Comprehensive guide for submitting medical expense claims, including eligible expenses, documentation requirements, and over-the-counter medication rules.
See template
See template
Expense Reimbursement Voucher For Healthcare Flexible Spending Account (Healthcare FSA)Health Reimbu
PDF template
A form for employees to request reimbursement for medical expenses through their flexible spending account or health reimbursement arrangement.
See template
See template
Medical Inquiry Form Accommodation Request
PDF template
A medical form for healthcare providers to evaluate an employee's physical or mental impairments and potential workplace accommodations.
See template
See template
Co PayDeductible Reimbursement Form
PDF template
Form for students to request reimbursement for medical co-pays and deductibles, with specific instructions and limitations.
See template
See template
Health Examination Form (Form 003)
PDF template
Comprehensive health examination and immunization requirements form for nursing students entering a clinical program.
See template
See template
Health Benefits Plan Enrollment For Retirees And Survivors
PDF template
Enrollment form for CalPERS retirees and survivors to manage health benefits coverage and dependent information.
See template
See template
Student Health Services Health Evaluation Form
PDF template
Medical form used by students to document health status, current conditions, and activity clearance for university health services.
See template
See template
Required NYS School Health Examination Form
PDF template
Comprehensive health assessment form for students in New York State, documenting medical history and physical examination details.
See template
See template
CHILDCARE GENERAL HEALTH EXAMINATION FORM
PDF template
A health examination form for children enrolling in early education programs to document their medical status and health conditions.
See template
See template
Certificate Of Child Health Examination
PDF template
Official state document for recording child's health examination and immunization records.
See template
See template
Health Extras Reimbursement Form
PDF template
Form for submitting healthcare service reimbursement claims through Independent Health's Health Extras program.
See template
See template
Health Form
PDF template
Medical health assessment form for participants in wilderness expeditions with Alaska Mountain Guides and Climbing School Inc.
See template
See template
Girl Scouts Of West Central Florida Health Examination Form
PDF template
Comprehensive health form for documenting medical history and emergency contact information for Girl Scouts participants and volunteers.
See template
See template
Physical Examination Form
PDF template
Medical form for documenting a child's physical health status and ability to participate in a child care program.
See template
See template
Health Records Form
PDF template
Comprehensive health documentation required for student enrollment at Bennett College, including immunization records and medical consent forms.
See template
See template
Medical History Form
PDF template
Comprehensive medical history form for students collecting personal health information, medical conditions, and health maintenance details.
See template
See template
Medical History Form
PDF template
Comprehensive medical history form capturing patient's health status, previous illnesses, and current medical conditions.
See template
See template
Health History Physical Exam Form
PDF template
Confidential medical history form for Allied Health and Nursing students at Minnesota West Community and Technical College to document health status and medical background.
See template
See template
MEDICAL HISTORY FORM
PDF template
Comprehensive medical history form for patient intake, collecting personal health information, medical conditions, and allergies.
See template
See template
Health History Form
PDF template
Comprehensive health form for students to provide medical history, insurance, and emergency contact information to the university's student health center.
See template
See template
Health Information Form
PDF template
Detailed medical history and personal health form for participants, collecting comprehensive health information and emergency contact details.
See template
See template
Retiree Health Cancellation Form
PDF template
A form for retirees to cancel their health coverage and dependent coverage through Blue Cross Blue Shield.
See template
See template
Health Insurance Refund Request Form For F 1 Students
PDF template
Form for international F-1 students to request a refund of their health insurance premium under specific conditions at Santa Monica Community College.
See template
See template
HEALTH INVENTORY FORM
PDF template
A comprehensive medical history form for collecting student health information, including past diseases, treatments, and current medical status.
See template
See template
Medical Claim Form
PDF template
A comprehensive form for submitting medical insurance claims, capturing patient, subscriber, and medical service details.
See template
See template
Authorization For Use Or Disclosure Of Protected Health Information
PDF template
A confidential form authorizing the disclosure of protected health information by The Episcopal Church Medical Trust
See template
See template
HealthMedication Authorization Form
PDF template
Form for authorizing medication administration for participants in M-NCPPC park and recreation programs, including prescription and non-prescription medications.
See template
See template
10 Day Agreement Review Cancellation
PDF template
A form for subscribers to request cancellation of a health insurance policy within 10 days of coverage effective date.
See template
See template
New Provider Contract Inquiry Form
PDF template
A comprehensive form for healthcare providers seeking to join a health insurance network, detailing provider information and contract review process.
See template
See template
HEALTHPHYSICAL EXAMINATION FORM
PDF template
Medical examination form for students enrolling in various healthcare and child care educational programs to assess physical fitness and health status.
See template
See template
Health Professions Personal Medical History Form
PDF template
Medical documentation form for health professions students to submit immunization and health screening records for clinical experiences.
See template
See template
HEALTH PROFESSIONS STUDENT HEALTH FORM
PDF template
Medical documentation form for students in nursing, pharmacy, physician assistant, and dietetic internship programs, requiring immunization history and verification.
See template
See template
ETA FORM 653 Job Corps Health Questionnaire
PDF template
A health assessment form for Job Corps applicants to provide medical information and authorize basic healthcare services
See template
See template
Health Risk Assessment Form
PDF template
A comprehensive form that evaluates an individual's physical health, personal safety, fitness, nutrition, work environment, and social-emotional well-being.
See template
See template
Health And Safety Student Waiver Form Part A
PDF template
COVID-19 safety waiver for students participating in boot camp activities at the Bahamas Technical and Vocational Institute.
See template
See template
Health Savings Account (HSA) Contribution Form
PDF template
A form for depositing funds into a Health Savings Account with instructions for contribution types and participant authorization.
See template
See template
Physical Examination Form
PDF template
A comprehensive medical examination form required for admission to health science programs at Laredo College.
See template
See template
Health Screening Benefit Claim Form
PDF template
Claim form for requesting reimbursement of health screening benefits under critical illness or supplemental health plans.
See template
See template
Health Services Student Medical Form
PDF template
Comprehensive medical form for students enrolling in various healthcare-related programs and continuing education classes at Catawba Valley Community College.
See template
See template
MCPS Form SRS 6 Student Record Card 6
PDF template
A comprehensive health form for students entering Maryland public schools, requiring medical examination and immunization documentation.
See template
See template
Meningitis And Hepatitis B Immunization Health History Form
PDF template
Comprehensive form detailing immunization requirements for students, including MMR, Varicella, and Tuberculosis skin test documentation guidelines.
See template
See template
School Health Services Health Survey Form
PDF template
A comprehensive health information form for students entering school, collecting medical history, contact information, and health service needs.
See template
See template
DCH 1315 Health Risk Assessment
PDF template
A confidential form for collecting personal health information to help individuals improve their health and healthcare coverage through the Healthy Michigan Plan.
See template
See template
Heartland Anglers Membership Form
PDF template
Membership registration form for Heartland Anglers fishing tournament participants with liability release and contact information collection.
See template
See template
STUDENT RECORD CARD SR 6 (Local)
PDF template
A mandatory health form for students entering Maryland public schools, documenting physical examinations and immunization requirements.
See template
See template
Mexican Springs Chapter Heavy Equipment Rental Agreement Form
PDF template
A rental agreement form for grader and backhoe equipment from the Mexican Springs Chapter, including rental terms and liability provisions.
See template
See template
Medical Form
PDF template
Medical history and immunization form for students, requiring detailed health information and parental consent.
See template
See template
Medical Form
PDF template
Comprehensive medical history and immunization form for students, requiring detailed health information to be completed by parents/guardians and physicians.
See template
See template
DR. E. BRUCE HENDRICK ONTARIO SCHOLARSHIP PROGRAM 2023 MEDICAL ASSESSMENT FORM
PDF template
A medical assessment form for students with spina bifida or hydrocephalus applying for the Dr. E. Bruce Hendrick Ontario Scholarship Program.
See template
See template
Hepatitis B Vaccination Waiver Form
PDF template
Form for students to decline Hepatitis B vaccination while acknowledging potential health risks from occupational exposure.
See template
See template
NIDDK Hepatology Fellowship Application Form
PDF template
Application form for individuals seeking a hepatology fellowship at the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK)
See template
See template
THREE WAY CONFIDENTIALITY AGREEMENT
PDF template
A multi-party confidentiality agreement for potential research and business collaboration involving exchanging sensitive information.
See template
See template
Disability Claim Form
PDF template
A comprehensive claim form for submitting disability insurance claims with Unum Group subsidiaries.
See template
See template
Release And Waiver Of Liability
PDF template
Legal document releasing Habitat for Humanity from liability for volunteers participating in construction and related activities
See template
See template
PATIENT FRIENDLY BILLING PATIENT GLOSSARY OF BILLING TERMS
PDF template
A comprehensive guide to commonly used financial terms in healthcare billing, designed to improve patient understanding of medical financial communications.
See template
See template
NYCHHC HIPAA Authorization To Disclose Health Information
PDF template
A form authorizing the release of personal medical and health information with specific privacy protections and consent requirements.
See template
See template
Hickory Hill Member Family Emergency Contact Form
PDF template
A form for collecting emergency contact and medical authorization details for club members and their families.
See template
See template
Important Notice For Household Goods Carriers Previously Designated As Type B
PDF template
Notice for household goods carriers regarding registration status, requirements, and re-establishing active registration with the Texas Department of Transportation.
See template
See template
Texas Health And Human Services Acronym Guide
PDF template
A comprehensive list of acronyms used by Texas Health and Human Services covering various healthcare and administrative terms.
See template
See template
NCIEC Healthcare Interpreting Fellowship Application Form
PDF template
Application form for healthcare interpreters seeking a professional fellowship program in medical interpreting across multiple US locations.
See template
See template
Patient Intake Form
PDF template
Comprehensive medical questionnaire collecting patient personal, insurance, and health history information for medical providers.
See template
See template
FDNY HIPAA AUTHORIZATION TO DISCLOSE HEALTH INFORMATION
PDF template
Form authorizing the release of personal health information with specific consent parameters and privacy protections.
See template
See template
HIPAA Compliance Patient Consent Form
PDF template
A form detailing patient consent for healthcare information usage, disclosure, and privacy practices under HIPAA regulations.
See template
See template
Authorization For Release Of Health Information Pursuant To HIPAA
PDF template
Official form allowing patient authorization for release of sensitive medical information in compliance with HIPAA regulations.
See template
See template
HIPAA Acknowledgement And Medical Information Release Form
PDF template
A form for patients to authorize release of medical information and provide contact preferences for communication.
See template
See template
Privacy Complaint Form
PDF template
A form for patients to submit written complaints regarding privacy and confidentiality of protected health information.
See template
See template
HIPAA Privacy Authorization Form
PDF template
A form authorizing the use and disclosure of protected health information (PHI) in compliance with HIPAA regulations.
See template
See template
HIRER COLLISION Or DAMAGE REPORT FORM
PDF template
Comprehensive form for documenting details of a vehicle rental accident, including vehicle, driver, witness, and incident information.
See template
See template
Friends Of Hawaii State Art Museum Membership
PDF template
A membership form for supporting and contributing to the Hawaii State Art Museum's local arts community.
See template
See template
Histology Service Request Form
PDF template
A form for requesting histology laboratory services with sample submission details and contact information.
See template
See template
HSS Histopathology Service New Project Request
PDF template
A form for researchers to request histopathological services at the HSS Research Institute for investigating autoimmune, inflammatory, and orthopedic diseases.
See template
See template
Medical History Form
PDF template
Comprehensive medical form for capturing patient health history, symptoms, and medical conditions across various body systems.
See template
See template
HIV Case Report Form
PDF template
A comprehensive medical form for documenting HIV patient demographics, testing history, and risk factors.
See template
See template
Accident Report Form
PDF template
A comprehensive form for documenting details of a motor vehicle accident for legal and insurance purposes.
See template
See template
Pediatric Provider Referral Form
PDF template
A form for healthcare providers to refer pediatric patients for additional services or evaluations.
See template
See template
Hmsa Travel Assistance Request Form
PDF template
A form for requesting travel-related medical assistance or coverage through HMSA health plan
See template
See template
Harvard Outing Club Medical Form
PDF template
A comprehensive medical form for Outing Club members to provide emergency medical information and disclose health conditions that might impact trip participation.
See template
See template
HOD COMMITTEE VOLUNTEER FORM
PDF template
A form for volunteering to serve on various committees for the House of Delegates meeting, including reference committees and other organizational groups.
See template
See template
Holiday Magic 2016 Competition Guidelines
PDF template
A competition inviting participants to create imaginative gingerbread houses for display at the Springfield Science Museum during the holiday season.
See template
See template
Annual Holiday Pickleball Tournament
PDF template
A holiday pickleball tournament for various skill levels and age groups, raising funds for junior tennis scholarships.
See template
See template
HOME INVENTORY
PDF template
A comprehensive guide for documenting household valuables to assist in theft recovery, insurance claims, and disaster preparedness.
See template
See template
HOME INVENTORY FORM
PDF template
A comprehensive form for documenting household possessions and their replacement costs across different rooms for insurance purposes.
See template
See template
Hooper DSC Referral Form
PDF template
A medical referral form for patient intake and scheduling at a healthcare facility with specific requirements and patient information collection.
See template
See template
Hematology And Oncology Physician Coverage (HO PC) Service
PDF template
A document outlining objectives and expectations for physician coverage in Hematology and Oncology during nights and weekends.
See template
See template
Hospital Admission And Discharge Records
PDF template
A document discussing a new standardized form for recording psychiatric hospital patient admissions and discharges, with concerns about patient confidentiality.
See template
See template
Hospital Discharge Form
PDF template
A form to document patient details and discharge readiness, including medical conditions and follow-up care requirements.
See template
See template
Hospitalization Pre Authorization Form
PDF template
A comprehensive form for patients and healthcare providers to request pre-authorization for hospital admission and medical treatment from Jubilee Health Insurance.
See template
See template
Hotel Guest Shipping Form
PDF template
A form for hotel guests to request shipping of lost or found items with mailing and insurance options.
See template
See template
AUTHORIZATION FOR PRE AUTHORIZED DEBITS (PADS) AND CREDIT CARD DEBITS
PDF template
A form authorizing Howick Mutual Insurance Company to automatically debit insurance premiums from a bank account or credit card.
See template
See template
How To Choose The Correct Proof Of Insurance Form
PDF template
A decision tree for University of Illinois staff, faculty, students, and medical professionals to determine the appropriate proof of insurance form to submit.
See template
See template
How To Submit A Claim For Critical Illness, Accident And Hospital Indemnity Insurance
PDF template
Comprehensive guide for filing insurance claims for critical illness, accident, and hospital indemnity coverage with The Hartford.
See template
See template
Short Term Disability Claim Form
PDF template
Instructions for filing a short-term disability insurance claim through Mutual of Omaha, detailing submission methods and required sections.
See template
See template
Medical Release Form
PDF template
Step-by-step guide for completing an online medical release form for Forest Home organization through CircuiTree registration account.
See template
See template
Request For Evaluation Form
PDF template
Guidance for meet hosts on using and customizing the Request for Evaluation form for officials qualification purposes.
See template
See template
HIGH PLAINS MUSIC CAMP MEDICAL FORM
PDF template
Comprehensive medical form for participants of High Plains Music Camp, collecting personal, medical, and emergency contact information.
See template
See template
Health Professions Recruitment And Exposure Program 2022 Parental Consent Form
PDF template
Consent form for minor students participating in a medical education recruitment and exposure program at Weill Cornell Medical College.
See template
See template
PARENTAL CONSENT FORM
PDF template
Consent form for minors to participate in the Health Professions Recruitment and Exposure Program at Weill Cornell Medical College.
See template
See template
Entity Professional Liability Insurance Application
PDF template
An insurance application form for healthcare entities seeking professional liability coverage for their practice and healthcare professionals.
See template
See template
Medical History Form
PDF template
Comprehensive form for documenting patient medical history, conditions, and potential health issues
See template
See template
Health Reimbursement Arrangement (HRA) Claim Form
PDF template
Claim form for health reimbursement arrangements for members of Operating Engineers Local #49, used to request reimbursement for eligible healthcare expenses.
See template
See template
Mid Central Operating Engineers Health And Welfare Fund Health Reimbursement (HRA) Account Reimburse
PDF template
A form for submitting health care expense reimbursement claims through a Health Reimbursement Arrangement (HRA) account.
See template
See template
Health Reimbursement Account (HRA) Claim Form
PDF template
A form for employees to submit healthcare expense reimbursement claims through their Health Reimbursement Account (HRA)
See template
See template
Service Request Form
PDF template
A comprehensive form for making various changes to an insurance policy, including beneficiary, name, address, and ownership modifications.
See template
See template
REQUEST FOR REIMBURSEMENT FORM
PDF template
A form for submitting healthcare expense reimbursement requests through the Southern California Pipe Trades Health & Welfare Fund HRA program.
See template
See template
Active Local Government And Local Education Employee Group Employee Coverage WaiverReinstatement For
PDF template
Form for New Jersey state employees to waive or reinstate health benefits coverage under the State Health Benefits Program (SHBP) or School Employees' Health Benefits Program (SEHBP).
See template
See template
FMLA LEAVE REQUEST FORM
PDF template
A comprehensive form for employees to request leave under the Family and Medical Leave Act (FMLA) for various qualifying reasons.
See template
See template
Supplemental Insurance Cancellation Form
PDF template
A form for employees to cancel pre-tax and post-tax supplemental insurance deductions with specified effective date.
See template
See template
International Travel Authorization Request
PDF template
A form for requesting and documenting international travel for university employees, students, and volunteers, including safety and risk assessment details.
See template
See template
Claim Form
PDF template
A form for seeking reimbursement of eligible out-of-pocket expenses with participant certification and submission instructions.
See template
See template
Health Savings Account 2023 Payroll Deduction Contribution Form
PDF template
Form for employees to start, stop, or change Health Savings Account (HSA) contributions through payroll deductions.
See template
See template
Health Savings Account 2024 Payroll Deduction Contribution Form
PDF template
Form for employees to start, stop, or change Health Savings Account (HSA) contributions through payroll deductions for the 2024 plan year.
See template
See template
Health Savings Account (HSA) Contribution Form
PDF template
A form for employees to enroll in and specify Health Savings Account (HSA) contributions, including eligibility requirements and tax considerations.
See template
See template
Health Savings Account (HSA) Contribution Form
PDF template
A form for individuals to make contributions to their Health Savings Account through various deposit methods.
See template
See template
Health Savings Account Employer Contribution Form
PDF template
A form for employers to make contributions to employee Health Savings Accounts with specific contribution details and authorization.
See template
See template
HSA Enrollment Form
PDF template
A form for employees to enroll in a Health Savings Account (HSA) with employer contribution and payroll deduction options.
See template
See template
Health Savings Account FAQs
PDF template
Comprehensive guide explaining Health Savings Accounts (HSAs), their benefits, eligibility, and tax advantages for participants.
See template
See template
Health Savings Account Payroll Deduction 2021
PDF template
Form for employees to authorize health savings account contributions through payroll deduction for qualified high deductible medical plans.
See template
See template
Health Savings Account (HSA) Payroll Deduction Form
PDF template
A form for employees to establish, change, or stop payroll deductions for their health savings account (HSA)
See template
See template
Health Savings Account Payroll Deduction Form
PDF template
Form for employees to set up payroll deductions for a Health Savings Account with High Deductible Health Plan coverage details.
See template
See template
BlueFund HSA Payroll Deduction Form
PDF template
A form for employees to set up payroll deductions for a Health Savings Account (HSA) with contribution guidelines and instructions.
See template
See template
Health Savings Account (HSA) Transfer Request Form
PDF template
A form for transferring funds from an existing Health Savings Account (HSA) to a new HSA administered by Aptia and custodied by WEX Inc.
See template
See template
HSA Transfer Request Form
PDF template
A form for transferring Health Savings Account assets between custodians or trustees, potentially involving a former spouse in a divorce scenario.
See template
See template
Concurrent Enrollment Agreement
PDF template
Application for high school students to enroll concurrently in college courses at Northeastern State University
See template
See template
Health Contact Form
PDF template
A bilingual form for tracking medical, dental, and health visits for foster children in Sonoma County
See template
See template
Physical Examination Form
PDF template
A comprehensive medical physical examination form for nursing students at Mennonite College of Nursing, Illinois State University.
See template
See template
HSR Special Risk Claim Form Fill Able
PDF template
Comprehensive guide for filing a special risk insurance claim, detailing required documentation and submission process.
See template
See template
Scott City High School Student Handbook
PDF template
A comprehensive guide for students and parents at Scott City High School, covering academic eligibility, activities, and school policies.
See template
See template
ParentGuardian Consent Form For Children And Youth
PDF template
A consent form for parents/guardians to authorize their children's participation in church-sponsored activities and provide medical information.
See template
See template
State University Of New York Medical Reimbursement Form Claims Incurred Outside Of The United States
PDF template
A medical reimbursement form for SUNY employees and members to claim medical expenses incurred outside the United States.
See template
See template
Prescription Reimbursement Form
PDF template
A form for submitting prescription drug expenses for insurance reimbursement, requiring patient and prescription details.
See template
See template
Health Insurance Information
PDF template
Form for collecting student health insurance details and coverage acknowledgment for Hobart and William Smith Colleges students.
See template
See template
Voluntary Benefits Whole Life Cash Surrender, Dividend Withdrawal, Cancellation And Loan Request For
PDF template
A form for managing whole life insurance policy transactions including cash surrender, dividend withdrawal, cancellation, and policy loans.
See template
See template
Special Olympics Massachusetts Release And Waiver Of Liability
PDF template
Liability waiver for participants in the 2019 Berkshire County Sheriff's Office Law Enforcement Torch Run Humvee Push event
See template
See template
Huu Ay Aht First Nations Event Agreement Form
PDF template
A form outlining participation requirements and expense reimbursement for Huu-ay-aht First Nations citizens attending events.
See template
See template
Huron Valley Percussion Physical Examination Form
PDF template
Comprehensive health screening form for student musicians detailing medical history and physician examination findings.
See template
See template
Then And Now Photography Competition Entry Form
PDF template
A photography competition entry form for recreating historical images of the Roman Wall in Northumberland.
See template
See template
VOLLEY HOOPS PEER FEEDBACK FORM
PDF template
A structured form for students to provide peer feedback on volleyball serving technique and performance during group practice sessions.
See template
See template
Record Of Employment
PDF template
A form for documenting employment status for unemployment insurance purposes in New York State.
See template
See template
Record Of Employment
PDF template
A form for documenting employment details for unemployment insurance claims in New York State.
See template
See template
Newborn Notification Of Delivery Form
PDF template
Healthcare form for providers to report newborn details for Amerigroup Iowa, Inc. Medicaid members within 24 hours of delivery.
See template
See template
Iowa Accident Report Form
PDF template
Official form for reporting motor vehicle accidents in Iowa involving death, injury, or property damage over $1,000.
See template
See template
BA T1103 Project Readiness Assessment For The Port Of Barbados
PDF template
Technical cooperation document to support the government of Barbados in assessing project readiness for port infrastructure through a Global Infrastructure Facility methodology.
See template
See template
Irrevocable Burial Trust Form
PDF template
A comprehensive form for documenting personal, financial, and funeral service preferences with detailed client and next of kin information.
See template
See template
2020 DAY CAMP EMERGENCY CONTACT FORM
PDF template
A form for collecting camper and family information, emergency contacts, and medical permissions for a day camp program.
See template
See template
Ice, Turf And Room Request And Rental Agreement
PDF template
A rental agreement for ice, turf, and room facilities managed by the Minneapolis Park and Recreation Board for various organizations and groups.
See template
See template
ICE, TURF AND ROOM REQUEST AND RENTAL AGREEMENT
PDF template
Rental agreement for ice arena and facility time from the Minneapolis Park and Recreation Board for organizations and individuals.
See template
See template
Employee Emergency Contact Form
PDF template
A form for collecting employee personal and emergency contact details for workplace safety and emergency response purposes.
See template
See template
Cancel My Insurance Cover
PDF template
Form for members to cancel some or all of their insurance coverage with Brighter Super for Local Government & Associated Industries.
See template
See template
MEDICAL HISTORY FORM TEMPLATE
PDF template
A comprehensive form for collecting patient medical information including medications, surgical procedures, illnesses, and vaccination history.
See template
See template
Patient Discharge Form
PDF template
A comprehensive form for documenting patient discharge details, medical treatment, and follow-up information.
See template
See template
Patient Intake Form Template
PDF template
A comprehensive form for collecting patient personal, medical, insurance, and payment information during initial healthcare visit.
See template
See template
ICSVEBA 2021 Back To School E Kit Guide
PDF template
Comprehensive benefits enrollment guide for San Pasqual Valley Unified School District employees for the 2021-2022 school year
See template
See template
MVA Report Form 111121
PDF template
A comprehensive form for reporting details of a motor vehicle accident for insurance and workplace documentation purposes.
See template
See template
RELEASE FORM
PDF template
A legal document granting IEEE permission to use participant's media and content for various business and promotional purposes without compensation.
See template
See template
Preparticipation Physical Evaluation Medical Eligibility Form
PDF template
Medical form for evaluating student-athlete's health and sports participation eligibility, including medical history and emergency contact information.
See template
See template
Staff And Physician Q A Changes To Consent Policy Forms
PDF template
Detailed guidance on updates to medical consent forms, including new separate forms for different types of medical consent and procedures.
See template
See template
Saint Ignatius High School FreshmanTransfer PHYSICAL EXAMINATION FORM
PDF template
Required medical examination form for freshmen and transfer students at Saint Ignatius High School, including health screening and medical history details.
See template
See template
Ignite Award Incident Report Form
PDF template
A comprehensive form for documenting details of an incident involving personal injury or property damage with multiple sections for reporting information.
See template
See template
Personal Automobile Policy Change Form
PDF template
A form for making changes to a personal automobile insurance policy, including options to reject certain coverages.
See template
See template
Immune Globulin Referral Form
PDF template
Medical referral form for patients requiring immune globulin treatment for various neurological and immune disorders.
See template
See template
Minutes Of The Meeting Of The New Jersey Individual Health Coverage Program Board
PDF template
Official minutes documenting the meeting of the New Jersey Individual Health Coverage Program Board, including staff reports and board actions.
See template
See template
2010 IHSA Telephone Service Request Form
PDF template
Form for ordering telephone lines for the Individual Wrestling State Final event at Assembly Hall in Champaign.
See template
See template
Public Law 94 437 Title I Scholarship Program Application Checklist
PDF template
Comprehensive application checklist for scholarship programs offered by the Indian Health Service for healthcare professionals and students.
See template
See template
MRG MINI REGISTRATION FORM
PDF template
A registration form for patients at the Naval Health Clinic in Annapolis, Maryland, collecting basic patient demographic and contact information.
See template
See template
Employee SystemsAccess Checklist Form
PDF template
A form for tracking and managing system access and resources for new or transitioning employees in an educational or administrative setting.
See template
See template
ILCA Africa Fellowship 2022 Application Form
PDF template
Application form for research fellowship program by the International Liver Cancer Association targeting African researchers and medical professionals.
See template
See template
Direct Deposit Form
PDF template
Form for setting up or updating direct deposit payment instructions for Independent Life Insurance Company
See template
See template
Textile Society Art Submission Form
PDF template
A form for artists to submit multiple art pieces with details and project statements for consideration by the Textile Society.
See template
See template
Imaging Order Request
PDF template
A comprehensive medical imaging request form for various diagnostic scans and procedures
See template
See template
NEW PATIENT INTAKE FORM
PDF template
Comprehensive medical form for collecting new patient personal, contact, and medical history information.
See template
See template
Required Certificate Of Immunization
PDF template
A comprehensive form documenting required immunizations for students, including vaccination history and personal information.
See template
See template
Immunization Consent Form
PDF template
A medical form capturing patient consent for immunizations, detailing potential adverse reactions and risks associated with vaccine administration.
See template
See template
IMMUNIZATION CONSCIENTIOUSRELIGIOUSMEDICAL FORM
PDF template
A form for students to request exemption from immunization requirements due to conscientious, religious, or medical reasons
See template
See template
Immunization Record Form
PDF template
A comprehensive form for documenting student immunization history and requirements for university enrollment.
See template
See template
Authorization For Release Of MedicalHealth Information
PDF template
Missouri Department of Social Services form authorizing the release of an individual's medical and health information to specified parties.
See template
See template
IPL TEST REQUISITION FORM
PDF template
Medical form for submitting patient specimens for oncology immunophenotyping testing at Cincinnati Children's Hospital Medical Center laboratory.
See template
See template
Parental Consent Form
PDF template
Consent form for students to participate in computerized concussion baseline testing program for athletic participation.
See template
See template
Incident Or Injury Form
PDF template
A comprehensive form documenting details of an incident or injury involving a child in a care facility.
See template
See template
Incident Report Form Accidents
PDF template
Confidential form for documenting accidents and injuries at school sites, used for reporting and potential legal purposes.
See template
See template
Incident Report Form
PDF template
A comprehensive form for reporting incidents across various settings, capturing details about the event, location, and involved parties.
See template
See template
New York State PTA Incident Report Form
PDF template
A detailed form for documenting incidents, accidents, or injuries during PTA-related activities or events.
See template
See template
4 H Youth Development Incident Report Form
PDF template
A standardized form for reporting safety incidents, injuries, or situations involving 4-H program participants, volunteers, or staff.
See template
See template
Incident Report Form
PDF template
A comprehensive form for documenting incidents resulting in bodily injury during approved club activities or potential insurance issues.
See template
See template
INCIDENT, ACCIDENT, ILLNESS, DEATH OR ARREST REPORT
PDF template
A comprehensive form for documenting and reporting health-related incidents, accidents, illnesses, or other critical events in a community health network.
See template
See template
Angeles Chapter Sierra Club Incident Report Instructions
PDF template
Instructions for Sierra Club trip leaders on reporting various types of incidents during outings, including mandatory reporting requirements and documentation procedures.
See template
See template
Incident Report
PDF template
A form used to document details of incidents involving city property, personnel, or citizens, including damages, injuries, and witness information.
See template
See template
Moycullen Basketball Club Accident Report Form
PDF template
A standardized form for documenting accidents and incidents occurring during basketball club activities.
See template
See template
Angeles Chapter Sierra Club Incident Report Instructions
PDF template
Detailed instructions for reporting incidents during Sierra Club outings, specifying types of incidents that require formal reporting and submission process.
See template
See template
Incident Report Form
PDF template
A form for reporting violations of NASPA's Code of Conduct during sanctioned events or activities.
See template
See template
RESIDENT DAMAGESINCIDENT CLAIM FORM
PDF template
A form for reporting property damage or personal injury incidents for residents to document details and submit to management.
See template
See template
Incident Report Form
PDF template
A comprehensive form for documenting details of an incident, including participant information, injury details, first aid, and follow-up actions.
See template
See template
Incident Report Form
PDF template
A form for documenting and reporting incidents, injuries, or accidents within an organization or club setting.
See template
See template
Incident Report Form
PDF template
Form for reporting non-auto related incidents involving potential bodily injury or property damage at the University of Virginia.
See template
See template
Incoming Loan Agreement
PDF template
A form for borrowing artwork or objects for temporary exhibition, detailing loan conditions, insurance, shipping, and signatures.
See template
See template
Incoming Art Loan Agreement
PDF template
A legal agreement for lending artwork to the University of Southern California for exhibition purposes.
See template
See template
Indemnity And Waiver Form For Acro Angels Gymnastics
PDF template
Legal document waiving liability for potential injuries during gymnastics activities at Acro Angels Gymnastics.
See template
See template
Surety Program Application
PDF template
Application for surety bond program with details on fees, levels, and payment terms for potential applicants.
See template
See template
Acrobranch Adventure Park Indemnity Form
PDF template
Comprehensive safety and liability waiver for participation in extreme sports activities at Acrobranch Adventure Park, outlining risks, safety guidelines, and participant responsibilities.
See template
See template
Acrobranch Adventure Park Indemnity Form
PDF template
Legal waiver and safety guidelines for participating in extreme sports activities at Acrobranch Adventure Park, outlining risks, responsibilities, and participant obligations.
See template
See template
How To Use Your New Caremark Prescription Drug Program
PDF template
Guide explaining new prescription drug coverage details for county employees through Caremark beginning January 1, 2011.
See template
See template
IRO Annual Report
PDF template
Annual reporting form for Independent Review Organizations detailing external health insurance review processes in Oklahoma.
See template
See template
Indirect Membership Agreement
PDF template
A membership and loan agreement document outlining membership eligibility, insurance requirements, and authorization for joining Lewis Clark Credit Union.
See template
See template
Gymnastics BC Individual Member Registration Form
PDF template
Registration form for Gymnastics BC members, collecting participant and emergency contact information for the 2024-2025 season.
See template
See template
Individual Membership Form
PDF template
A confidential membership form for individuals interested in joining the Narcolepsy Network organization with various membership levels and donation options.
See template
See template
Individual Player Waiver Form
PDF template
A comprehensive waiver form for sports participants covering liability, medical information, and consent for activities at Crown Sports Center.
See template
See template
Initial Disability Claim Form
PDF template
Insurance claim form for reporting initial disability claims, covering policyholder and patient information related to sickness or injury.
See template
See template
Indoor Section Competition Form
PDF template
Entry form for bowls club competitions across various categories including singles, pairs, and triples for ladies, men, and mixed events
See template
See template
33rd EACTS Annual Meeting Industry Opportunities Booking Form
PDF template
Registration and booking form for industry sponsorship opportunities at the 33rd European Association for Cardio-Thoracic Surgery Annual Meeting in Lisbon, Portugal.
See template
See template
Industry Presentation Submission Form
PDF template
A form for submitting clinical research presentations for The Aesthetic MEET 2025 conference.
See template
See template
Form 2C Uniform Certificate Of Authority Application (UCAA) Corporate Amendments Application
PDF template
A form used by insurance companies to request changes to their existing certificate of authority across multiple states.
See template
See template
Uniform Certificate Of Authority Application (UCAA) Corporate Amendments Application Checklist
PDF template
A checklist and guide for insurers submitting corporate amendments to their certificate of authority application.
See template
See template
Uniform Certificate Of Authority Application (UCAA) Expansion Application Checklist
PDF template
A comprehensive checklist for insurance companies seeking to expand their operational jurisdictions and obtain new insurance authority.
See template
See template
Form 2C Uniform Certificate Of Authority Application (UCAA) Corporate Amendments Application
PDF template
A comprehensive form for insurance companies to request amendments to their existing certificate of authority across multiple U.S. states and territories.
See template
See template
Uniform Certificate Of Authority Application (UCAA) Expansion Application
PDF template
A form for insurance companies to apply for expansion of business lines across multiple states in the United States.
See template
See template
Inflatable Rental Terms Conditions
PDF template
Comprehensive rental agreement outlining safety rules, weather policies, risk assumptions, and liability releases for inflatable rental equipment.
See template
See template
Influenza Sample Submission Form
PDF template
A detailed form for submitting influenza test samples to the South Dakota Public Health Laboratory with comprehensive patient and specimen information.
See template
See template
West Virginia Informational Letter No. 1 A
PDF template
Guidelines for insurance companies regarding policy cancellation notices and policyholder rights in West Virginia.
See template
See template
Limited License Fee Waiver Affidavit Form
PDF template
A form for employers to certify that a volunteer physician will not receive monetary compensation, enabling a fee waiver for medical licensure.
See template
See template
Informant Interview Form Instructions
PDF template
Instructions for completing an interview form about a participant through a close contact when direct participant data collection is not possible.
See template
See template
Information For Potential Research Volunteers Who Complete MCW On Line Webforms
PDF template
Document outlining data collection, usage, and privacy practices for medical research volunteer webforms at Medical College of Wisconsin.
See template
See template
Informed Consent And Liability Waiver Form
PDF template
A consent form detailing patient rights, treatment expectations, and liability release for physical therapy services.
See template
See template
UNIVERSITY OF PENNSYLVANIA RESEARCH SUBJECT INFORMED CONSENT AND HIPAA AUTHORIZATION FORM
PDF template
Informed consent document for participation in medical research biobank involving genetic and biological sample collection and research studies.
See template
See template
Informed Risk Insurance Form For Allied Health Students
PDF template
A document detailing potential infectious disease risks for allied health students and insurance requirements during clinical studies.
See template
See template
Prescription Reimbursement Claim Form
PDF template
A form for submitting prescription medication reimbursement claims to an insurance provider, detailing patient, pharmacy, and insurance information.
See template
See template
PLASTIC COSMETIC CENTER IN HOUSE FINANCING FORM CREDIT CHECK
PDF template
A comprehensive form for patients seeking in-house financing for cosmetic procedures with credit authorization.
See template
See template
INITIAL CONTACT FORM (ICF)
PDF template
Comprehensive intake form for patient medical, substance use, and treatment history for healthcare services.
See template
See template
Initial Disability Claim Form
PDF template
Insurance claim form for reporting initial disability claim with details about injury, hospitalization, and patient information.
See template
See template
Initial Uniform Health Assessment Form
PDF template
A comprehensive health evaluation form for medical professionals to assess fitness for duty and potential health risks to patients.
See template
See template
Nursing Education Program Medical Form
PDF template
Medical form required for students entering the Jefferson State Community College Nursing Program, documenting health status and immunizations.
See template
See template
Medical History Form
PDF template
Comprehensive medical history questionnaire used by Egea Medical Weight Loss Center to collect patient health information and background.
See template
See template
Initial Disability Claim Form
PDF template
Insurance claim form for reporting initial disability due to sickness or injury, used by Aflac to process insurance claims.
See template
See template
Injury Incident Report Workers Compensation
PDF template
A form documenting workplace injury incidents with no medical treatment required, used for tracking workplace safety and potential compensation claims.
See template
See template
Form D Student Injury Report Form
PDF template
A form used to document and report student injuries or exposures during academic or clinical activities.
See template
See template
Injury And Third Party Liability Form
PDF template
A form for documenting injuries potentially involving third-party liability for the Southern California Pipe Trades Health & Welfare Fund.
See template
See template
INNOVATION GRANT APPLICATION FORM
PDF template
A comprehensive application form for researchers seeking innovation grants from the British Medical Ultrasound Society (BMUS)
See template
See template
California Lawyer Association In Person Program Submission Form
PDF template
A form for submitting in-person legal programs and events by the California Lawyer Association, designed for programs 4 hours or less in length.
See template
See template
CERTIFICATE REQUEST FORM
PDF template
Form for requesting insurance certificates with coverage details for Colorado State University.
See template
See template
Report Of Head Injury During Sports Season
PDF template
A form to document head injuries occurring during school sports or extracurricular athletic activities for students.
See template
See template
Reimbursement Account Claim Form
PDF template
Claim form for submitting healthcare and dependent care expenses for reimbursement through a flexible spending account or reimbursement account.
See template
See template
Art Submission Form
PDF template
Form for artists to submit artwork for gallery exhibition, with details about the artwork and artist information.
See template
See template
Instructions For Submitting Curricular Changes For 2023 24 Catalog
PDF template
Detailed instructions for Southern Oregon University faculty on submitting course and program changes for the 2023-24 academic catalog.
See template
See template
CMS 1500 Claim Form Instructions
PDF template
Detailed instructions for completing the CMS 1500 form for medical service billing to SFHP by healthcare providers.
See template
See template
INSTRUCTIONS FOR MEDICAL REQUIREMENTS FOR CONDITIONALLY APPOINTED APPLICANTS
PDF template
Detailed guidelines for completing medical forms for conditionally appointed VMI applicants through the Medicat Portal.
See template
See template
INSTRUCTIONS FOR PRE AUTHORIZATION FORM
PDF template
Detailed instructions for completing a pre-authorization form for medical procedures and services at Kaiser Permanente.
See template
See template
Carroll County Recreation Parks PROGRAM PROPOSAL FORM
PDF template
A form for submitting program proposals to Carroll County Recreation & Parks, including program details, instructor information, and scheduling.
See template
See template
City Of Lincoln Contract Instructor Proposal Packet
PDF template
Guidelines for becoming a contract instructor with the City of Lincoln Recreation Department, outlining responsibilities, requirements, and program details.
See template
See template
Insurance And Safety Policy
PDF template
Policy document outlining safety standards and insurance coverage for Seventh-day Adventist Medical Cadet Corps activities in Florida.
See template
See template
MOTOR VEHICLE INSURANCE AGENT INSURANCE BINDER CANCELLATION FORM
PDF template
Official form for cancelling a temporary motor vehicle insurance binder in Kentucky, required by state regulation.
See template
See template
SPD SP048 Insurance And Bonding Guidelines
PDF template
Comprehensive guide detailing insurance types, limits, certificates, and bonding recommendations for vendors and contractors working with Georgia state entities.
See template
See template
Certificate Of Insurance Form
PDF template
Insurance requirements and guidelines for parade participants, mandating a minimum $2 million public liability insurance policy.
See template
See template
Certificate Of Insurance Form
PDF template
Insurance requirements and documentation for parade participants at Westerner Days Fair and Exposition
See template
See template
INSURANCE FINANCIAL POLICY
PDF template
A comprehensive financial policy document outlining insurance billing, payment expectations, and patient responsibilities for chiropractic services.
See template
See template
Insurance Form 1
PDF template
Details insurance coverage requirements for contractors, specifying minimum insurance limits across multiple categories.
See template
See template
Insurance Form 1
PDF template
Detailed insurance requirements for a contract, specifying minimum insurance limits and coverage types for a seller.
See template
See template
Insurance Requirements Form
PDF template
A document outlining insurance requirements and indemnification terms for vendors participating in a Rotary Club event.
See template
See template
Insurance Form 2
PDF template
Detailed insurance coverage requirements for a seller, specifying minimum insurance limits and types of coverage needed for contractual performance.
See template
See template
Dental Insurance Information
PDF template
Insurance form for collecting patient dental insurance details and treatment consent
See template
See template
KAPOS Insurance Information Form
PDF template
A form to collect insurance and personal details for team participation in a regional competition.
See template
See template
Insurance Form Filing Procedures
PDF template
Official document outlining procedures for submitting insurance form filings through the System for Electronic Rate and Form Filing (SERFF) for the District of Columbia.
See template
See template
Insurance Form For Residence Hall Students
PDF template
Form for collecting student health insurance information for residential students at Monroe Community College.
See template
See template
Insurance Information And Authorization Form
PDF template
Medical insurance and patient authorization document for Drs. Mark and Suzanne Boas' eyecare practice, collecting patient insurance details and financial responsibilities.
See template
See template
NEW PATIENT INFORMATION SHEET
PDF template
Comprehensive patient intake form for collecting personal, contact, and insurance information for new patients at the university student health center.
See template
See template
Student Athlete Insurance Information Form
PDF template
A comprehensive insurance information form for student-athletes at Kutztown University to provide medical and contact details.
See template
See template
Insurance Reference Manual
PDF template
Comprehensive insurance manual for Moose International lodges, chapters, and associated organizations covering various insurance programs and risk management guidelines.
See template
See template
Insurance Form
PDF template
Form for requesting, canceling, or changing insurance coverage for members of iQ Super For Life and iQ Super Business.
See template
See template
CA.04 21.REF.05 Insurance Terms And Conditions
PDF template
Detailed insurance guidelines and requirements for applicants seeking an encroachment agreement with the City of Mississauga.
See template
See template
PARKS RECREATION DEPARTMENT PERMIT INSURANCE REQUIREMENTS
PDF template
Detailed guidelines for insurance requirements for organizations seeking permits for events in Palm Beach County Parks & Recreation Department
See template
See template
Insurance WaiverChange Of Address
PDF template
A document for patients to waive insurance coverage and update contact information for medical services.
See template
See template
Change Of Address Form
PDF template
Official form for updating company contact and address information with the Nevada Division of Insurance.
See template
See template
Insuring Technology Risks In A Professional Environment
PDF template
A white paper addressing technology-related risks and insurance considerations for professional engineering practices.
See template
See template
DELL COMPUTER REQUEST FORM
PDF template
Official form for requesting Dell computer products for university departments, with specific instructions for processing and approval.
See template
See template
Consent To Treat
PDF template
A legal document authorizing medical treatment and explaining patient rights under HIPAA privacy regulations.
See template
See template
Primary Eyecare Associates Patient Form
PDF template
Comprehensive medical and vision history intake form for eye examination and patient records.
See template
See template
Patient Intake Form
PDF template
Patient intake document providing contact information for multiple PanCare Health medical and dental clinics across Florida counties.
See template
See template
Patient Intake Form
PDF template
A comprehensive medical intake form for collecting patient personal and health information for acupuncture treatment.
See template
See template
Patient Intake Form
PDF template
A comprehensive patient intake document for collecting detailed personal, medical, and contact information at a memory clinic.
See template
See template
Adult Patient Intake Form
PDF template
Comprehensive medical intake form for collecting patient personal, contact, emergency, and insurance information for medical treatment.
See template
See template
New Patient Intake Form
PDF template
Comprehensive form for collecting patient demographic, contact, insurance, and scheduling information for new healthcare patients.
See template
See template
NEW PATIENT INTAKE FORM
PDF template
Comprehensive medical and insurance information form for new patients, focusing on vision and health insurance details.
See template
See template
Patient Intake Form
PDF template
Comprehensive medical intake form for new chiropractic patients to document personal information, health history, and current medical conditions.
See template
See template
NEW PATIENT INTAKE FORM
PDF template
Comprehensive patient intake form for podiatry medical practice collecting patient information, medical history, and insurance details.
See template
See template
Patient Intake Form
PDF template
Comprehensive patient intake form collecting personal information, medical history, insurance details, and pre-examination assessment for medical treatment.
See template
See template
Claim Form ICS Non Medical Expenses Aon Student Insurance
PDF template
A comprehensive claim form for reporting various types of non-medical insurance damages and losses for student insurance policies.
See template
See template
Neighborhood Health Plan Of Rhode Island (NHPRI) DME Authorization Form
PDF template
Healthcare authorization form for durable medical equipment (DME) services from Neighborhood Health Plan of Rhode Island
See template
See template
Orthopaedic Surgery Program Intent To Travel Form
PDF template
A form for documenting and requesting travel reimbursement for residents in the Orthopaedic Surgery Program with details about mileage and funding sources.
See template
See template
Accepted Interactive Sports Wagering Gaming Service Provider Notifications
PDF template
Official list of authorized providers for interactive gaming and sports wagering services with contact details and service descriptions.
See template
See template
Interlocal Contact Form
PDF template
A form for submitting contact details for interlocal entities to the Oklahoma Insurance Department.
See template
See template
International Claim Form
PDF template
A comprehensive form for submitting international healthcare insurance claims with patient and coverage details.
See template
See template
Generali Worldwide Health Insurance Healthcare Pre Authorization
PDF template
A pre-authorization form for healthcare services requiring insurance approval and documentation for Generali Worldwide Health Insurance.
See template
See template
Health Insurance Pre Authorization Form For Therapy
PDF template
Insurance form for pre-authorization of physical, occupational, speech, and chiropractic therapy treatments.
See template
See template
BOBST INTERNATIONAL CENTER SERVICE REQUEST FORM
PDF template
A comprehensive form for patients seeking medical services, including travel, consultation, and treatment details.
See template
See template
International Student Insurance Refund Request
PDF template
A form for international students studying remotely due to COVID-19 to request a health insurance refund for the Spring 2023 semester.
See template
See template
International Student Medical Form
PDF template
Comprehensive medical form for international students attending community colleges in North Carolina, capturing personal and medical information.
See template
See template
Intern Medical Treatment Authorization Form
PDF template
Medical authorization form for interns to provide emergency treatment details and contact information in case of medical incidents.
See template
See template
StudentInternPracticum Application
PDF template
Application form for students seeking internship or practicum placement at a community mental health center
See template
See template
INTERNSHIPFIELD EXPERIENCE RESPONSIBILITIES AGREEMENT
PDF template
Legal document outlining responsibilities, insurance requirements, and liability terms for student internships and field experiences.
See template
See template
Internship Learning Agreement Form
PDF template
A comprehensive agreement outlining student responsibilities, expectations, and legal considerations during an internship placement.
See template
See template
Internship Project Form
PDF template
A form for documenting student internship projects in art-related courses, outlining project details, responsibilities, and evaluation criteria.
See template
See template
Interventional Radiology Referral Form
PDF template
Medical referral form for various interventional radiology procedures and services at Cincinnati Children's Hospital Medical Center
See template
See template
Entry Medical Examination United Nations And Specialized Agencies
PDF template
Medical examination form for employment candidates seeking positions with United Nations and specialized agencies, requiring comprehensive health disclosure and authorization for medical record review.
See template
See template
Waukee Community Education Intramural Waiver Form
PDF template
A consent and release form for students participating in Waukee Community Education intramural programs, acknowledging risks and providing medical authorization.
See template
See template
Skate Swap Seller Inventory Form
PDF template
A form for sellers to list and track items for a skating equipment and clothing swap event with proceeds benefiting Denver Synchronicity.
See template
See template
Fireside Members Gallery Inventory
PDF template
Gallery form for artists to submit artwork details and agree to exhibition terms for display at the Williamsburg Cultural Arts Center gallery.
See template
See template
GALLERY EXHIBIT INVENTORY FORM
PDF template
A form for artists to submit artwork for a gallery exhibit, including details about artwork categories, fees, and docent responsibilities.
See template
See template
IPAC Application Form
PDF template
Application form for research project consultation and imaging analysis services at a medical research facility.
See template
See template
Salesian College IPad LossDamage Report Form
PDF template
A form for reporting lost, stolen, or damaged iPads at Salesian College with details about the incident and insurance claim process.
See template
See template
IPA TRAVEL FORM
PDF template
Travel form for IPA members seeking assistance and travel arrangements between police sections.
See template
See template
Data Protection Consent Form For Athletes
PDF template
Consent form for athletes regarding transfer of World Para Snow Sports governance from IPC to International Ski and Snowboard Federation (FIS)
See template
See template
Data Protection Consent Form For Athletes
PDF template
Consent form for athletes regarding the transfer of Para dance sport governance from IPC to World Abilitysport
See template
See template
Informed Consent For Research Participation
PDF template
A template for obtaining informed consent from research study participants at Washburn University.
See template
See template
Informed Consent For Participation Of A MINOR In A Research Study
PDF template
A legal document obtaining parental consent for a minor's participation in a research study, outlining study details and participant rights.
See template
See template
Sample Assent Form For Child
PDF template
A template form for obtaining a child's voluntary agreement to participate in a research study with parental consent.
See template
See template
IRCP Medical History Form
PDF template
Comprehensive medical history form for patients with polio, capturing details about diagnosis, hospitalization, symptoms, and current health status.
See template
See template
Medicare Part B Income Related Monthly Adjustment Amount (IRMAA) Reimbursement Form
PDF template
Form for NYC employees to request reimbursement for Medicare Part B premiums exceeding standard monthly amounts.
See template
See template
ArtPoetry Competition Entry Form
PDF template
Entry form for students to submit artwork or poetry for local art competitions with parent/guardian permission.
See template
See template
Irondale Youth Sports Volunteer Form
PDF template
Comprehensive volunteer application for Irondale youth sports programs, collecting personal information and background details
See template
See template
Is It An Emergency
PDF template
A guide to recognizing and responding to medical emergency warning signs for adults and children.
See template
See template
Cancellation Form
PDF template
Form for cancelling enrollment in Medica health insurance plans with multiple reason options.
See template
See template
Information Technology Project Request Form
PDF template
A comprehensive form for submitting and evaluating technology project proposals within an organization
See template
See template
ISS Trip Liability Waiver Form
PDF template
A legal waiver form for students participating in an ISS trip, releasing the University at Buffalo from liability for potential injuries or damages.
See template
See template
IT Addendum To ContractorS Contract Form
PDF template
An addendum modifying standard contract terms for IT services between a contractor and the Virginia Community College System (VCCS)
See template
See template
WELLNESS CENTER LIABILITY WAIVER
PDF template
A comprehensive liability waiver for participation in university wellness center activities and events, acknowledging risks and releasing the university from potential claims.
See template
See template
CDW Customer Service Order Form
PDF template
Agreement between Tulsa County and CDW Government, LLC for Mimecast M2A and LCS-Gold annual subscriptions
See template
See template
MCSA 5870 Insulin Treated Diabetes Mellitus Assessment Form
PDF template
A medical form used to evaluate individuals with insulin-treated diabetes mellitus for commercial motor vehicle operator qualification.
See template
See template
Cooperative Agreement Between U.S. Army Corps Of Engineers And National Loon Center Foundation
PDF template
A cooperative agreement between the U.S. Army Corps of Engineers and the National Loon Center Foundation for managing and interpreting the Cross Lake Recreation Area in Minnesota.
See template
See template
Board Meeting Agenda Submittal Maintenance Agreement For Leon Rose Ball Field
PDF template
Resolution approving a maintenance agreement with Groveland Sports Zone for Leon Rose Ball Field, with no cost to the district.
See template
See template
Items Of Extraordinary Value Inventory
PDF template
A shipping document to identify and declare high-value items for special handling and liability protection during transportation.
See template
See template
I.T Maintenance Request Form
PDF template
A form used to document and track IT equipment maintenance requests within an organization.
See template
See template
ITP 3 Technology Governance And Procurement Review
PDF template
Administrative procedure defining the technology governance process and requirements for technology procurement review at Marshall University.
See template
See template
Information Technology Professional Services Agreement
PDF template
A service agreement between Cornell University and a technology consultant for professional IT services and deliverables.
See template
See template
SIUE ITS Network Infrastructure Management Service Requisition Form
PDF template
A form for requesting network and infrastructure services at Southern Illinois University Edwardsville (SIUE)
See template
See template
Information Technology Services Purchase Requisition Form
PDF template
Guidelines for staff to request and purchase IT equipment through the Information Technology Services department's requisition process.
See template
See template
Outpatient Physician Visit Referral Form
PDF template
A medical referral form for patient transfer between healthcare providers, collecting patient and referral details.
See template
See template
J88 Report On A Medico Legal Examination
PDF template
Official form for documenting medical findings in legal investigations, completed by healthcare practitioners for forensic purposes.
See template
See template
Scholars Insurance Compliance Form
PDF template
A form for verifying health insurance requirements for international scholars, conforming to US Department of State guidelines.
See template
See template
J 1 Visa Application For Prospective UTSW International Visitor
PDF template
Comprehensive application package for international trainees seeking J-1 visa sponsorship at UT Southwestern Medical Center.
See template
See template
Release And Waiver Of Liability And Indemnity Agreement To Jeep Adventure Academy
PDF template
Legal waiver and liability release form for participants in Jeep Adventure Academy off-road events, outlining participant responsibilities and risk acknowledgment.
See template
See template
Jane Farver Memorial Fund Residency Application
PDF template
Application form for artists seeking a residency at the International Studio & Curatorial Program (ISCP)
See template
See template
Patient Intake Form
PDF template
Comprehensive medical intake document collecting patient personal, contact, insurance, and consent information for medical services.
See template
See template
Accident Waiver And Release Of Liability Form
PDF template
Legal document releasing liability for participants in an event or activity organized by the Society of American Military Engineers (SAME).
See template
See template
Medical Release Form
PDF template
A form for documenting participant medical history, conditions, medications, and emergency contact information.
See template
See template
Journal Of Hospital Medicine Author Contribution Form
PDF template
A form detailing authorship guidelines and contributions for a medical research manuscript submission.
See template
See template
FOBT FOLLOW UP FORM
PDF template
A medical chart audit form for tracking patient follow-up after a positive fecal occult blood test (FOBT) result in a colorectal cancer screening study.
See template
See template
Jeep Jamboree Waiver And Release Of Liability
PDF template
Legal waiver for participants in Jeep Jamboree off-road events, releasing organizers from liability and setting vehicle participation requirements.
See template
See template
JLTI Logo Design Competition Entry Form
PDF template
An entry form for a logo design competition organized by the Japanese Language Teachers of Ireland (JLTI) for logo submissions.
See template
See template
Job Application Form
PDF template
Comprehensive job application form for potential employees seeking work at Jones & Associates Insurance, collecting personal, employment, and educational information.
See template
See template
Urgent Care Application For Employment
PDF template
Comprehensive employment application for various medical positions at an urgent care facility, including equal opportunity and work authorization sections.
See template
See template
MSUB Recreation Activities Position Application
PDF template
A job application form for a position with the Recreation Activities department at Montana State University Billings
See template
See template
Medical Alert Form
PDF template
Medical information form for students using Johnson Bus Company transportation services in Menomonee Falls School District.
See template
See template
HCP Referral Form
PDF template
A comprehensive referral form for healthcare coordination and client information collection
See template
See template
JOVC Billing Form
PDF template
A comprehensive billing form for collecting payment details, player information, and optional merchandise purchases for a sports team or organization.
See template
See template
Fresh Osteochondral Allograft And Fresh Frozen Meniscus Order Form
PDF template
Medical order form for requesting fresh osteochondral allografts and meniscus grafts for surgical procedures.
See template
See template
Medical Examination Physician Statement
PDF template
A medical examination form for visa applicants requiring documentation of medical screening by an embassy-approved physician.
See template
See template
Authorship Contribution Form
PDF template
A form documenting author contributions for manuscript submission to medical journal publications.
See template
See template
Junior Treekeeper Camp Accident Waiver And Release Of Liability
PDF template
A legal document waiving liability for participants in a youth camp program, acknowledging potential risks and releasing event organizers from legal responsibility.
See template
See template
JudicialCourt Bond Application
PDF template
Application form for obtaining a judicial or court bond for legal proceedings, used by attorneys or law firms.
See template
See template
FSCS Newsletter
PDF template
Newsletter from FSCS detailing changes to pension application forms for seven specific firms, including new mandatory questions and document requirements.
See template
See template
Transitions
PDF template
Monthly update document from Massachusetts Department of Transitional Assistance covering case transfer functionality, MBTA fare changes, and participation form guidelines.
See template
See template
Participation And Attendance Form Data Entry Online Guide
PDF template
Detailed instructions for submitting and entering participation and attendance forms for the Department of Transitional Assistance
See template
See template
Physical Examination Form
PDF template
Required medical form for participants in Junior Hilltoppers Sports Clubs, documenting health status and emergency contact information.
See template
See template
Junior Naturalist Program 2023 Scholarship Application Form
PDF template
Scholarship application for children to attend summer nature camp, sponsored by Friends of Forsyth Nature Center and available only to Kingston residents.
See template
See template
Junior Volunteer Application
PDF template
Application for teenagers aged 15+ interested in volunteering at Valley View Hospital healthcare facility.
See template
See template
WSCC Fellows Proposal Form
PDF template
A proposal to use iPads as digital sketchbooks in a printmaking course to enhance student learning and project documentation.
See template
See template
Medical Form
PDF template
A comprehensive medical history form for applicants to the JVC Northwest program, to be completed by a healthcare professional.
See template
See template
Artwork Loan Agreement
PDF template
A legal agreement for loaning artwork to The Joy & Whimsy Depot for exhibition purposes, outlining responsibilities of the lender and the exhibitor.
See template
See template
Kentucky Assigned Claims Plan Billing Summary Form
PDF template
A detailed form for submitting reimbursement requests and subrogation recoveries for insurance claims in Kentucky's Assigned Claims Plan.
See template
See template
Kentucky Assigned Claims Plan Billing Summary Form
PDF template
Detailed guide for insurers on submitting reimbursement requests and subrogation details for the Kentucky Assigned Claims Plan.
See template
See template
Kaiser Permanente Payment Selection Form
PDF template
A form for selecting automatic payment methods via bank account or credit card for Kaiser Permanente services.
See template
See template
Member Reimbursement Form For Medical Claims
PDF template
A comprehensive form for submitting medical claim reimbursement requests, including patient and provider details.
See template
See template
Peralta Community College District Reimbursement Form
PDF template
Form for Peralta Community College District employees and retirees to claim medical expense reimbursements based on specific eligibility criteria.
See template
See template
Kaiser Permanente Senior Advantage (HMO) Group Medicare Election Form
PDF template
Form for enrolling in Kaiser Permanente's Senior Advantage Medicare health plan for group participants.
See template
See template
Dengue Report Form
PDF template
Medical reporting form for collecting patient information related to dengue fever cases in Kansas, used for public health tracking and epidemiological research.
See template
See template
NEW PATIENT INTAKE FORM
PDF template
Comprehensive medical intake form for patients seeking joint replacement or orthopedic consultation, collecting detailed medical history and symptom information.
See template
See template
Keenan Insurance Scholarship Guidelines 2024
PDF template
Guidelines for a scholarship program administered by the Foundation for California Community Colleges, providing funding for students in insurance and related fields.
See template
See template
Keenan Insurance Scholarship Guidelines 2024
PDF template
Guidelines for a scholarship program providing financial support to California Community College students studying insurance and related fields.
See template
See template
Key Facts You Need To Know About Helping Families That Include Immigrants Apply For Health Coverage
PDF template
A guide explaining health coverage application processes and eligibility for families that include immigrants, addressing key concerns and immigration status implications.
See template
See template
KHC And KHCNVL Alternate Requisition Form
PDF template
Medical requisition form for various heart-related diagnostic tests with detailed patient instructions and testing protocols.
See template
See template
Athletic Participation Form
PDF template
Form for parental consent and student participation in high school interscholastic athletics, including emergency contact and insurance information.
See template
See template
KIDS FUNFEST 2019 PROGRAM INFORMATIONCONFIRMATION FORM
PDF template
Registration form for participants in the City of Sarnia's Kids FunFest 2019 event at Clearwater Grounds.
See template
See template
Fertility Assessment Form
PDF template
A detailed medical form for couples assessing fertility challenges and medical history related to reproductive health.
See template
See template
New Patient Intake Form
PDF template
Comprehensive medical intake form for collecting new patient personal, contact, and health provider information
See template
See template
Evaluating Drivers And Issuing The Medical Report Form
PDF template
Guidelines for DMV staff to assess a driver's medical fitness and ability to operate a motor vehicle safely.
See template
See template
Aflac Cancer Wellness Claim Form
PDF template
Document providing guidance on filing wellness claims with Aflac insurance and information about Primary Care Provider (PCP) selection.
See template
See template
Member Reimbursement Form For Over The Counter COVID 19 Tests
PDF template
A form for Kaiser Permanente members to request reimbursement for over-the-counter COVID-19 test purchases.
See template
See template
Incoming Freshman And Transfer Student Scholarship Form
PDF template
Scholarship application form for incoming art students to submit artwork, transcript, and recommendation for consideration.
See template
See template
Accident Waiver And Release Of Liability Form
PDF template
A legal document that releases event organizers from liability and confirms participant's physical fitness and voluntary participation.
See template
See template
Accident Waiver And Release Of Liability Form
PDF template
A legal document that releases event organizers from liability and confirms participant's fitness and understanding of potential risks.
See template
See template
PREVENTATIVE HEALTH CARE EXAMINATION FORM
PDF template
A comprehensive health screening form for students entering Kentucky public schools, documenting medical history and physical examination results.
See template
See template
Kentucky Immunization Registry Enrollment
PDF template
Instructions for healthcare providers to enroll in the Kentucky Immunization Registry and create user accounts.
See template
See template
Competition Entry Form
PDF template
Entry form for a national insurance customer service representative award recognizing excellence in professional performance.
See template
See template
PREVENTATIVE HEALTH CARE EXAMINATION FORM
PDF template
Required health examination form for Kentucky public school students entering school or sixth grade, documenting medical history and physical screening results.
See template
See template
Community Supports Medically Tailored Meals (CS MTM) Referral Form For MCLA CMC Members Only
PDF template
Referral form for L.A. Care Health Plan members to enroll in a Medically Tailored Meals Program with specific chronic condition eligibility criteria.
See template
See template
Incident Report Form For Bodily Injury
PDF template
Insurance form for documenting details of a bodily injury incident, likely related to cycling or athletic events.
See template
See template
LABORATORY SAFETY CHECKLIST (FORM 3010)
PDF template
A comprehensive safety checklist designed to ensure awareness and compliance with laboratory safety policies and procedures for employees and visitors.
See template
See template
Laboratory Services Outpatient Lab Requisition
PDF template
A comprehensive form for ordering laboratory supplies, collection containers, and specifying test requirements for various medical specimens.
See template
See template
Leukemia Diagnostic Test Request Form
PDF template
Medical form for submitting patient specimens for leukemia-associated diagnostic testing and immunophenotype analysis.
See template
See template
Lab Requisition
PDF template
Medical form for ordering and documenting various laboratory diagnostic tests and panels.
See template
See template
Boise State UniversityS Lab Waiver Of Liability And Assumption Of Risk
PDF template
A legal document granting parental permission and outlining liability terms for students participating in Boise State University lab programs.
See template
See template
Ladies Bowling Section Competition Entry Form 2024
PDF template
Form for ladies to enter various bowling competitions at Uddingston Bowling and Tennis Club for the 2024 season
See template
See template
Chronic Illness Benefit Application Form
PDF template
Application form for patients seeking chronic illness benefits through LA Health Medical Scheme, requiring patient and medical professional details.
See template
See template
My Medical Info
PDF template
A comprehensive medical information form designed to provide critical health details for emergency personnel in case of medical emergencies.
See template
See template
Bessie Marshall Benefit Fund Instructions
PDF template
Detailed instructions for members to apply for weekly benefits in case of sickness or injury, with specific eligibility requirements and limitations.
See template
See template
Ladies Auxiliary To The Maryland State FiremenS Association Bessie Marshall Benefit Fund Instructi
PDF template
Benefit fund guidelines for sick or injured members of the Maryland State Firemen's Association providing weekly financial assistance under specific conditions.
See template
See template
PROOF OF DISABILITY CLAIM FORM
PDF template
A form for employees to document and claim disability benefits through the Labor Alliance Managed Trust Fund.
See template
See template
NATIONAL STANDING ORDER FORM
PDF template
Medical transportation request and service authorization form for patient transportation services
See template
See template
Laser Operations Safety Audit Form
PDF template
A comprehensive safety audit form for documenting laser operation safety compliance and inspection of various laser classes.
See template
See template
Parent Handbook And Required Forms 20222023 School Year
PDF template
Comprehensive handbook for parents outlining the Lauri Ann West Community Center's after-school arts and enrichment program, its vision, mission, and operational details.
See template
See template
Authorization For Release Of Information And Liability Waiver
PDF template
Legal document authorizing disclosure of employment files for law enforcement job candidates in Wisconsin, with liability release provisions.
See template
See template
Circular Letter 241 Of The Commissariat Aux Assurances On The Insurance Agencies Annual Reporting
PDF template
Official document providing instructions for insurance agencies' annual reporting requirements and submission process for the year 2024.
See template
See template
Schulman Gallery Artists Submission Agreement Form
PDF template
Agreement for artists to submit and exhibit artwork in the LCCC Juried Faculty and Alumni Exhibition at Schulman Gallery.
See template
See template
INSURANCE PRE AUTHORIZATION FORM
PDF template
A form for collecting client and insurance details for pre-authorization of therapeutic services.
See template
See template
Legacy Community Health Client Intake
PDF template
Comprehensive patient intake form for collecting personal and medical contact information for Legacy Community Health services.
See template
See template
Budget Form Instructions
PDF template
Comprehensive instructions for completing a budget form for program services, including details on administration, program costs, and budgeting guidelines.
See template
See template
Dealership Cancellation Form
PDF template
A form for cancelling a dealer's mechanical breakdown insurance policy with options for various cancellation reasons and refund processing.
See template
See template
Addendum To Lease
PDF template
Supplemental lease agreement outlining additional tenant responsibilities, rent payment terms, and property conduct rules.
See template
See template
Broward County Civic Arena License Agreement
PDF template
Lease agreement for the BB&T Center, detailing terms of use by the Florida Panthers hockey team with Broward County.
See template
See template
Least Expensive Milk Declaration Form
PDF template
Form for WIC vendor applicants to declare their lowest-cost milk brand for program participation.
See template
See template
LEAVE OF ABSENCE REQUEST FORM
PDF template
Detailed guidelines for employees requesting a leave of absence, including required documentation for various types of leave.
See template
See template
Leave Request Form
PDF template
A form for employees to request various types of leave, including family medical, annual, compensatory, and sick leave.
See template
See template
Leave Of Absence Request Form
PDF template
A comprehensive form for employees to request various types of leave, including personal, medical, and family-related absences.
See template
See template
Cancellation Form
PDF template
A form for employees to cancel or continue legal resources and identity theft plan coverage during employment termination or open enrollment.
See template
See template
ARAG Legal Insurance LLNS Benefit Program Summary
PDF template
Summary of legal insurance benefits for employees and retirees under the LLNS Health and Welfare Benefit Plan
See template
See template
ARAG Legal Insurance LANS Benefit Program Summary
PDF template
Summary of legal insurance benefits for LANS employees and retirees, effective January 1, 2017.
See template
See template
City Of Raleigh Parks, Recreation And Cultural Resources Program Registration Form
PDF template
Registration form for participants to sign up for City of Raleigh recreational programs and activities, including personal and emergency contact information.
See template
See template
Approved Lender Participation Contact Form
PDF template
A form for lenders to select and register for mortgage programs offered by the Agency for the calendar year 2025.
See template
See template
Disability Claim Form
PDF template
A comprehensive form for employees to file a disability claim, documenting injury/illness details, personal information, and income sources.
See template
See template
New Patient Past Medical History Form
PDF template
Comprehensive medical history form for new patients to provide personal, medical, and family health information.
See template
See template
Maryland Insurance Administration Complaint Form Life And Health Insurance
PDF template
Official form for submitting complaints about insurance companies to the Maryland Insurance Administration, covering various insurance types and policy details.
See template
See template
LHC Supplemental Medical 2023 Update23
PDF template
Medical form for Laurel Highlands Council camp registration requiring health information and medication permissions for scouts
See template
See template
Review Requirements Checklist Group Accident Only And Indemnity Insurance
PDF template
A comprehensive checklist for insurance carriers to submit group accident and indemnity insurance forms for approval in Virginia.
See template
See template
Long Term Care Applications Review Requirements Checklist
PDF template
A comprehensive checklist for insurance carriers preparing long-term care application form filings for approval by the Virginia Bureau of Insurance.
See template
See template
Preparticipation Physical Evaluation Physical Examination Form
PDF template
A comprehensive medical evaluation form for athletes to assess physical fitness and health status prior to participation in sports activities.
See template
See template
Release And Waiver Of Liability And Indemnity Agreement
PDF template
Legal document releasing the Winona Family YMCA from liability for injuries or damages during facility use or program participation.
See template
See template
Accident Waiver And Release Of Liability Form
PDF template
Legal document releasing The First Tee of San Antonio from liability for potential injuries or damages during volunteer activities.
See template
See template
Liability And Indemnity Agreement
PDF template
Legal agreement outlining contractor responsibilities, indemnification, and insurance requirements for performing work in the Town of West Hartford.
See template
See template
Teen Entrepreneur Academy (TEA) Liability Medical Release Form
PDF template
Liability and medical release form for participants in the Teen Entrepreneur Academy program at Concordia University, Irvine.
See template
See template
Liability And Photo Media Release Form
PDF template
A comprehensive release form for participants covering liability, health insurance, and media usage rights for museum activities.
See template
See template
Personal Liability Claim Form
PDF template
A comprehensive form for filing a personal liability insurance claim, specifically related to travel incidents.
See template
See template
City Of South Gate Liability Claim Form
PDF template
Official form and instructions for filing a liability claim against the City of South Gate for personal injury or property damage.
See template
See template
City Of South Gate Liability Claim Form
PDF template
Official form for filing a liability claim with the City of South Gate for personal injury or property damage.
See template
See template
Assumption Of Risk, Waiver Of Liability And Indemnification Agreement
PDF template
Legal document for participants to assume risks and waive liability for University of Utah program or event activities.
See template
See template
Conference Registration, Personal And Liability Release Form
PDF template
Registration and liability release form for SkillsUSA conference participants, covering student details and emergency contact information.
See template
See template
Release Of Liability, Waiver Of Claims, Assumption Of Risks And Indemnity Agreement
PDF template
A comprehensive legal document that releases MetamorphiiFit Fitness Society from liability for potential risks and injuries during fitness programs and activities.
See template
See template
Liability Insurance Form
PDF template
A form for obtaining a certificate of insurance and listing additional insured parties for facility usage events.
See template
See template
Professional Liability Insurance For Nurse Aide Students
PDF template
Insurance option for nurse aide students providing professional liability coverage with policy limits between $1,000,000 and $3,000,000.
See template
See template
Liability Media Release Form Required Of All Students
PDF template
A legal document for student registration that includes liability waiver and media release permissions for Community Music School activities.
See template
See template
UNIVERSITY DAY LIABILITY RELEASE FORM
PDF template
A legal document for releasing liability and providing medical consent for campus visitors to Franciscan University of Steubenville.
See template
See template
Waiver Of Liability And Hold Harmless Agreement
PDF template
Legal document releasing College of the Mainland from liability for potential injuries or damages during an activity.
See template
See template
Liability Waiver Form Adult Student (18 YrsOlder)
PDF template
A legal document waiving liability for adult students participating in service-learning activities at a college.
See template
See template
Leave No Trace Center For Outdoor Ethics Course Participant Acknowledgment, Assumption Of Risks, Rel
PDF template
Legal document outlining participant risks and responsibilities for Leave No Trace outdoor education courses.
See template
See template
Liability Release And Assumption Of Risk For Activity Participation And Local Travel
PDF template
A legal document releasing the University of Maryland, Baltimore County (UMBC) from liability during an activity or travel event
See template
See template
Liability Release
PDF template
A legal document releasing Laredo College from liability for potential injuries during a student activity or trip.
See template
See template
Liability, Risk Acknowledgment, And Claims Release Form
PDF template
A legal document for participants to acknowledge risks and release claims for activities sponsored by Los Angeles City College.
See template
See template
Release Liability Medical Release Form
PDF template
A comprehensive form for collecting student medical information, emergency contacts, and liability release for a summer orientation program
See template
See template
ToursClasses Liability Release
PDF template
A comprehensive liability release for kayaking and stand-up paddleboarding tours and classes, acknowledging inherent risks and waiving legal claims.
See template
See template
Release And Indemnity Agreement
PDF template
A legal document that releases Southern Adventist University from liability for risks associated with student, employee, or volunteer activities.
See template
See template
Liability Waiver Form Shoreline Cleanup
PDF template
Waiver for volunteers participating in shoreline cleanup activities at Blowing Rocks Preserve, outlining risks and participant responsibilities.
See template
See template
Liability Waiver
PDF template
A legal document releasing the University of Indianapolis from liability for injuries or damages that may occur during participation in university activities.
See template
See template
Waiver, Indemnification, And Media Release Form
PDF template
Legal document releasing Houston Christian University from liability for participants in university events and activities.
See template
See template
Liability Waiver Form
PDF template
A legal document waiving liability for potential health risks associated with consuming food at student-organized events.
See template
See template
Arkansas Tech University Student Liability Waiver
PDF template
A comprehensive liability waiver for students participating in on or off-campus university activities, outlining participant responsibilities and risks.
See template
See template
Disability Claim Form
PDF template
A comprehensive form for employees to report disability, injury, or illness for benefits claim purposes.
See template
See template
EmployerS Statement For Disability Insurance
PDF template
Comprehensive employer documentation form for reporting employee disability insurance details and work status
See template
See template
Permission Form For Minors With Indemnity Agreement And Emergency Contacts
PDF template
A consent and liability waiver form for parents/guardians allowing minor children to participate in a diocesan event with legal indemnification provisions.
See template
See template
Library Program Proposal Form
PDF template
A form for individuals to propose library programs for consideration by the Kent Free Library.
See template
See template
PHYSICAL EXAMINATION FORM
PDF template
Comprehensive medical examination form for health assessment and licensing purposes.
See template
See template
Contractor License Application
PDF template
A comprehensive application form for obtaining a contractor license in Pennington County, South Dakota, with detailed requirements and checklist.
See template
See template
License Cancellation Request Form 206
PDF template
Official form for cancelling various types of insurance-related licenses in the State of New Mexico.
See template
See template
Retiree Life Cancellation Form
PDF template
Form for cancelling retiree life insurance coverage with UCM Benefits Group, with a warning that once cancelled, participation cannot be reinstated.
See template
See template
VENDOR AGREEMENT
PDF template
A vendor participation agreement for the Lights On! festival with liability waiver and event guidelines.
See template
See template
Junior Application Parental Consent Form
PDF template
Parental consent form for minors participating in the Junior Volunteer Program at Northwell Health Long Island Jewish Valley Stream.
See template
See template
Medical Release Form
PDF template
A comprehensive medical consent and release form for students at Lyndon Institute's Boarding or Summer Program, granting medical treatment permissions and health information sharing.
See template
See template
Limerick Travel Form
PDF template
A comprehensive travel registration form for program participants to provide personal and travel details for an upcoming trip.
See template
See template
Limestone College Medical Consent Form
PDF template
A medical consent form for collecting student medical history and immunization records to support health monitoring and campus safety.
See template
See template
Form IV Application For Limited Registration As A Health Practitioner
PDF template
Application form for foreign health professionals seeking temporary registration to practice in Zambia for up to six months.
See template
See template
State Of Florida Group Long Term Disability Claim Form
PDF template
A comprehensive claim form for employees seeking long-term disability benefits through the State of Florida's insurance program administered by Cigna.
See template
See template
Life Solutions COVID 19 Impacts Frequently Asked Questions
PDF template
Document providing guidance on Lincoln Financial Group's operational changes and policies during the COVID-19 pandemic for financial professionals.
See template
See template
ENROLLMENT FORM FOR GROUP INSURANCE
PDF template
Insurance enrollment form for employees of Ashland School District to select various life and disability coverage options
See template
See template
Linkage To Care Referral Form
PDF template
A referral form for HIV intervention, medical care linkage, and patient tracking across various healthcare programs
See template
See template
Adult LIPOS Private BedPHPAdmissionUtilization Form
PDF template
A form for documenting admission and utilization details for mental health hospital or partial hospitalization program (PHP) services.
See template
See template
Youth LIPOS Funding Discharge Form
PDF template
Form for documenting discharge and funding verification for youth psychiatric inpatient or partial hospitalization services without insurance coverage.
See template
See template
Medical IncidentAccident Report
PDF template
A comprehensive form for documenting medical incidents or accidents, detailing injury specifics and first aid procedures.
See template
See template
Shaw Environmental, Inc.S Exhibit List
PDF template
Exhibit list submitted by Shaw Environmental, Inc. for a legal case related to FEMA trailers and potential formaldehyde liability.
See template
See template
Athletics School Carnival Booking Form
PDF template
A booking form for schools to request technical officials and support for athletics carnivals from Little Athletics SA in South Australia.
See template
See template
LLNS Prescription Drug Benefit For Anthem Members
PDF template
A summary of prescription drug benefits for Anthem members provided by CVS/Caremark, covering retail and mail-order pharmacy options.
See template
See template
Vessel Liveries Inspection Form
PDF template
Inspection form for boat rental businesses to ensure safety standards and liability compliance at Lake Norman.
See template
See template
LOAN AGREEMENT REPAYMENT FORM
PDF template
A form for policyholders to document and agree to loan repayment terms for their life insurance policy.
See template
See template
Loan Application Form
PDF template
A form detailing loan terms and conditions for policyholders seeking to borrow against their life insurance policy's surrender value.
See template
See template
Application For First Loan In Respect Of Policies Prior To 1 6 69
PDF template
Application form for obtaining a loan against a life insurance policy from the Life Insurance Corporation of India, with specific terms and conditions.
See template
See template
Loan Application Form
PDF template
A loan application form for borrowing money against a life insurance policy from the Eswatini Royal Insurance Corporation (ESRIC).
See template
See template
Leave Of Absence Request Form
PDF template
A comprehensive form for employees to request extended time off for various personal, medical, or family-related reasons.
See template
See template
NJDOBI Location Of Records Agreement Form
PDF template
A legal agreement between a licensee and the New Jersey Department of Banking and Insurance regarding the storage and accessibility of business records.
See template
See template
Lodge Transfer Request Form
PDF template
A form for members to request transfer of their lodge membership to a different location or lodge chapter.
See template
See template
Lodge Transfer Request Form
PDF template
Form for requesting transfer of lodge membership to another location or lodge within Hermann Sons Life organization.
See template
See template
Pain Clinic Naming And Art Competition Entry Form
PDF template
An entry form for children to submit names for a new pain clinic and its treatment rooms, along with artwork celebrating well-being.
See template
See template
Disability Claim Form FL
PDF template
A comprehensive form for filing a disability insurance claim with detailed sections for employer and employee information.
See template
See template
Student Blanket Insurance Policy Disability Claim Form
PDF template
A comprehensive form for students to file a disability insurance claim, documenting medical conditions, educational status, and treatment details.
See template
See template
Long Term Disability Insurance For Judges Attorneys FAQs
PDF template
Informational document about long-term disability insurance options for New Mexico Judicial Branch judges and attorneys through Northwestern Mutual.
See template
See template
Lost Instrument Bond Application
PDF template
A legal form used to apply for a bond when an original financial instrument has been lost, requiring comprehensive applicant information.
See template
See template
Trips And Visits Medical And Consent Form
PDF template
A comprehensive medical and consent form for students participating in a school trip, collecting health and emergency contact information.
See template
See template
Physician Referral Form
PDF template
A form used to facilitate patient referrals between healthcare providers, capturing patient and referring physician details.
See template
See template
Volunteer Agreement Waiver
PDF template
A volunteer agreement form for individuals interested in volunteering with Baltimore County Department of Recreation and Parks and Lake Roland Nature Council.
See template
See template
NJCAALake Superior College Physical Examination Form
PDF template
Medical certification form for student athletes participating in National Junior College Athletic Association intercollegiate sports.
See template
See template
Group Health Claim Form
PDF template
A comprehensive form for submitting healthcare claims for employees, spouses, and dependents under the LSU First Health Plan.
See template
See template
Invoice For Independent Health Care Providers
PDF template
A form for independent healthcare providers to record time and cost of care services provided to insured individuals under a long-term care insurance policy.
See template
See template
Long Term Care Insurance Medical History Form
PDF template
A medical history form for long-term care insurance professionals to collect patient health information for underwriting purposes.
See template
See template
Insurance Cancellation Request
PDF template
A form for employees to request cancellation of group insurance coverage, specifically long-term disability insurance.
See template
See template
Group LTD Insurance Cancellation Form
PDF template
Form for employees to cancel voluntary long-term disability insurance coverage with Tennessee Board of Regents
See template
See template
2024 LTD Change Form
PDF template
Form for employees to select or modify their Long-Term Disability (LTD) coverage options at the University of Rochester
See template
See template
Long Term Disability Claim Form
PDF template
A claim form for employees to submit long-term disability insurance claims with personal and medical information.
See template
See template
Disability Claim Form
PDF template
A comprehensive form for filing a disability insurance claim, requiring input from the member, plan sponsor, and attending physician.
See template
See template
Group Long Term Disability Claim Form
PDF template
A comprehensive claim form for employees seeking long-term disability benefits, requiring details from both the employee and attending physician.
See template
See template
Long Term Disability Claim Form Employer Statement
PDF template
Comprehensive employer statement form for filing a long-term disability insurance claim, capturing employee and claim details.
See template
See template
Long Term Disability Claim Form Statement Of Employer
PDF template
A form used by employers to submit details for an employee's long-term disability insurance claim with Lincoln Financial Group.
See template
See template
NRECA Long Term Disability Plan Summary Plan Description
PDF template
A comprehensive summary plan description detailing the long-term disability benefits provided by the National Rural Electric Cooperative Association for eligible participants.
See template
See template
LAMAR UNIVERSITY UNIVERSITY INSURANCE POLICY
PDF template
Policy governing insurance procurement and risk management for Lamar University, defining institutional approaches to purchasing property, liability, and other non-benefit insurance.
See template
See template
McKenzie Institute International Lumbar Spine Assessment
PDF template
Comprehensive medical assessment form for evaluating lumbar spine conditions, symptoms, and patient history.
See template
See template
McKenzie Institute International Lumbar Spine Assessment
PDF template
Comprehensive medical assessment form for evaluating patient's lumbar spine condition, symptoms, and functional limitations.
See template
See template
Fax Referral Form
PDF template
A comprehensive medical referral form for patient information, insurance details, and provider selection in pulmonary and sleep medicine.
See template
See template
Lutheridge Adult Medical Form
PDF template
A comprehensive medical form for collecting health and emergency contact information for adult participants at Lutheridge camp.
See template
See template
Lutheridge Camper Medical Form
PDF template
Comprehensive medical and registration form for children attending Lutheran church camp programs, capturing health information, emergency contacts, and medication details.
See template
See template
Lutherock Camper Medical Form
PDF template
Comprehensive medical and emergency contact form for children attending Lutheran summer camp programs
See template
See template
Luther Springs Camper Medical Form
PDF template
Medical and emergency information form for children attending Luther Springs summer camp programs
See template
See template
LEHIGH UNIVERSITY WAIVER And RELEASE OF LIABILITY FORM For ACTIVITIES OFF CAMPUS
PDF template
A legal document that releases Lehigh University from liability for potential injuries or losses during off-campus activities or trips.
See template
See template
Match Day Incident Investigation Form
PDF template
A form for reporting and investigating incidents during lacrosse matches by Lacrosse Victoria officials.
See template
See template
Liability Waiver Form
PDF template
A municipal form for waiving insurance requirements for building and construction-related permit applications in Boston.
See template
See template
Test Requisition Form
PDF template
Medical test requisition form for collecting patient specimen information and diagnostic testing details.
See template
See template
Test Requisition Form
PDF template
Medical form for collecting patient and specimen information for specialized laboratory testing.
See template
See template
Digital Application For Contraception Management Member Reimbursement Form
PDF template
A form for members to request reimbursement for digital contraception management application subscriptions under their Blue Cross and Blue Shield of Minnesota plan.
See template
See template
21st Maccabiah Medical Form
PDF template
Medical clearance form for athletes, coaches, and staff participating in the 21st Maccabiah sporting event requiring physician certification of health status.
See template
See template
Emergency Contact Form
PDF template
A form for parents to provide comprehensive emergency contact, health, and medical information about their child
See template
See template
Homeschool Affidavit
PDF template
A verification form for homeschooled students participating in the MathWorks Math Modeling Challenge (M3 Challenge)
See template
See template
Medical Claim Form
PDF template
A form for submitting out-of-network medical claims for reimbursement by UnitedHealthcare for Pennsylvania members.
See template
See template
NBPS Magnus Instruction Changing Credentials
PDF template
Comprehensive guide for parents to complete online health documentation and enrollment forms for students at Notre Dame school
See template
See template
Workers Compensation Audit Report Form
PDF template
A detailed form for documenting payroll, employee information, and policy details for workers compensation insurance auditing purposes.
See template
See template
Male Medical History Form
PDF template
A comprehensive medical history form specifically designed for male patients to record personal and family health information.
See template
See template
Male Medical History Form
PDF template
Comprehensive medical history form specifically designed for male patients, covering sexual health, medical conditions, and personal health background.
See template
See template
Professional Liability Insurance Form
PDF template
Form for medical doctors to provide professional liability insurance details for employment with Research Foundation for Mental Hygiene, Inc.
See template
See template
Malpractice Payment Report Form For Insurance Companies
PDF template
Official form for reporting medical malpractice judgments and settlements in Alabama by insurance companies and healthcare entities.
See template
See template
MAMFA Studio Programs Application Form
PDF template
Application form for admission to graduate art programs at California State University, Fullerton with various concentration options.
See template
See template
MAMI Assessment Form
PDF template
A comprehensive medical assessment form for infants, evaluating health status, growth, and potential risks.
See template
See template
Ticket Purchase Form Fine Art Raffle Maggie Meiners
PDF template
A form for purchasing raffle tickets for an art event at the Montclair Art Museum
See template
See template
Managed Care Referral Form
PDF template
A medical referral form for Blue Cross and Blue Shield of Minnesota managed care patients requiring specialist or additional medical services.
See template
See template
Texas 4 H Group Enrollment Form
PDF template
Official form for documenting participant details and demographics for 4-H youth programs in Texas.
See template
See template
Mandatory Travel Form
PDF template
A required form for documenting details of Sport Club travel, including participant information and trip itinerary for insurance purposes.
See template
See template
Medical History Form
PDF template
A comprehensive medical form for camp participants to document health information, emergency contacts, and treatment authorization.
See template
See template
PolicyholderS Change And Service Request
PDF template
A form for making changes to a ManhattanLife insurance policy, including coverage modifications, beneficiary updates, and personal information changes.
See template
See template
Manual Claim Form
PDF template
Form for submitting out-of-pocket healthcare expense claims for reimbursement through Flexible Spending Accounts (FSAs) or Health Reimbursement Arrangements (HRAs).
See template
See template
Extended Health Care Claim
PDF template
Insurance claim form for submitting extended healthcare expenses to Manufacturers Life Insurance Company group benefits plan.
See template
See template
Medical Assistant Physical Examination Form
PDF template
A comprehensive health screening form for medical assistant students, documenting physical health status and potential medical conditions.
See template
See template
Massachusetts Property Insurance Underwriting Association Producers Operations Manual
PDF template
A comprehensive manual for licensed insurance producers in Massachusetts detailing procedures and guidelines for placing business with the Association.
See template
See template
PHYSICAL EXAMINATION FORM 2019 2020 Academic Year
PDF template
A comprehensive medical examination form for students participating in clinical practice settings at the University of Michigan School of Nursing.
See template
See template
Department Of State Academic Exchanges Participant Medical History And Examination Form
PDF template
A medical form required for participants in U.S. Department of State educational exchange programs to confirm health status and obtain medical clearance.
See template
See template
Student Physical Exam Information Form
PDF template
Comprehensive health form for collecting student physical examination details and medical history for college enrollment.
See template
See template
Marketplace Appeal Request EAII Form (062019)
PDF template
A form for appealing decisions related to health insurance marketplace eligibility and financial assistance.
See template
See template
Marketplace Medical Claim Form
PDF template
A comprehensive form for submitting medical insurance claims, including subscriber and patient information, accident details, and coverage information.
See template
See template
Miami County Marlins Swim Team Emergency Medical Authorization Form
PDF template
A form allowing parents to authorize emergency medical treatment for children during swim team activities when parents cannot be reached.
See template
See template
MAP Marshall Adventure Program Commitment To Excellence Media Release Form
PDF template
A form outlining participant expectations and media usage consent for Marshall University's Adventure Program activities.
See template
See template
ITP 1 Technology Governance And Procurement Review
PDF template
Defines the technology governance process and outlines requirements for technology procurement review at Marshall University.
See template
See template
Maryland Youth Camp Incident Report Form
PDF template
Official form for documenting incidents, injuries, or illnesses occurring at youth camps in Maryland.
See template
See template
Patient Intake Form
PDF template
Comprehensive medical history form for collecting patient personal and health information for Dr. Maria Suurna's medical practice.
See template
See template
MASH North Arkansas Regional Medical Center APPLICATION CHECKLIST
PDF template
Comprehensive checklist for student application to medical shadowing program with required forms and documentation.
See template
See template
Mass Casualty Event O Red Cell Inventory Form
PDF template
A form for hospitals to assess and manage red blood cell inventory during a mass casualty event, calculating needed blood units.
See template
See template
Craniofacial Fellowship Application Form
PDF template
Comprehensive application form for medical professionals seeking a craniofacial fellowship, collecting detailed personal and professional information.
See template
See template
Master Medical Form
PDF template
Comprehensive medical form for camp participation, focusing on epilepsy and health conditions for Epilepsy Alliance Ohio's Camp Flame Catcher/Camp for Champs.
See template
See template
New Student CHECK LIST
PDF template
Comprehensive checklist for incoming students at Rutgers covering email activation, ID, medical forms, and document submission requirements.
See template
See template
NORTH DAVIS PREPARATORY ACADEMY (NDPA) STUDENT MEDICAL FORM
PDF template
A comprehensive medical form for collecting student health information and emergency contact details for North Davis Preparatory Academy.
See template
See template
1st Malaysia Open Diving Championship 2023 Travel Information Form
PDF template
Travel information form for participants of the 1st Malaysia Open Diving Championship 2023, collecting arrival and departure details.
See template
See template
Adult TB Risk Assessment And Screening Form
PDF template
A comprehensive screening form to assess an individual's risk factors and symptoms related to tuberculosis (TB) infection.
See template
See template
Misconduct, Match And Incident Report Form
PDF template
A form used to document misconduct, match penalties, and incidents during a sporting event, typically for ringette leagues in British Columbia.
See template
See template
Material Damage Proposal
PDF template
Insurance proposal form for documenting property details, insurance requirements, and risk assessment for material damage coverage.
See template
See template
Pregnancy Tips And Information For MUSC University Employees
PDF template
Comprehensive guide for MUSC university employees providing information about pregnancy-related benefits, insurance, and leave policies.
See template
See template
Short Term Disability Insurance For Maternity Leave
PDF template
A detailed explanation of short-term disability insurance coverage for maternity leave, including claim filing process and state-specific benefits.
See template
See template
Incident Report Form Template
PDF template
A standardized form for documenting and reporting incidents involving individuals, with details about the event, participants, and follow-up actions.
See template
See template
Pregnancy Booking Form For Harrogate Hospital
PDF template
Comprehensive medical intake form for pregnant patients seeking care at Harrogate Hospital, collecting personal, medical, and lifestyle information.
See template
See template
Alcohol Service Request Form
PDF template
Form for requesting permission to serve alcohol at city facilities, requiring approval and documentation for event organizers.
See template
See template
Bank Account Withdrawal Pre Authorization Form
PDF template
A form allowing Medicare Advantage members to authorize electronic funds transfer for monthly plan premiums from their bank account.
See template
See template
Cardiac Requisition
PDF template
Medical form for requesting cardiac diagnostic imaging and consultation, including patient history and risk factors assessment
See template
See template
MayorS Christmas Card Competition Entry Form
PDF template
A submission form for students to enter a local government's Christmas card design competition.
See template
See template
Multnomah Bar Association Enrollment Application Change Of Information Form
PDF template
A comprehensive form for enrolling or making changes to membership or insurance coverage for Multnomah Bar Association members
See template
See template
Multnomah Bar Association EnrollmentChange Of StatusWaiver Form
PDF template
A comprehensive form for attorneys to enroll in or modify health insurance coverage through the Multnomah Bar Association.
See template
See template
MetroPlusHealth Wellness And Fitness App Reimbursement Program
PDF template
A program offering up to $300 per year in reimbursements for specific wellness and fitness mobile applications for MetroPlusHealth members.
See template
See template
Sharp Health Plan Reimbursement Request Form
PDF template
A form for submitting medical expense reimbursement claims to Sharp Health Plan with detailed instructions and personal information fields.
See template
See template
Insurance Declaration Form 1 To Participate In 2023 South Dakota 4 H Rodeo
PDF template
Insurance form for 4-H members to declare insurance coverage for participation in South Dakota 4-H Rodeo events
See template
See template
Donald C. Balfour Alumni Association Award For Meritorious Research 2024 Nomination
PDF template
Nomination form for recognizing exceptional research contributions by early-career medical researchers at Mayo Clinic.
See template
See template
Edward C. Kendall Alumni Association Award For Meritorious Research 2024 Nomination
PDF template
Nomination form for the Edward C. Kendall Alumni Association Award recognizing outstanding research accomplishments by early-career medical and doctoral researchers.
See template
See template
Contribution Form
PDF template
A form for making financial contributions to Mayo Clinic for various programs and purposes.
See template
See template
Duke Gastroenterology Referral Form
PDF template
A medical referral form for gastroenterology services at Duke Health, used by healthcare providers to request clinic evaluations and procedures.
See template
See template
Proteomics Core Service Request
PDF template
A research service request form for proteomics analysis and sample submissions at Mayo Foundation.
See template
See template
Mayo Clinic Administrative Fellowship Application Form
PDF template
Fellowship application form for graduate students seeking leadership roles in healthcare at Mayo Clinic across various programs and settings.
See template
See template
Vehicle Use Permit Power Of Attorney
PDF template
A legal document granting permission to another person to operate a specific vehicle at MCB Camp Lejeune
See template
See template
Exhibitor Appointed Contractors (EACs)Third Party Contractor Guidelines
PDF template
Guidelines for using third-party contractors at the MC2020 event, including requirements for insurance and contractor approval.
See template
See template
MCH 213G School Health Entrance Form Instructions
PDF template
A comprehensive form for documenting student health information, immunization status, and physical examination required for school entry in Virginia.
See template
See template
Graduate Medical Education Disciplinary Action Form
PDF template
Form documenting academic deficiencies, misconduct, and potential disciplinary actions for medical residents.
See template
See template
Chronic Illness Benefit Application Form 2024
PDF template
An application form for patients seeking chronic illness benefits through the MultiChoice Medical Aid Scheme for the year 2024.
See template
See template
LAB REQUISITION FORM
PDF template
A laboratory test request form listing multiple lab test options and medical facility locations in Southern California.
See template
See template
MCO Discharge Form
PDF template
A comprehensive discharge form for behavioral health and recovery services tracking client status, diagnoses, and referral information.
See template
See template
MEDICAL HISTORY FORM
PDF template
Comprehensive medical intake form collecting patient personal, medical, social, and health history details.
See template
See template
CVS Caremark Mail Service Order Form
PDF template
A form for submitting prescription medication orders through CVS Caremark's mail service pharmacy program.
See template
See template
VISION EVALUATION REPORT (Form MCSA 5871)
PDF template
A medical form for evaluating the vision capabilities of commercial motor vehicle drivers to determine physical qualification standards.
See template
See template
VISION EVALUATION REPORT (Form MCSA 5871)
PDF template
A medical form for evaluating the vision capabilities of commercial motor vehicle drivers to determine physical qualification standards.
See template
See template
Medical Expense Claim Form
PDF template
A form for employees to claim medical expense reimbursements through their flexible spending account with detailed claim submission instructions.
See template
See template
Mount Sinai Adolescent School Based Health Center Parental Consent Form
PDF template
Parental consent form for students to use school-based health center services at Manhattan area schools.
See template
See template
Meadville Community Theatre Parental Consent Form
PDF template
A consent form for parents to authorize their child's participation in Meadville Community Theatre productions, including medical and liability provisions.
See template
See template
Montgomery County Volunteer Fire Rescue Association Union Member Facilities Access Membership Form
PDF template
Membership form for Montgomery County Volunteer Fire Rescue Association members to access recreational facilities as a collectively bargained benefit.
See template
See template
Release And Indemnification Agreement
PDF template
A legal document releasing The Medical College of Wisconsin from liability for potential injuries or damages during an unspecified activity involving a minor participant.
See template
See template
Miami County YMCA Marlins Swim Team Payment Agreement
PDF template
A payment form for swimmers detailing program fees, membership requirements, and payment options for the YMCA Marlins Swim Team.
See template
See template
Miami Dade County Employee Benefits
PDF template
Comprehensive overview of employee benefits package for Miami-Dade County employees, including insurance, retirement, and support services.
See template
See template
CLAIM FORM PART A
PDF template
A comprehensive form for filing health insurance claims, designed to collect detailed patient and insurance information.
See template
See template
Standardized Health Claim Form Model Regulation
PDF template
A model regulation for standardizing health care claim forms to reduce complexity and encourage electronic data interchange in healthcare billing and reimbursement.
See template
See template
MEDICAL BENEFITS SUBSCRIBER CLAIM FORM
PDF template
A comprehensive medical insurance claim form for submitting healthcare expense reimbursement and insurance details.
See template
See template
Medco By Mail Order Form
PDF template
A form for submitting prescription medication orders through Medco Health Solutions via mail, including payment and patient information.
See template
See template
Consent For Administration Of Health Treatment AndOr Medication At School
PDF template
A form for obtaining parental and physician consent to administer medical treatments or medications to students during school hours.
See template
See template
Prescription Drug Reimbursement Form
PDF template
A form for submitting prescription medication reimbursement claims through an insurance or benefits program.
See template
See template
ENROLLMENT FORM
PDF template
A comprehensive form for employees to enroll in medical, dental, vision, and life insurance benefits with dependent information and coverage election details.
See template
See template
Emergency Medicine Medical Education Fellowship Application
PDF template
Application form for medical professionals seeking an emergency medicine medical education fellowship at the Medical University of South Carolina.
See template
See template
NWC EMSS Non Transport Vehicle Inspection Instructions
PDF template
Instructions for completing Illinois Department of Public Health (IDPH) non-transport vehicle inspection forms for emergency medical services vehicles
See template
See template
MEDEVAC REQUEST FORM
PDF template
A standardized form for requesting medical evacuation with detailed instructions for field reporting of patient and site conditions.
See template
See template
MEDEX ACADEMY Consent Form
PDF template
Consent form for students 21 years and older participating in MedEx Academy, covering medical treatment, liability release, and media permissions.
See template
See template
ParentalGuardian Consent Form
PDF template
A consent form for parents/guardians to authorize student participation in the MedEx Academy program, including medical treatment and promotional permissions.
See template
See template
Medex Subscriber Claim Form
PDF template
A claim submission form for medical services processed by Blue Cross Blue Shield of Massachusetts for Medex subscribers.
See template
See template
Student Medical Form
PDF template
Comprehensive medical form collecting student health details, emergency contact information, and medical history for school purposes.
See template
See template
Media Release Form
PDF template
A comprehensive release form for participation in university programs, covering media usage and liability waiver for participants and guardians.
See template
See template
Medical Release Form
PDF template
A form authorizing the release of medical treatment information to specified facilities or individuals.
See template
See template
Media Release Form
PDF template
A consent form for parents/guardians to authorize the use of swim team photos, statistics, and contact information for team communications and media purposes.
See template
See template
LULAC Adelante America Program Media Release Form
PDF template
A consent form allowing LULAC and Verizon to use participant images and statements for marketing and promotional purposes.
See template
See template
Media Release Form
PDF template
A consent form allowing Northside ISD to use a student's image and name for publicity purposes related to intramural sports.
See template
See template
Media Release Form
PDF template
A form allowing parents/guardians to grant or deny permission for using a swimmer's photos, statistics, and contact information for team communication and media purposes.
See template
See template
Medicaid Form Order
PDF template
A form for ordering various Medicaid-related medical and administrative forms from Montana Medicaid.
See template
See template
NJCAA Medical Evaluation Form
PDF template
Comprehensive medical history and evaluation form for student athletes to assess their health and fitness for sports participation.
See template
See template
Medical History Form
PDF template
Instructions and form for students to provide medical history, immunization records, and insurance information for campus health services.
See template
See template
Anderson University Summer Camp Program Participation Form
PDF template
Registration form for Anderson University Summer Camp Program with medical and liability information for participants
See template
See template
NAUI Medical Form
PDF template
Medical screening form for diving training applicants to assess potential health contraindications for SCUBA activities.
See template
See template
Medical Release Form For 4 H Youth Adults
PDF template
A comprehensive medical release and health information form for 4-H program participants, collecting emergency contact, medical history, and treatment authorization details.
See template
See template
COLTS YOUTH ORGANIZATION MEDICAL RELEASE FORM
PDF template
A comprehensive medical history and health disclosure form for Colts Youth Organization volunteers and staff members.
See template
See template
Working Environment, Medical Approval And Fit Testing Forms
PDF template
Comprehensive form for assessing employee fitness for respirator use, including work environment evaluation and medical approval.
See template
See template
Medical Assessment Form
PDF template
A medical form used to assess disability status for subsidized child care program eligibility.
See template
See template
Studentsafe Inbound Medical Risk Assessment Form
PDF template
Insurance form for international students to disclose pre-existing medical conditions for coverage under Studentsafe insurance policy.
See template
See template
USA Ultimate Medical Authorization Form
PDF template
A medical authorization form for parents/guardians to provide emergency treatment consent for children participating in Ultimate activities.
See template
See template
Subscriber Medical Claim Form
PDF template
A comprehensive form for submitting medical insurance claims, capturing patient and insurance details.
See template
See template
Medical CertificationInquiry Form
PDF template
A form used to assess an employee's medical condition and potential workplace accommodations by requesting medical professional certification of job function limitations.
See template
See template
Medical Plan CHANGE Form
PDF template
Comprehensive guide for completing and submitting a medical plan change form with detailed documentation requirements.
See template
See template
H.P.T.R.6 MEDICAL CHARGES REIMBURSEMENT FORM
PDF template
A comprehensive form for employees to claim reimbursement of medical expenses with detailed documentation and verification requirements.
See template
See template
Claim Form To Pay InsuredSubscriber
PDF template
A comprehensive form for submitting medical insurance claims, capturing patient and treatment details for reimbursement.
See template
See template
Medical Claim Form
PDF template
Insurance claim form for submitting medical expenses and travel-related healthcare claims with multiple payment options.
See template
See template
Medical Claim Form
PDF template
Form for submitting out-of-network health care claims to UnitedHealthcare for reimbursement of eligible medical services.
See template
See template
Medical Claim Form
PDF template
A form for submitting medical insurance claims with patient and insurance details for reimbursement processing.
See template
See template
Claim Form To Pay InsuredSubscriber
PDF template
A comprehensive insurance claim form for submitting medical treatment claims, capturing patient and treatment details.
See template
See template
Claim Form To Pay InsuredSubscriber
PDF template
A comprehensive medical insurance claim form for submitting healthcare treatment reimbursement or payment requests.
See template
See template
Claim Form To Pay InsuredSubscriber
PDF template
A comprehensive form for submitting medical insurance claims with details about patient, treatment, and coverage information.
See template
See template
Medical Clearance Form
PDF template
A comprehensive medical form for incoming students requiring medical history, immunization records, TB screening, and insurance information.
See template
See template
Fondren Foundation Special Patient Clinic Dental Referral Form
PDF template
A medical referral form for patients with complex medical conditions seeking dental screening and assessment at UTHealth Houston School of Dentistry's Special Patient Clinic.
See template
See template
Direct Member Reimbursement Form
PDF template
A form for AvMed members to request reimbursement for covered medical services by submitting documentation and details of treatment.
See template
See template
Medical Emergency Contact Form For StudyInternTeach Away
PDF template
A medical contact and history form for students participating in study, internship, or teaching programs abroad.
See template
See template
Medical Plan Enrollment Form
PDF template
Comprehensive form for enrolling in medical coverage, changing plans, or adding/dropping dependents for ACERA members.
See template
See template
Easterseals Wisconsin Camps Medical Examination Form
PDF template
Medical form for documenting a camper's health status, medical history, and immunization records for participation in Easterseals Wisconsin Camps.
See template
See template
Medical Examination Report For Commercial Driver Fitness Determination
PDF template
Comprehensive medical assessment form for commercial drivers to determine fitness for driving based on health status and medical history.
See template
See template
Form MCSA 5875 Medical Examination Report Form
PDF template
Medical examination form for commercial driver license (CDL) applicants to assess medical fitness for driving.
See template
See template
Medical History Form
PDF template
A comprehensive medical history form for assessing health status and potential exercise risks, specifically for Central Oregon Community College's Exercise Physiology Lab.
See template
See template
Seoul International School Authorization For Medical Procedure Student Medical History Health Fo
PDF template
Medical authorization and health history document for students at Seoul International School, covering emergency care permissions and medical history details.
See template
See template
ISTEM Summer Program Medical Form
PDF template
Medical form for students attending the UCF iSTEM Summer Program, collecting personal, emergency, and health information.
See template
See template
Medical Information Form
PDF template
A comprehensive medical form for participants in Andes Climb and Atacama Leadership Ventures, requiring full medical disclosure and physician examination.
See template
See template
COLTS DRUM BUGLE CORPS MEDICAL HISTORY FORM
PDF template
Comprehensive medical history form for student members of a drum and bugle corps, covering personal health history and potential medical conditions.
See template
See template
MEDICAL FORM PERSONAL INFORMATION
PDF template
A confidential form to collect medical and personal details for kayaking tour participants to ensure safety and appropriate instruction.
See template
See template
Medical Information Form
PDF template
A detailed medical form capturing patient and treatment information for cancer patients seeking support from Angel Foundation.
See template
See template
Emergency Contact And Medical Information
PDF template
Form for collecting medical information, emergency contacts, and medical authorization for a child during a specific event or period.
See template
See template
Medical Form
PDF template
Comprehensive medical history and health information form for students at St. Mary's College.
See template
See template
Medical Form
PDF template
Form for documenting medical life support needs and service requirements for utility account holders with medical conditions.
See template
See template
Upward Bound Medical Information Release Form
PDF template
A comprehensive medical form for students in the Ohio State ATI Upward Bound Program that provides medical information, emergency contact details, and parental consent for medical treatment.
See template
See template
Medical Consent Form
PDF template
Comprehensive medical form for collecting a child's health history, emergency contact information, and medication permissions.
See template
See template
New York State Science Olympiad Medical Form
PDF template
Medical form for participants and alternates in Science Olympiad tournament, requiring comprehensive health and emergency contact information.
See template
See template
Injuries Resolution Board Medical Assessment Form (Form B)
PDF template
A standardized medical report template for documenting injuries and medical assessments for personal injury compensation claims in Ireland.
See template
See template
Medical Information Form
PDF template
Medical information and consent form for student enrollment, including health details, allergies, and medication permissions
See template
See template
Medication Emergency Treatment Authorization For Participants In Programs Involving Minors
PDF template
A comprehensive medical authorization form for parents/guardians to provide health and emergency contact information for children participating in Boston College youth programs.
See template
See template
Department Of State Academic Exchanges Participant Medical History And Examination Form
PDF template
A comprehensive medical history form required for participants in U.S. Department of State educational exchange programs to confirm health status and obtain medical clearance.
See template
See template
Medical Form
PDF template
A comprehensive medical form for collecting student health information, emergency contacts, and parental consent for medical treatment.
See template
See template
Adult Confidential Medical Record
PDF template
A comprehensive medical form for collecting personal health information and emergency contact details for program participation.
See template
See template
Diving Medical History Form
PDF template
A comprehensive medical screening form for applicant-divers to assess their fitness for diving activities and potential health risks.
See template
See template
MEDICAL FORM SELF REPORT
PDF template
A comprehensive medical self-report form for patients to document their medical history and current health conditions.
See template
See template
Camp Mak A Dream Summer Staff Medical Information Form 2023
PDF template
Comprehensive medical information form for summer camp staff to document health history, immunizations, medical conditions, and emergency contacts.
See template
See template
Camp Mak A Dream Summer Staff Medical Information Form 2024
PDF template
Comprehensive medical history and health information form for summer camp staff members, collecting details about medical conditions, immunizations, and emergency contacts.
See template
See template
Medical Form
PDF template
A comprehensive medical information form for students to provide health details, emergency contact information, and medical treatment permissions.
See template
See template
Messiah University Young Writers Workshop Medical Form
PDF template
A medical form for participants of a youth writing workshop, capturing emergency contact, medical history, and medication information.
See template
See template
Medical History Form
PDF template
Comprehensive medical history questionnaire for patient medical assessment, including health conditions, personal details, and examination data.
See template
See template
Cottonwood Crossing Summer Institute Health Insurance And Medical History Form
PDF template
A form collecting student health information, insurance details, and medical emergency consent for a summer program participation.
See template
See template
Medical History And Permission Form For Treatment
PDF template
Medical authorization and medication details form for parents of summer program participants to provide medical treatment consent and medication information.
See template
See template
MEDICAL HISTORY
PDF template
Comprehensive medical history form covering personal health, medical conditions, medications, allergies, lifestyle, and previous medical procedures.
See template
See template
NEW PATIENT MEDICAL HISTORY FORM
PDF template
Comprehensive medical history form for new patients to document current medications, health problems, and medical conditions.
See template
See template
MEDICAL HISTORY FORM
PDF template
A comprehensive form for collecting patient personal and insurance information for medical purposes.
See template
See template
DENTALMEDICAL HISTORY FORM
PDF template
Comprehensive form for collecting patient dental and medical history information for a student dental hygiene clinic.
See template
See template
MEDICAL HISTORY FORM
PDF template
Comprehensive form for collecting patient personal and insurance information for medical purposes.
See template
See template
Sport Club Medical History Form
PDF template
Medical history and health screening form for participants in sport club activities at CSU Recreation Services.
See template
See template
MEDICAL HISTORY FORM
PDF template
Comprehensive medical history and personal health information form for students at Vanguard University's Health Center.
See template
See template
MEDICAL HISTORY FORM
PDF template
Comprehensive medical history form for collecting patient personal details, health conditions, and contact information.
See template
See template
Medical History Form
PDF template
A comprehensive medical form documenting a patient's medical condition and impairments for service dog placement evaluation.
See template
See template
Medical History, Examination, And Fitness For Training
PDF template
A medical history and examination form for law enforcement officer training applicants to determine fitness for training at the Criminal Justice Academy.
See template
See template
Medical History Form
PDF template
A comprehensive form for collecting patient medical history, current health status, and therapy-related information.
See template
See template
Patient Questionnaire Medical History Form
PDF template
Comprehensive medical intake form for patient history and current medical condition assessment, used in healthcare settings.
See template
See template
Student Health History Form
PDF template
Comprehensive health history form for students enrolling at Watertown campus, collecting personal and family medical information.
See template
See template
Medical History Form
PDF template
Comprehensive medical intake form for capturing patient personal information, medical history, and contact details for a dermatology practice.
See template
See template
PARTICIPANT MEDICAL HISTORY FORM
PDF template
Comprehensive medical history form for participant health information, emergency contacts, and authorization details for a camp or program.
See template
See template
Medical History
PDF template
Comprehensive medical history form for collecting patient health information, medical conditions, and lifestyle details.
See template
See template
Medical History
PDF template
Detailed medical history document capturing patient health information across multiple body systems and medical conditions.
See template
See template
Health History Form
PDF template
A comprehensive medical history form for students to document their personal health information and medical conditions.
See template
See template
Medical History Form (For Immigration Examination)
PDF template
Comprehensive medical history form for immigration purposes, covering various health conditions and medical background
See template
See template
Medical History Form
PDF template
Comprehensive medical form for collecting patient's personal and family medical history, including past diagnoses, allergies, and health conditions.
See template
See template
Medical History Form
PDF template
Comprehensive medical form for collecting patient's personal health information, medical history, current symptoms, and social history.
See template
See template
Health History Form
PDF template
Comprehensive medical history form for patients to provide detailed health information prior to a medical appointment.
See template
See template
Medical History Form
PDF template
Comprehensive medical form for collecting patient personal information, medical history, current health status, and pain assessment details.
See template
See template
Medical History Form
PDF template
Comprehensive medical history form for collecting patient personal information, medical background, lifestyle details, and current medications.
See template
See template
UVM OUTING CLUB MEDICAL HISTORY FORM
PDF template
Comprehensive medical information form for University of Vermont Outing Club participants to assess health status and potential risks during outdoor activities.
See template
See template
Preparticipation Physical Examination Medical History Form
PDF template
Medical history form for students participating in school sports, collecting health and medical background information prior to athletic participation.
See template
See template
Medical History Form
PDF template
Comprehensive medical history form for dental patients to provide health background and current medical status.
See template
See template
MEDICAL HISTORY FORM
PDF template
Comprehensive medical history form focusing on patient's hearing health, ear conditions, and communication difficulties.
See template
See template
Medical History Form
PDF template
Comprehensive medical history and health status documentation form for patients at Freedom House for Women
See template
See template
Medical History Form
PDF template
Comprehensive medical history form collecting patient health information, current treatments, medications, and past medical conditions.
See template
See template
SLEEP STUDIES PERSONAL HISTORY FORM
PDF template
Comprehensive medical history form for patients undergoing sleep studies, collecting personal health information and symptoms.
See template
See template
Personal Medical History
PDF template
Comprehensive form for collecting patient's personal medical history, surgical history, allergies, and family medical background.
See template
See template
MSSU Willcoxon Health Center Medical History
PDF template
Comprehensive medical history and contact form for Missouri Southern State University students to provide health and emergency information.
See template
See template
Intake And History Form
PDF template
Comprehensive medical intake form for collecting patient's personal information, current health concerns, medical history, and past treatments.
See template
See template
MEDICAL HISTORY FORM
PDF template
A comprehensive form for collecting detailed medical history information about a child, including birth history, past medical history, and family medical history.
See template
See template
Fontbonne University Resident Medical Information
PDF template
Comprehensive medical information and immunization requirements for new resident students at Fontbonne University.
See template
See template
Medical History Form
PDF template
Comprehensive medical history form for dermatology patients collecting personal health information, medical background, and contact details.
See template
See template
Adult Medical History Form
PDF template
Comprehensive medical history form for collecting patient health information, medical conditions, surgical history, and current medications.
See template
See template
Andrew College Medical History Form
PDF template
A comprehensive medical history form for student athletes at Andrew College, collecting personal health information and medical background details.
See template
See template
Medical History And Physical Examination Form
PDF template
Comprehensive medical history and physical examination form for students, collecting personal health information and examination results.
See template
See template
Medical Incident Report
PDF template
A comprehensive form for documenting medical incidents and patient health status during flight.
See template
See template
University Of Alaska Southeast Outdoor Education Medical Information Questionnaire
PDF template
A confidential medical form for participants in University of Alaska Southeast outdoor education courses, collecting personal and medical details for safety purposes.
See template
See template
Medical Inquiry Form In Response To A Disability Accommodation Request
PDF template
A form used by California State University, East Bay to assess an employee's disability status and potential reasonable accommodations under the ADA.
See template
See template
Medical Inquiry Form In Response To A Reasonable Accommodation Request
PDF template
A medical form used to evaluate an employee's disability status and potential workplace accommodations under ADAAA guidelines.
See template
See template
Medical Inquiry Form In Response To An Exemption Request To In Person Work For Medical Reasons
PDF template
A medical form used to assess an employee's medical conditions and potential limitations for workplace accommodations or remote work exemptions.
See template
See template
Medical Inquiry Form In Response To An Accommodation Request
PDF template
Medical form for healthcare providers to assess an employee's disability status and potential workplace accommodations under the Americans with Disabilities Act (ADA).
See template
See template
Medical Inquiry Form In Response To An Accommodation Request
PDF template
A medical form used to evaluate an employee's disability status and potential workplace accommodations under the Americans with Disabilities Act (ADA).
See template
See template
Medical Inquiry Form In Response To A Reasonable Accommodation Request
PDF template
A form used to assess an employee's disability status and potential need for reasonable accommodations under the ADAAA.
See template
See template
Medical Inquiry Form For Employee ADA Accommodation Request
PDF template
Form for healthcare providers to document medical information related to employee accommodation requests under ADA guidelines.
See template
See template
MEDICAL INQUIRY FORM
PDF template
A form authorizing release of medical information for evaluating workplace disability accommodations and job function capabilities.
See template
See template
MEDICAL INQUIRY FORM RESPONSIVE TO ACCOMMODATION REQUEST
PDF template
A form for employees to request medical accommodations by authorizing their healthcare provider to release relevant medical information to their employer.
See template
See template
Medical Inquiry Form In Response To An Employee Accommodation Request
PDF template
A medical form used to assess an employee's disability status and potential workplace accommodations at Portland Community College.
See template
See template
ORNL Physical Examination Instructions
PDF template
Instructions for new hires at Oak Ridge National Laboratory (ORNL) regarding medical examination preparation and required documentation.
See template
See template
University Health Center Medical Insurance Form
PDF template
A form for collecting student and insurance policy details for medical services at a university health center.
See template
See template
PATIENT INTAKE FORM PPOMEDICARESELF PAY
PDF template
Comprehensive patient registration form collecting personal, insurance, and financial information for medical services.
See template
See template
Medical Panel Transfer Request Form
PDF template
A form for healthcare practices to transfer between medical panels with required practice and Designated Provider Representative (DPR) information.
See template
See template
Campus Guest Medical Release Form
PDF template
Medical authorization form for campus visitors allowing emergency medical treatment and documenting health information.
See template
See template
Medical Release FormPermission To Treat
PDF template
A comprehensive medical form for collecting personal, emergency contact, insurance, and medical information with treatment authorization.
See template
See template
Medical Power Of Attorney
PDF template
A legal document that allows an individual to designate an agent to make medical decisions on their behalf when they are no longer able to do so.
See template
See template
Medical Practitioner Authorization Form (MPAF) For SBAP Services
PDF template
Authorization form for medical practitioners to approve health-related services for students in the School-Based Access Program (SBAP)
See template
See template
Pre Authorization Form For Medical Procedures
PDF template
A form for pre-authorizing medical procedures for state employees with work-related injuries
See template
See template
MEDICAL HISTORY QUESTIONNAIRE ILEA Students
PDF template
A comprehensive medical history form for students to assess health status and readiness for training, ensuring confidentiality and emergency preparedness.
See template
See template
MEDICAL HISTORY QUESTIONNAIRE ILEA Students
PDF template
A comprehensive medical history form for students to assess health status and readiness for training, ensuring medical confidentiality.
See template
See template
Medical Release Form
PDF template
A form authorizing the release of medical records from one healthcare provider to another, with patient consent.
See template
See template
Medical Release Form
PDF template
Authorization for releasing protected health information to a designated company with patient consent.
See template
See template
PI 118 Medical Referral Of Restricted Participant
PDF template
Official form for medical provider referrals for restricted Missouri Medicaid participants to document medically necessary service transfers.
See template
See template
H.P.T.R. 6 MEDICAL CHARGES REIMBURSEMENT FORM
PDF template
A form for treasury employees to claim reimbursement of medical expenses incurred for treatment of themselves or dependents.
See template
See template
Peace Corps Invitee Medical Reimbursement Form
PDF template
A form for Peace Corps invitees to claim reimbursement for medical expenses not covered by primary health insurance.
See template
See template
Medical Reimbursement Form
PDF template
Form for seeking reimbursement of medical expenses in a domestic relations case, detailing documentation requirements and payment process.
See template
See template
MEDICAL RELEASE FORM 2024 2025 Lifetime Fitness Program
PDF template
A medical release form for participants in the University of Illinois at Urbana-Champaign Lifetime Fitness Program, requiring physician assessment of medical conditions.
See template
See template
Virginia Military Institute Medical Release Form
PDF template
Medical form certifying an applicant's physical and mental fitness for the rigorous Virginia Military Institute cadet program.
See template
See template
Medical Release Form
PDF template
Medical authorization form for children participating in Kinetic Kids sports and recreation programs, allowing parents to specify health conditions and activity clearances.
See template
See template
Medical Release And Accommodations Related To Injury Or Illness
PDF template
A document detailing the process for students with medical conditions to request accommodations in nursing school classrooms and clinical settings.
See template
See template
Medical Release Form
PDF template
A form granting permission to release confidential medical information to the Virginia Tech Adult Day Care Center.
See template
See template
Authorization To Release Medical Information Form
PDF template
A form authorizing the release of medical records and personal health information between healthcare providers or entities.
See template
See template
Williamsport Volunteer Fire Emergency Services Inc. Medical Release Form
PDF template
A form authorizing the release of medical information from Williamsport Volunteer Fire Emergency Medical Services Inc.
See template
See template
Authorization For Disclosure Of Health Information
PDF template
A form authorizing the release of personal health information with consent and understanding of privacy rights.
See template
See template
Little League Baseball And Softball Medical Release
PDF template
Medical authorization form for youth baseball and softball players, allowing emergency medical treatment and capturing critical health information.
See template
See template
Medical Liability Release Form
PDF template
A medical liability release form for HOSA delegates, parents, and guardians to attend conferences and experiences during the 2019-2020 academic year.
See template
See template
IM, Inc. ETEAM MEDICAL RELEASE FORM
PDF template
A comprehensive medical information and emergency contact form for gathering participant health details and insurance information.
See template
See template
Medical Release Form
PDF template
A medical form authorizing camp staff to administer prescribed medications to a child during camp hours.
See template
See template
Medical Liability Release Form
PDF template
A liability release form for HOSA delegates, parents/guardians, guests, and advisors to participate in conferences and experiences.
See template
See template
Medical Release Form
PDF template
A legal document authorizing the release of patient's medical records and health information to designated individuals or organizations.
See template
See template
Medical Release Form
PDF template
Medical release and health information form for adult participants in Eagle Bluff activities, requiring personal and medical details.
See template
See template
Medical Release Form ADA 3 Pages
PDF template
A medical authorization form for students seeking disability accommodations at Missouri Valley College, allowing healthcare providers to share medical information with college personnel.
See template
See template
Medical Record Release Form
PDF template
A form authorizing the release of confidential medical records to Complete Dermatology medical offices
See template
See template
Medical Release Form
PDF template
A form to authorize the release of patient medical information for insurance claim processing.
See template
See template
HIPAA Privacy Authorization Form
PDF template
Authorization form for releasing protected health information for St. John Fisher College students, complying with HIPAA regulations.
See template
See template
Honors Symposium Medical Release Form
PDF template
Medical release and health history form for students participating in the Harding University Honors Symposium program
See template
See template
Soapstone United Methodist Church Information, Permission And Medical Release Form For Adults
PDF template
A comprehensive medical release and information form for adults participating in church activities, including emergency contact and medical details.
See template
See template
Christ In Youth Discipline, Liability Medical Release Form
PDF template
A comprehensive release form for participants of Christ In Youth events covering discipline, liability, and medical information.
See template
See template
Medical Release Form
PDF template
A medical consent form for parents/guardians to authorize medical treatment for a minor in their absence.
See template
See template
MEDICAL LIABILITY RELEASE
PDF template
Comprehensive medical and liability release form for camp registration, including health information, emergency contacts, and photo/transportation permissions.
See template
See template
RELEASE FROM LIABILTY And MEDICAL CARE
PDF template
A form allowing individuals to decline medical assistance and release the college from liability for such refusal.
See template
See template
Medical Release Form
PDF template
A medical consent and emergency contact form for students participating in SkillsUSA activities, allowing designated personnel to seek medical treatment if necessary.
See template
See template
Event Medical Release Permission Form
PDF template
A comprehensive medical release and permission form for students participating in church youth events, covering medical history, contact information, and emergency details.
See template
See template
Medical Release Form
PDF template
A form authorizing the release and disclosure of patient health information, including medical records and sensitive health data.
See template
See template
Authorization For Use And Disclosure Of Medical Information
PDF template
A legal document authorizing healthcare providers to release confidential medical records to a specified facility.
See template
See template
MEDICAL RELEASE FORM
PDF template
Medical form for seniors to obtain physician approval for exercise program participation at Teaneck Senior Services Center.
See template
See template
Medical Information Release Form
PDF template
A document authorizing the release of medical or personal information by an individual to a specified entity.
See template
See template
USAV YOUTH JUNIOR VOLLEYBALL PLAYER MEDICAL RELEASE FORM
PDF template
A medical release form for youth and junior volleyball players to capture medical information, emergency contacts, and insurance details.
See template
See template
Little League Baseball And Softball Medical Release
PDF template
Medical authorization form for youth baseball and softball players, providing emergency contact and medical information for team participation.
See template
See template
Medical Release Form
PDF template
Medical release form for children participating in sports and recreation programs, documenting health status and activity clearance.
See template
See template
Medical Release Form Treatment Of Minor Child
PDF template
A form granting medical treatment authorization for a minor child in case of emergency, including contact and medical information.
See template
See template
Medical Release Form
PDF template
A form allowing patients to authorize the transfer of medical records to or from Market Street Dermatology.
See template
See template
Waal Community Academy Medical Release Form
PDF template
A medical release form for documenting student medical information and emergency contact details, with parental authorization for medical treatment.
See template
See template
MEDICAL RELEASE FORM
PDF template
A legal form authorizing medical treatment for a minor by parent or legal guardian, including medical history and emergency contact information.
See template
See template
Medical Release Form
PDF template
A legal document authorizing medical treatment for a minor and designating emergency contacts and medical information.
See template
See template
Youth Junior Volleyball Player Medical Release Form
PDF template
A comprehensive medical release and consent form for youth and junior volleyball players to participate in volleyball activities and competitions.
See template
See template
FALAB Medical Form
PDF template
Medical examination form for firearm license applicants to assess physical and mental fitness for weapon ownership.
See template
See template
South Carolina State Guard Medical Service Inquiry
PDF template
A comprehensive medical history inquiry form for South Carolina State Guard members, collecting personal and health-related information.
See template
See template
IUOE Local 4 Reimbursement Form
PDF template
Medical reimbursement form for IUOE Local 4 members seeking compensation for DOT physical exams, massage therapy, and related services.
See template
See template
AUTHORIZATION FOR THE RELEASE OF MEDICAL INFORMATION
PDF template
A form allowing students to authorize the release of medical information to the Office of Accessibility for determining disability service eligibility.
See template
See template
Pikes Peak Regional Law Enforcement Academy Medical Examination Form
PDF template
Medical certification form for law enforcement trainees to verify physical fitness for academy training and activities.
See template
See template
New York Health Benefits Waiver Of Coverage
PDF template
Form for employees to decline group health insurance coverage and document alternative coverage status
See template
See template
Direct Member Reimbursement Request Form
PDF template
A form for Medicare plan members to request reimbursement for dental, eyewear, and hearing aid services.
See template
See template
Medical Reimbursement Request Form
PDF template
A form used to request reimbursement for medical, dental, vision, hearing, and foreign travel care and supplies from a health insurance plan.
See template
See template
Plan Selection Form Retiree Supplemental Medical
PDF template
A form for retired Oklahoma State University employees to select supplemental medical insurance plans with Medicare eligibility requirements.
See template
See template
PATIENT INTAKE FORM
PDF template
Comprehensive form for collecting patient personal, medical, and insurance information for medical services or therapy referral.
See template
See template
Medication Authorization Form
PDF template
Official form for obtaining parental and medical permission to administer medication to a child in a care facility in Washington, DC.
See template
See template
Medication Inventory Form
PDF template
A detailed form for tracking medication quantities, dosages, and expiration dates for various medical supplies.
See template
See template
MEDICAL HISTORY FORM
PDF template
A form for patients to document their current medications and medical history details.
See template
See template
Medication Prior Approval Form
PDF template
Healthcare form for requesting prior approval of medical procedures, medications, and services with patient and provider information.
See template
See template
Fidelis Care Medication Request Form
PDF template
A comprehensive form for requesting medications through Fidelis Care health plans, requiring detailed patient and prescription information.
See template
See template
MEDICATIONS REPORT FORM
PDF template
A detailed form for documenting therapeutic medication administration for horses in a veterinary or racing context.
See template
See template
Cancellation Request Form
PDF template
A form used to request cancellation of Medigap insurance plan coverage, including provisions for refund of premiums.
See template
See template
Claim Form Instructions
PDF template
Detailed instructions for submitting prescription medication reimbursement claims with specific guidance on documentation requirements.
See template
See template
NEW PATIENT INTAKE FORM
PDF template
Comprehensive medical intake form for collecting patient personal, contact, and medical history information for a healthcare provider.
See template
See template
UA Affidavit Authorization For Release Of Information
PDF template
Official affidavit and authorization document for releasing information related to physician licensure application for the Maine Board of Osteopathic Licensure.
See template
See template
Medical Form Requirements Policy
PDF template
Policy update regarding medical form submission requirements for Rhode Island state pilots and medical certification compliance.
See template
See template
Medical Provider Inquiry Form In Response To An Accommodation Request
PDF template
A form for medical providers to provide details about an employee's medical limitations for workplace accommodation purposes.
See template
See template
MIT Student Medical Report Form 20242025
PDF template
Medical report form for new and returning MIT students requiring health documentation, immunization records, and medical screening information.
See template
See template
Chronic Medicine Benefit Application
PDF template
A medical form for applying to a chronic medicine benefit program, to be completed by patients seeking ongoing medication coverage.
See template
See template
Nouveau Medispa Medical History Form
PDF template
Comprehensive medical history form for patients seeking medical spa treatments, collecting personal and health information.
See template
See template
New Patient Medical History Form
PDF template
Comprehensive medical form for collecting patient's personal medical and surgical history, covering a wide range of health conditions and past surgical procedures.
See template
See template
USA Gymnastics Competition Entry Form
PDF template
Official entry form for registering athletes in a USA Gymnastics competition, capturing participant and club details.
See template
See template
BULLETIN MEL 24 04 Crime Statutory Bond Coverage
PDF template
Provides guidelines for statutory bond coverage for specific municipal positions requiring underwriting in joint insurance funds.
See template
See template
Meltdown Release Of Liability, Waiver Of Claims, Express Assumption Of Risk And Indemnity Agreement
PDF template
Legal document releasing liability for participation in the Meltdown Mechanical Ride, outlining potential risks and participant responsibilities.
See template
See template
Member Claim Form
PDF template
A form for Quartz health plan members to submit claims for medical services paid out-of-pocket when providers will not submit claims directly.
See template
See template
Member Claim Form
PDF template
Insurance claim form for submitting medical service reimbursement requests to BlueCross North Carolina.
See template
See template
Member Claim Reimbursement Form
PDF template
A form for Scripps Health Plan members to request direct reimbursement for covered medical benefits and provide claim details.
See template
See template
Member Claim Submission Form
PDF template
A comprehensive form for submitting medical, vision, and other healthcare-related insurance claims with detailed service type options.
See template
See template
4 H Youth Development 2018 2019 Member Health Information Form
PDF template
A comprehensive health form for 4-H youth members to document medical history, conditions, medications, allergies, and emergency information.
See template
See template
4 H Youth Development 2019 2020 MEMBER HEALTH INFORMATION FORM
PDF template
A comprehensive health form for 4-H youth members to record medical history, medications, allergies, and emergency information.
See template
See template
Member Inquiry Form
PDF template
A comprehensive form for members to submit inquiries about medical claims, health plans, and personal information updates.
See template
See template
Claim Form 1 Reimbursement For Out Of Network Benefit
PDF template
Form for submitting vision service reimbursement claims for out-of-network eye doctor visits and services.
See template
See template
Member PCP Transfer Request Form
PDF template
A form for healthcare providers to request transfer of a patient's primary care provider due to various clinical or administrative reasons.
See template
See template
Member Reimbursement Form
PDF template
A form for members to request reimbursement for healthcare services and medical expenses from Network Health insurance.
See template
See template
Member Reimbursement Form
PDF template
A form for members to request reimbursement for various medical services and expenses from Network Health insurance plan.
See template
See template
Member Reimbursement Form
PDF template
A form for Kaiser Permanente members to request reimbursement for medical expenses paid directly to a healthcare provider.
See template
See template
MemberS Confidential Evaluation Of USEF Judges, Stewards, Technical Delegates, And Course Designers
PDF template
A confidential form for United States Equestrian Federation members to evaluate the performance of licensed officials at equestrian competitions.
See template
See template
Winona Family YMCA Membership Agreement
PDF template
A comprehensive membership agreement for joining the Winona Family YMCA, detailing member information, conditions, and policies.
See template
See template
FORM C APPLICATION FOR MEMBERSHIP And FELLOWSHIP EXAMINATIONS
PDF template
Application form for candidates seeking membership and fellowship examinations with the West African College of Physicians.
See template
See template
White County Parks Recreation Membership Form
PDF template
Membership registration form for White County Parks & Recreation facilities with personal and family information collection.
See template
See template
Syncrude Sport Wellness Centre Membership Cancellation Form
PDF template
A form for members to officially cancel their annual or continuous membership at the Syncrude Sport & Wellness Centre with specific terms and conditions.
See template
See template
Los Altos Senior Program Membership Form
PDF template
Membership registration form for seniors participating in Los Altos Recreation Department programs with contact and emergency information.
See template
See template
MEMBERSHIP FORM
PDF template
Application form for joining or renewing membership in the North End Ski Club, with various membership levels and benefits.
See template
See template
El Lago Center Membership
PDF template
Membership form for accessing the El Lago fitness center, including terms of use and liability release
See template
See template
2023 24 Youth In Government Membership Form
PDF template
Membership form for youth program participation, collecting personal and emergency contact information.
See template
See template
Center For Healthy Living Membership Form
PDF template
Membership form for University of Nebraska Medical Center (UNMC) employees and affiliated individuals to join the Center for Healthy Living fitness facility.
See template
See template
MEMBERSHIP FORM
PDF template
Membership form for university staff, students, and community members to join a fitness center with various membership types and payment options.
See template
See template
Membership Fees Options
PDF template
Comprehensive membership guide for Cordts Physical Education Center with tiered membership levels and activity access options.
See template
See template
Hanalei Canoe Club Membership Form
PDF template
Membership registration form for Hanalei Canoe Club covering individual and family membership options for canoe paddling participants.
See template
See template
INDIAN MEDICAL ASSOCIATION MEMBERSHIP APPLICATION FORM
PDF template
Membership application form for medical professionals seeking to join the Indian Medical Association as life or direct members.
See template
See template
Appalachian State University Facility Access Membership Form
PDF template
A membership form for faculty and staff to access university recreation facilities, with options for individual and family memberships.
See template
See template
Vegas Tuffest Jr. World Championship Membership Application
PDF template
Membership application for participating in the Vegas Tuffest Jr. World Championship sporting event with liability release and payment details.
See template
See template
Membership Form
PDF template
Membership registration form for the Nasher Museum of Art at Duke University with multiple membership levels and payment options.
See template
See template
Anniston Outdoor Association Membership Form
PDF template
Membership registration form for Anniston Outdoor Association with personal indemnification agreement and membership survey
See template
See template
Park City Mountain Sports Club Membership Form
PDF template
Membership form for joining the Park City Mountain Sports Club, allowing individuals to register their interests and contact information.
See template
See template
MESA Exam7 ShippingForm
PDF template
A shipping form for documenting details of a medical exam shipment with recipient contact information and tracking details.
See template
See template
Method Schools Insurance Proposal
PDF template
Insurance coverage proposal for Method Schools by California Charter Schools Joint Powers Authority for the 2015-2016 school year.
See template
See template
Cancer, Specified Disease And Intensive Care Coverage
PDF template
Instructions for filing claims related to cancer, specified disease, and intensive care coverage under a MetLife insurance policy.
See template
See template
Disability Claim For Accident SicknessShort Term DisabilitySalary Continuance
PDF template
A comprehensive form for employers to document employee disability claims and related employment details.
See template
See template
Insurance Enrollment Form
PDF template
Comprehensive form for employees to enroll in various insurance coverages including life, disability, dental, and vision.
See template
See template
MetLife Legal Plans EnrollmentCancellation Form
PDF template
Form for enrolling in or canceling MetLife Legal Plans insurance coverage for San Diego and Imperial County Schools employees.
See template
See template
MetLife Legal Plans EnrollmentCancellation Form
PDF template
Insurance enrollment form for MetLife Legal Plan for San Diego and Imperial County Schools employees to select and authorize payroll deductions for legal plan coverage.
See template
See template
POLICYHOLDERS CHANGE AND SERVICE REQUEST
PDF template
A form for making changes to a MetLife insurance policy, including coverage modifications, beneficiary updates, and personal information changes.
See template
See template
Disability Claim For Accident SicknessShort Term DisabilitySalary Continuance
PDF template
A comprehensive form for employees to file a disability claim, capturing details about the employee, work status, and disability information.
See template
See template
MetLife WELL V1
PDF template
Insurance claim form for wellness benefit submission by policyholders of MetLife Insurance Company
See template
See template
OSSAA Physical Examination And Parental Consent Form
PDF template
A comprehensive medical screening form for student athletes to assess their health and fitness for participating in sports.
See template
See template
Hardship Waiver
PDF template
Official document outlining eligibility requirements for student athletes participating in OSSAA sanctioned athletic events.
See template
See template
Pre Participation Physical Evaluation Form And Parental Consent
PDF template
Official form for student-athletes to obtain medical clearance and parental consent for school sports and marching band participation in Oklahoma.
See template
See template
Internship Application Form
PDF template
Application form for internship opportunities at the Museum at FIT in New York City.
See template
See template
A MasterS Guide To Shipboard Accident Response
PDF template
A comprehensive guide for ship masters on handling incidents and protecting shipowner interests in Protection and Indemnity (P&I) risks.
See template
See template
CLHIA Standardized MGA Compliance Review Survey
PDF template
A standardized survey used by CLHIA member companies to assess compliance functions of Managing General Agencies (MGAs)
See template
See template
SCSPA Individual Magazine Competition Entry Form
PDF template
Form for submitting entries for various magazine categories including art, articles, cover, photography, poetry, reviews, and design
See template
See template
Medical History Form
PDF template
Comprehensive form for collecting patient medical background and consent for massage therapy services.
See template
See template
Research Patient Registration Form
PDF template
A comprehensive form for registering patients participating in medical research studies at Memorial Hermann - TMC.
See template
See template
Form To Request Documentation From An Employer Sponsored Health Plan Or A Group Or Individual Market
PDF template
A tool to help patients request information about mental health and substance use disorder treatment limitations from health insurers, based on mental health parity laws.
See template
See template
MHSAA Annual Sports Health Questionnaire
PDF template
Guidelines for student-athletes regarding physical examinations and health requirements for the 2020-2021 school year during COVID-19 pandemic.
See template
See template
Medical History Form
PDF template
Detailed medical form focusing on patient's sleep habits, including snoring, breathing during sleep, daytime sleepiness, and overall sleep quality.
See template
See template
HEALTH SUPPLY REQUISITION FORM
PDF template
A form for requesting health-related laboratory supplies and test forms from the Florida Department of Health's Bureau of Public Health Laboratories.
See template
See template
2013 MICP Evaluation Form
PDF template
Evaluation form for assessing case management skills, comportment, and program performance of MICP (Medical Insurance Compensation Program) panels and staff.
See template
See template
PCA 1 24 01338 Clinical FM 05142024
PDF template
A medical referral form used by primary care physicians to authorize specialist consultations and treatments within a health plan network.
See template
See template
JCPS Middle School Athletic Participation Folder
PDF template
A comprehensive form for student-athletes to participate in middle school sports, including parental consent and eligibility requirements.
See template
See template
Athletic ParticipationParental ConsentPhysical Examination Form
PDF template
Official form for student athletic participation in Prince William County Public Middle Schools, covering eligibility, consent, and physical examination requirements.
See template
See template
SAMPLE MIDLINE INSERTION CONSENT FORM
PDF template
A medical consent form for patients agreeing to have a midline catheter inserted, detailing potential risks and medical procedure details.
See template
See template
Mildura Pistol Club 2024 ISSF Open Competition Entry Form
PDF template
A competitive shooting event hosted by Mildura Pistol Club with entries for various shooting events and grades.
See template
See template
Mileage Reimbursement Form
PDF template
Form for cancer patients to request reimbursement for medical travel expenses and miles traveled for treatment.
See template
See template
Minor Care Consent Via Phone
PDF template
A consent form for authorizing medical treatment of a minor patient through phone communication, capturing key patient and guardian information.
See template
See template
Minor Consent To Travel Form
PDF template
Form authorizing transportation for minors aged 12-15 through Veyo's Non-Emergency Medical Transportation program in Connecticut.
See template
See template
Minor Consent Medical Form
PDF template
Medical consent form for students, allowing medical treatment and over-the-counter medication authorization by Caada College Health Center
See template
See template
Star Island Minor Medical Release Form
PDF template
A medical release and information form for minors attending a Star Island activity or conference, detailing medical history, medications, and emergency contacts.
See template
See template
Assumption Of Risk, Release From Liability, And Indemnification Form
PDF template
A consent form for parents/guardians allowing minors to participate in research or clinical activities at Yale University with potential exposure to hazardous materials.
See template
See template
Minor Volunteer Parental Consent Form
PDF template
Legal form allowing parents/guardians to consent to a minor's volunteer participation at McKinley Presidential Library & Museum with liability release and media permissions.
See template
See template
Minor Waiver Form
PDF template
A waiver form allowing a minor to use university recreation facilities under parental supervision and consent.
See template
See template
NEW PATIENT INTAKE FORM
PDF template
Comprehensive medical form for new patients to document pain history, symptoms, and current health conditions.
See template
See template
Monthly Reporting And Reimbursement Requirements Maritime Infrastructure Program
PDF template
Document detailing monthly reporting and reimbursement procedures for ports and navigation districts participating in a maritime infrastructure funding program.
See template
See template
Minor Participant Forms
PDF template
Comprehensive registration and medical form for minors participating in Global Passion Ministries travel programs.
See template
See template
Service Request Form For Software Development And System Changes
PDF template
A comprehensive form for requesting software development changes, system modifications, and technical support within an organization.
See template
See template
ACCIDENTINCIDENT REPORT FORM
PDF template
A comprehensive form for reporting accidents or incidents involving Maryknoll Lay Missioners during overseas missions, documenting details of the occurrence, injuries, and follow-up actions.
See template
See template
MKSAP Money Back Guarantee Refund Request Form
PDF template
A refund request form for medical professionals who did not pass the ABIM exam after completing MKSAP self-assessment questions.
See template
See template
Digital Patient Intake Form
PDF template
Form for medical providers to submit patient information, treatment details, and request insurance verification for wound care products.
See template
See template
Digital Patient Intake Form
PDF template
A medical form for provider and patient information collection, insurance verification, and wound treatment documentation.
See template
See template
Patient Intake Form
PDF template
A medical reimbursement form for verifying insurance coverage and documentation for skin substitute treatments.
See template
See template
Patient Information Form
PDF template
Comprehensive intake form for collecting patient personal, contact, and insurance information for dental practice.
See template
See template
Patient Medical History Form
PDF template
Comprehensive medical history form collecting patient personal information, medical conditions, medications, allergies, and healthcare provider details.
See template
See template
OBGYN Medical History Form
PDF template
Comprehensive medical history form for obstetrics and gynecology patients with sections covering medications, allergies, medical history, family history, and social history.
See template
See template
Mount Sinai Adolescent School Based Health Center Parental Consent Form
PDF template
Parental consent form for students to receive medical services at a school-based health center, allowing medical treatment without changing existing insurance or doctor relationships.
See template
See template
Medicare Billing Form CMS 1450 And The 837 Institutional
PDF template
A comprehensive guide for healthcare providers on submitting Medicare claims using Form CMS-1450 and 837I electronic format.
See template
See template
Miracle League Volunteer Application
PDF template
Volunteer information and application for a baseball program supporting children with disabilities in Stanislaus County, California.
See template
See template
No Fault Insurance Form
PDF template
A medical insurance claim form for documenting patient information and authorizing insurance benefits for accident-related medical services.
See template
See template
Workers Compensation Insurance Form
PDF template
A comprehensive form for documenting patient and employment details related to a workplace injury insurance claim.
See template
See template
MMCGME Required Resident Documentation
PDF template
Comprehensive documentation requirements for new, continuing, and graduating medical residents and fellows.
See template
See template
PreventiveCareAppealForm 20200507 V1.0
PDF template
Form for submitting preventive care exam documentation to Medical Mutual Wellness for wellness program compliance.
See template
See template
Patient And Insurance Claim Form
PDF template
A standardized form for submitting medical insurance claims with patient and subscriber information details.
See template
See template
Ross MM Prerequisite Assessment Form
PDF template
A form for students to submit non-University of Michigan courses for prerequisite evaluation for the Ross MM Program
See template
See template
Certificate Of Compliance
PDF template
A form required for businesses in Minnesota to verify workers' compensation insurance coverage when applying for licenses or permits.
See template
See template
BluePearlVet.Com Patient Assessment Form
PDF template
A form for referring veterinarians to provide detailed patient information to BluePearl veterinary clinicians for advanced medical care consultation.
See template
See template
Mobile Mammography Unit Registration Form
PDF template
A comprehensive registration form for patients seeking a mobile mammography screening, collecting medical history, personal, and insurance information.
See template
See template
VSU Participation Agreement And Waiver Form For Minors
PDF template
Comprehensive legal release form for minors participating in university-sponsored programs, acknowledging risks and liability waivers.
See template
See template
Model Authorization Form For Certified Application Counselors (CACs) In A Federally Facilitated Mark
PDF template
Authorization form allowing Certified Application Counselors to collect, access, and use personal information for healthcare marketplace enrollment assistance.
See template
See template
Model Authorization Form For Certified Application Counselors (CACs) In A Federally Facilitated Mark
PDF template
A consent form allowing Certified Application Counselors to handle and process personally identifiable information for healthcare marketplace enrollment assistance.
See template
See template
Standardized Health Claim Form Model Regulation
PDF template
A model regulation aimed at standardizing health care claim forms, reducing form complexity, and promoting electronic data interchange for healthcare billing and reimbursement.
See template
See template
Patient Intake Form
PDF template
Comprehensive medical intake form for new chiropractic patients to collect personal, medical, and health history information.
See template
See template
SAIL Referral Form
PDF template
A court referral form for considering a defendant for the SAIL program, to be completed for each defendant referred.
See template
See template
Mail Service Order Form
PDF template
A form for Service Benefit Plan members to order prescription medications through mail service pharmacy
See template
See template
MOHS Referral Form
PDF template
Medical referral form for physicians to submit patient details for Mohs micrographic surgery for skin cancer treatment.
See template
See template
Money Insurance Proposal Form
PDF template
Insurance proposal form for money protection and insurance coverage by Fidelity Shield Insurance Company in Kenya.
See template
See template
Insurance Of Money Proposal
PDF template
Insurance coverage proposal for loss of money in various scenarios including transit, premises, and personal custody.
See template
See template
SupervisorS Incident Investigation Report
PDF template
Detailed guide for supervisors to document and investigate workplace incidents across multiple categories of liability.
See template
See template
Monroe Community College International Student Accident And Sickness Insurance Waiver Form
PDF template
A waiver form for international students to demonstrate alternative health insurance coverage in lieu of the college's mandatory insurance plan.
See template
See template
ACCIDENT INCIDENTS REPORTING AND ACTIONS PROCEDURE
PDF template
A procedure for reporting and processing accidents and incidents within the Model Aeronautical Association of Australia (MAAA) to minimize recurrence and manage potential insurance claims.
See template
See template
EWOG MDSSAA Invoice Form For Morphology
PDF template
A medical form for collecting patient morphology data, laboratory samples, and clinical information related to hematological conditions.
See template
See template
MortgagorS And ContractorS Affidavit
PDF template
Document for releasing insurance claim funds for property damage repair by American Airlines Federal Credit Union
See template
See template
Medical Information Release Form
PDF template
A form authorizing Mosaic Comprehensive Care to send or receive medical records and patient health information to/from specified providers.
See template
See template
MOTOR ACCIDENT REPORT FORM
PDF template
A comprehensive form for documenting details of a motor vehicle accident for insurance claim purposes.
See template
See template
MOTOR ACCIDENT REPORT FORM
PDF template
Comprehensive form for documenting details of a motor vehicle accident for insurance claim purposes.
See template
See template
University Of Kentucky Vehicle Accident Report Form
PDF template
A comprehensive form for reporting vehicle accidents involving University of Kentucky vehicles, capturing details about the accident, vehicles, drivers, and potential injuries.
See template
See template
National Alumni Association Athletic Hall Of Fame Nomination Form
PDF template
A form for nominating alumni athletes to the university's Athletic Hall of Fame, requiring detailed information about the nominee's athletic achievements.
See template
See template
PATIENT INFORMATION AND MEDICAL RELEASE FORM (FORM I)
PDF template
A comprehensive form for patient medical information, insurance details, and authorization for medical information release and claims processing.
See template
See template
Parental Consent Form
PDF template
A consent form allowing treatment of a minor child at Medical Park Family Care, with options for treatment authorization and contact details.
See template
See template
Moore Public Schools Athletic Department Eligibility Checklist
PDF template
Comprehensive guide for student-athletes outlining sports physical requirements and electronic participation form procedures for Moore Public Schools.
See template
See template
Filing A Claim For Insurance Benefits
PDF template
Guide for lenders on submitting insurance benefit claims through the FHA Connection system for various claim types and loss mitigation options.
See template
See template
MR089S Annual Medical Examinations
PDF template
Detailed medical examination requirements and procedures for U.S. Astronauts including annual health evaluations and audiometry testing.
See template
See template
Application For Club Privileges And Membership Agreement
PDF template
Membership application and agreement for joining Malibu Racquet Club, including personal, employment, and billing information.
See template
See template
Confidentiality Agreement
PDF template
A confidentiality agreement for Medical Reserve Corps volunteers outlining patient privacy and HIPAA compliance responsibilities.
See template
See template
Patient Booking Form A
PDF template
A comprehensive form for patient admission and medical booking details with sections for personal, insurance, and medical information.
See template
See template
CEAR Construction And Erection All Risk Policy
PDF template
A comprehensive insurance policy covering project works, third-party liability, and potential delays in project start-up for construction and erection projects.
See template
See template
Sleep Respiratory Requisition
PDF template
Medical referral form for sleep apnea testing, pulmonary function tests, and oxygen therapy assessment
See template
See template
Sleep Respiratory Requisition
PDF template
Medical referral form for sleep apnea testing, pulmonary function tests, and oxygen therapy assessment
See template
See template
MRI SERVICE ORDER FORM
PDF template
Comprehensive form for ordering various MRI diagnostic imaging services with multiple body region and contrast options.
See template
See template
ACORD 131
PDF template
Standard insurance form for documenting policy details, liability limits, and carrier information.
See template
See template
Athletic ParticipationPhysical Examination Form
PDF template
Consent form for middle school students (grades 5-8) to participate in interscholastic athletic activities, including medical and emergency contact information.
See template
See template
MT. SOPHIA ACADEMY ATTENDANCE
PDF template
A form for documenting student attendance in school sports programs, tracking school day and sport activity details.
See template
See template
PLAN YEAR 2024 ENROLLMENTCHANGE FORM MEDICAL SPENDING CONVERSION (MSC) HEALTH BENEFITS BUY OUT WAIVE
PDF template
Form for NYC employees to enroll in or change health benefits buy-out waiver program for plan year 2024.
See template
See template
Motorcycle Safety Course Waiver Indemnification
PDF template
Legal waiver and release form for participants in a motorcycle safety training course, acknowledging risks and physical requirements.
See template
See template
MSHSAA Preparticipation Physical FormsProcedure Medical History Form
PDF template
A comprehensive medical history form for student athletes to be completed by students or parents and reviewed by healthcare professionals.
See template
See template
Texas Tech University HSC School Of Medicine Year 4 Rotations Student Evaluation Form
PDF template
Comprehensive evaluation form for assessing fourth-year medical students' clinical performance across multiple competency areas.
See template
See template
Medicare Secondary Payer (MSP) Manual
PDF template
A comprehensive manual detailing billing requirements and guidelines for healthcare providers under Medicare Secondary Payer regulations.
See template
See template
FCPS Middle School Sports Athletic ParticipationParental ConsentPhysical Examination Form
PDF template
A comprehensive form for middle school students to participate in interscholastic athletic programs, requiring student and parental consent and a physical examination.
See template
See template
Missouri Fine Arts Academy Medical ReleaseEmergency Form
PDF template
A medical form for collecting student health information, emergency contacts, and parental consent for medical treatment.
See template
See template
Missouri State University Sugar Bears Dance Team Medical And Liability Release
PDF template
A liability release and medical consent form for participants in the Missouri State University Sugar Bears Dance Team program
See template
See template
Missouri State University Sugar Bears Dance Team 2023 24 Medical And Liability Release
PDF template
A medical and liability release form for participants of the Missouri State University Sugar Bears Dance Team for the 2023-24 season.
See template
See template
MEMBERSHIP FORM
PDF template
A membership form for joining the Mount Tahoma Trails Association with options for individual and family annual memberships.
See template
See template
Mudstock Registration Form
PDF template
Community event for youth featuring a mud-filled activity designed as a healthy alternative to drugs and alcohol, hosted by The Alliance of Southwest Missouri.
See template
See template
Employee Disability Claim Form
PDF template
Comprehensive guidelines for completing an employee disability claim form with detailed instructions for each section.
See template
See template
MUI UI Incident Report Form
PDF template
A comprehensive form for documenting and reporting incidents involving participants, including details of occurrence, medical treatment, and follow-up actions.
See template
See template
MultiPlan Service Request Form
PDF template
A form for providers to investigate and submit claims processed through the MultiPlan network for service inquiries.
See template
See template
Prenatal Risk Assessment Form
PDF template
Comprehensive medical form for documenting patient pregnancy information, medical history, and potential risk factors during prenatal care.
See template
See template
34th Mushroom Shoot (180824) Booking Form
PDF template
Registration form for the 34th Mushroom Shoot archery tournament, collecting participant details and entry information.
See template
See template
Accessing Claims Online Using The Employee Portal
PDF template
A guide for employees on how to access and manage insurance claims through Mutual of Omaha's online employee portal.
See template
See template
Mutual Of Omaha And Affiliates Transfer Request Form
PDF template
A form for transferring insurance producer contracts and downlines between marketing agencies within Mutual of Omaha's network.
See template
See template
Volunteer Application Form
PDF template
Comprehensive application form for individuals interested in volunteering at MVH/IFCH hospital, covering personal details, preferences, and background information.
See template
See template
Medical Claim Reimbursement Request
PDF template
A form for members to request reimbursement for medical expenses paid out of pocket, requiring itemized receipts and proof of payment.
See template
See template
Prescription Enrollment Form
PDF template
Comprehensive medical enrollment form for patients receiving Pyrukynd (mitapivat) tablets, collecting patient, insurance, and prescription details.
See template
See template
My Medical Alert Passport
PDF template
A comprehensive medical form designed to help individuals, particularly those with autism, communicate their medical needs and personal preferences to healthcare providers.
See template
See template
MWSU Mystics Dance Team Medical Release
PDF template
Medical release and liability waiver for participants in MWSU Mystics Dance Team clinics and tryouts.
See template
See template
Enrollment Form
PDF template
A comprehensive enrollment form for patients seeking to enroll in VYVGART treatment pathway and services.
See template
See template
Visalia Rawhide 2024 Employment Application
PDF template
Job application form for Visalia Rawhide baseball organization, covering personal information and employment preferences.
See template
See template
Preparticipation Physical Evaluation PHYSICAL EXAMINATION FORM
PDF template
Comprehensive medical evaluation form for athletes to assess physical fitness and health status prior to participation in sports activities.
See template
See template
Health Examination Form
PDF template
A comprehensive medical evaluation form for documenting a child's health status and medical history for school or sports participation.
See template
See template
NACo Prescription Discount Card FAQ
PDF template
Informational document explaining the details and usage of a county-provided prescription discount card program for residents.
See template
See template
NAF 2018 Alabama Department Of Insurance Name Approval Form
PDF template
Official form for requesting name approval for insurance producer business entities in Alabama.
See template
See template
Health Examination Form For Admission To Nurse Aide Training Program
PDF template
A medical health screening form required for admission to a nurse aide training program, including tuberculosis testing and vaccination documentation.
See template
See template
NAIC Uniform Risk Retention Group Registration Form
PDF template
Official registration form for Risk Retention Groups operating under the Federal Liability Risk Retention Act of 1986.
See template
See template
NAIC Uniform Risk Retention Group Registration Form
PDF template
Official registration form for Risk Retention Groups operating under the Liability Risk Retention Act, used to register insurance operations across states.
See template
See template
Nominations Agreement Form
PDF template
A form for professionals to be considered for board positions within the NAIOP Southern Nevada organization, detailing professional experience and leadership interest.
See template
See template
Waiver And Release Of Liability
PDF template
Legal document waiving liability for potential COVID-19 exposure at Naish Scout Reservation during Boy Scouts activities.
See template
See template
ASHN North American Championship 2009 Hotel Audit Form
PDF template
Form for recording team and guest information for a sports championship hotel accommodation audit
See template
See template
Camp Fire USA National Art Competition Entry Form
PDF template
Entry form for submitting artwork to Camp Fire USA's national art competition for youth participants.
See template
See template
Naturalist Certificate Program Declaration Form
PDF template
Application form for individuals seeking to enter a naturalist certificate program at a museum, collecting personal and professional information.
See template
See template
MOTOR VEHICLE INSPECTION FORM
PDF template
A detailed form for documenting vehicle condition, specifications, accessories, and modifications for insurance or registration purposes.
See template
See template
DIRECT CANCELLATION FORM
PDF template
A form for requesting cancellation of service contracts, including vehicle-related contracts and services
See template
See template
National Producer Agreement
PDF template
A comprehensive agreement between Ryan Services Group and an insurance producer outlining terms of collaboration for specialty insurance products.
See template
See template
Post Employment Health Plan (PEHP) Claim Form
PDF template
Form for requesting medical expense reimbursement for post-employment health benefits, including insurance premiums and medical expenses.
See template
See template
Native Kidney Biopsy Requisition Form
PDF template
Medical form for requesting and documenting details of a native kidney biopsy procedure, including patient medical history and clinical information.
See template
See template
NatureS Healers Patient Intake Form
PDF template
Comprehensive medical intake form for patients considering hyperbaric oxygen therapy, including medical history and potential contraindications.
See template
See template
NavigatorAO Service Request Form
PDF template
Official form for licensed Navigators and Application Organizations to request changes to their licensing information with the Indiana Department of Insurance.
See template
See template
When You Go On LeaveMake Sure Your 1199SEIU Benefits Are Active
PDF template
Instructions for maintaining benefits during various types of leave, including paid family leave, disability, FMLA, and workers' compensation.
See template
See template
InsuranceAHCCCS Verification Form
PDF template
Form for verifying insurance and collecting information for newborn bloodspot screening in Arizona.
See template
See template
NCAA Division I Drug Testing Consent Form 22 1b
PDF template
A mandatory consent form for NCAA Division I student-athletes authorizing year-round drug testing and acknowledging testing consequences.
See template
See template
NCAA Student Athlete Statement And Drug Testing Consent Form
PDF template
Comprehensive forms for NCAA student-athletes covering eligibility, consent for records disclosure, and drug testing acknowledgment.
See template
See template
Authorization To Release AndOr Disclose Protected Health Information
PDF template
A form authorizing the release of protected health information between NCCU Student Health and Counseling Services and specified parties.
See template
See template
North Carolina FFA Center Consent Form
PDF template
A consent and liability release form for students attending the North Carolina FFA Center camp, outlining participant policies and photo permissions.
See template
See template
Cancer Coverage With Optional Riders Claim Form
PDF template
Insurance claim form for filing cancer coverage benefits with American Heritage Life Insurance Company.
See template
See template
North Country HealthCare ParentalPatient Consent Form
PDF template
Consent form for healthcare services provided by North Country HealthCare's School-Based Health Services Mobile Unit for students and parents/guardians.
See template
See template
North Carolina High School Athletic Association Transfer Request
PDF template
Official form for requesting transfer of a student-athlete between schools within the North Carolina High School Athletic Association
See template
See template
NCOAE Acknowledgment And Assumption Of Risks Release And Indemnity Agreement
PDF template
Legal agreement for participants in outdoor and adventure education programs, covering risks and liability for activities conducted by NCOAE.
See template
See template
NC Psychology Board Change Of Address Form
PDF template
A form for North Carolina psychology licensees to update their professional contact information and address with the state licensing board.
See template
See template
Health Examination Certificate North Carolina Public Schools
PDF template
Required medical certification form for school employees verifying health status and ability to perform job duties
See template
See template
Non Disclosure And Confidentiality Agreement
PDF template
A confidentiality agreement between the Interactive Advertising Bureau (IAB) and a board member regarding sensitive organizational information.
See template
See template
Non Disclosure And Confidentiality Agreement
PDF template
A legal document establishing confidentiality terms between the Interactive Advertising Bureau (IAB) and a member organization regarding sensitive business information.
See template
See template
NINDS Repository Tissue Biopsy Shipping Instructions
PDF template
Detailed instructions for collecting, labeling, and shipping tissue biopsy samples for the NINDS Repository.
See template
See template
ADA Request Medical Form
PDF template
A medical form used to assess an employee's disability status and potential workplace accommodations under the ADA.
See template
See template
TSB Leased Vehicle AccidentInsurance Claim Procedure
PDF template
Procedure for handling accident reports and repair claims for leased vehicles at TSB, involving reporting, estimates, insurance review, and repair coordination.
See template
See template
New England Food Allergy Treatment Center Medical History Form
PDF template
Comprehensive medical history form for documenting patient's food allergies, medical history, and current health status.
See template
See template
Neighborhood Association Membership Form
PDF template
A form for individuals to become members of a local neighborhood association, with options for different membership types and renewal.
See template
See template
DSS NEMT 970 SOUTH DAKOTA MEDICAID NON EMERGENCY MEDICAL TRAVEL (NEMT) REIMBURSEMENT FORM
PDF template
A form for Medicaid recipients to document and request reimbursement for non-emergency medical transportation services in South Dakota.
See template
See template
Netball Waiver
PDF template
Legal document releasing liability for risks associated with netball participation, including COVID-19 related risks.
See template
See template
Neuro Ophthalmology Referral Form
PDF template
A medical referral form for patients seeking ophthalmology services at Emory Eye Center, requiring patient and referral details.
See template
See template
Neuroscience Art Competition Entry Form 2020
PDF template
An art competition for neuroscience students to showcase artistic creativity through works inspired by neuroscience and brain imagery.
See template
See template
Sample Liability Insurance Form
PDF template
A standard form for documenting liability insurance coverage and related details.
See template
See template
Neuroscience Conference Service Agreement Form
PDF template
Agreement for professional conference services provided by Hawaii Pacific Neuroscience, covering event coordination, catering, and service terms.
See template
See template
IRS Form 1095 C
PDF template
A tax form documenting health coverage offered by the University of Alabama System as required by the Affordable Care Act (ACA)
See template
See template
ACCIDENT WAIVER AND RELEASE OF LIABILITY FORM
PDF template
A legal document that waives liability for participation in activities and acknowledges potential risks of engagement.
See template
See template
Patient Information And Dental Insurance Questionnaire
PDF template
Comprehensive form for collecting patient personal, contact, and dental insurance information for a dental practice.
See template
See template
NEW Adult Affiliated With A Junior Program Club Director, Coach, Chaperone, Team Representative, And
PDF template
Guide for new adult members joining the Carolina Region Volleyball program for the first time, providing step-by-step online registration instructions.
See template
See template
Preparticipation Physical Evaluation
PDF template
Comprehensive medical evaluation form for assessing an individual's physical fitness and health status prior to participation in an activity.
See template
See template
BROWN UNIVERSITY AUTO ACCIDENT REPORT FORM
PDF template
A comprehensive form for documenting vehicle accidents involving Brown University employees or vehicles.
See template
See template
Order Form For Newborn Screening Kits
PDF template
A form for ordering specimen collection cards and pre-addressed envelopes for newborn screening from the Office of Laboratory Services.
See template
See template
980 Retiree Welcome Packet Retirement Medical Benefit Account Claim Form
PDF template
A claim form for retirees to submit medical insurance premium reimbursement requests with specific documentation guidelines.
See template
See template
Dorchester Center For The Arts New ClassWorkshop Proposal Checklist
PDF template
A comprehensive checklist for instructors proposing new art classes or workshops at the Dorchester Center for the Arts.
See template
See template
Academic Proposal Form For All New Concentrations Within Existing Programs
PDF template
A comprehensive form for proposing new academic concentration within existing university programs, detailing structure, requirements, and implementation details.
See template
See template
Patient Treatment And Cancellation Policy
PDF template
Policy document outlining patient responsibilities, insurance claims processing, and appointment cancellation terms for physical therapy services.
See template
See template
New Contractor Form
PDF template
A registration form for new contractors seeking to obtain permits in the City of Okeechobee, requiring submission of various business and insurance documents.
See template
See template
Waiver Of Liability, Promise Not To Sue, Assumption Of Risk And Agreement To Pay Claims
PDF template
A comprehensive legal document waiving liability and assuming risks for participation in a university-sponsored activity.
See template
See template
Patient Intake Form
PDF template
Comprehensive medical intake form for collecting patient medical history, symptoms, and personal health information.
See template
See template
GAP Cancellation Form
PDF template
Form for cancelling a Guaranteed Asset Protection (GAP) insurance policy with options for refund destination and cancellation reasons.
See template
See template
Emergency Contact Form
PDF template
A form for collecting student emergency contact details, medical information, and insurance status for school records.
See template
See template
PATIENT GASTROENTEROLOGY HISTORY FORM
PDF template
Comprehensive medical intake form for gastroenterology patients, collecting personal, demographic, and insurance information.
See template
See template
New Hire Assessment Form Attachment B
PDF template
A form for new hires to disclose medical conditions, restrictions, and potential job-related health exposures prior to starting employment.
See template
See template
New Hire Benefits Enrollment Checklist
PDF template
Comprehensive checklist for new employees of the Office of the Comptroller of the Currency to complete benefits enrollment and required forms within specified timeframes.
See template
See template
Histology Service Request Form
PDF template
A comprehensive form for requesting histology laboratory services, including biospecimen processing, staining, and immunohistochemistry analysis.
See template
See template
Patient Intake Form
PDF template
Comprehensive form for collecting patient personal, medical, and insurance information for healthcare providers.
See template
See template
IT Project Initiation Proposal Form
PDF template
A comprehensive form for proposing and initiating new IT projects, capturing project vision, goals, resources, and approval requirements.
See template
See template
Newly Wed Checklist (Active Retired)
PDF template
Instructions for adding a spouse to welfare benefits for Uniformed Firefighters Association members.
See template
See template
Annual Minor Participant Health And Medical Form
PDF template
Comprehensive medical information form for minors under 18 years old, collecting health details, emergency contacts, and medical consent.
See template
See template
New Participant Medical Form
PDF template
A comprehensive medical information form for new participants requiring detailed health history and medical details
See template
See template
New Patient Intake Form
PDF template
Comprehensive form for collecting new patient medical information, health history, and insurance details.
See template
See template
Patient Information Packet
PDF template
Welcome packet for new pediatric speech and occupational therapy patients, including required documentation for therapy services.
See template
See template
NEW PATIENT REGISTRATION FORM
PDF template
Comprehensive medical form for collecting new patient personal, contact, insurance, and emergency contact information.
See template
See template
Patient Intake Form
PDF template
Comprehensive medical intake form collecting patient personal information, insurance details, medical history, and treatment authorization.
See template
See template
Otolaryngology Head And Neck Surgery Consultation
PDF template
Comprehensive medical consultation form for otolaryngology patients, covering detailed review of systems and medical history.
See template
See template
New Patient Insurance Form
PDF template
A comprehensive intake form for new patients seeking outpatient therapy, collecting personal, insurance, and referral information.
See template
See template
New Patient Intake Form
PDF template
Comprehensive medical intake form for collecting new patient personal, contact, medical, and insurance information.
See template
See template
Patient Information Sheet
PDF template
A patient information and policy document for a gynecological medical practice outlining registration requirements, payment policies, and office rules.
See template
See template
TRI COUNTY FAMILY MEDICINE NEW PATIENT INTAKE FORM
PDF template
Comprehensive medical form for collecting patient medical history, current medications, allergies, and recent medical history
See template
See template
New Patient Intake Form
PDF template
A comprehensive medical form for collecting new patient personal, contact, medical history, and emergency contact information.
See template
See template
NEW PATIENT INTAKE FORM
PDF template
Comprehensive medical intake form for new pediatric patients, collecting personal, medical, and insurance information.
See template
See template
New Patient Intake Form
PDF template
Comprehensive form for collecting new patient medical history, personal information, and health status for medical practice intake.
See template
See template
Dermatology Patient Intake Form
PDF template
Comprehensive patient intake form for dermatology practice including personal information, insurance details, and medical consent.
See template
See template
New Patient Information Form
PDF template
Comprehensive medical intake form for new patients seeking mental health services at Triad Psychiatric Practice.
See template
See template
New Patient Intake Form
PDF template
Comprehensive medical form for collecting patient personal information, medical history, current health conditions, and insurance details.
See template
See template
New Patient Intake Form
PDF template
Comprehensive form for new pharmacy patients to provide personal, medical, and insurance information for prescription services.
See template
See template
NEW PATIENT INTAKE FORM
PDF template
Comprehensive medical intake form for collecting patient personal, insurance, and health information for a medical clinic or practice.
See template
See template
New Patient Intake Form
PDF template
A comprehensive patient intake form for new pharmacy customers, including personal information, contact details, and insurance information.
See template
See template
NEW PATIENT REGISTRATION FORM
PDF template
Comprehensive form for collecting patient demographic, contact, and personal information for new healthcare patients.
See template
See template
Blase Chiropractic New Patient Intake Form
PDF template
Comprehensive intake form for new patients seeking chiropractic services, collecting personal, contact, and employment information.
See template
See template
NEW PATIENT VISIT INTAKE FORM
PDF template
Comprehensive medical intake form for pediatric patients with potential endocrine and metabolic conditions.
See template
See template
NEW PATIENT INTAKE FORM
PDF template
Comprehensive medical intake form for new patients to provide detailed health background and current medical conditions.
See template
See template
NEW PATIENT INTAKE FORM
PDF template
Comprehensive form for collecting new patient personal, medical, insurance, and contact information for healthcare providers.
See template
See template
New Patient Intake Form
PDF template
Comprehensive medical intake form for new patients to document medical history, current medications, and pain assessment details.
See template
See template
Patient Intake Form
PDF template
Comprehensive medical intake form for naturopathic patients collecting personal, medical, and health history information.
See template
See template
Allina Health John Nasseff Neuroscience Specialty Clinic New Patient Intake Form
PDF template
Comprehensive medical intake form for new patients at a neuroscience specialty clinic, collecting personal, medical, and diagnostic history.
See template
See template
New Patient Intake Form
PDF template
Comprehensive medical intake form for documenting patient medical history, pain assessment, and physical limitations.
See template
See template
New Patient Intake Form
PDF template
Medical intake form for collecting comprehensive patient information for an eye care practice.
See template
See template
NEW PATIENT MEDICAL HISTORY FORM
PDF template
Comprehensive medical history intake form for new patients, collecting personal information, medical conditions, allergies, and current medications.
See template
See template
NEW PATIENT MEDICAL HISTORY FORM
PDF template
Comprehensive medical history form for new patients seeking weight management treatment, detailing weight history, triggers, and previous weight loss attempts.
See template
See template
NEW PATIENT INTAKE FORM
PDF template
Comprehensive intake form for new patients at Chicago Gastro, collecting personal and medical contact information along with financial policy acknowledgment.
See template
See template
PATIENT INTAKE FORM
PDF template
Confidential form for collecting comprehensive patient personal and demographic information for medical record purposes.
See template
See template
New Patient Questionnaire
PDF template
Comprehensive medical history intake form for new patients covering various health conditions and medical background.
See template
See template
NEW PATIENT REFERRAL FORM
PDF template
Comprehensive medical referral form for new patients seeking cardiothoracic surgical consultation, collecting patient, insurance, and medical information.
See template
See template
Patient Intake Form
PDF template
A comprehensive patient intake form for collecting personal, medical, and insurance information with communication preferences and service consent.
See template
See template
White Bird Medical Clinic NEW PATIENT INTAKE FORM
PDF template
Comprehensive intake form for new patients at White Bird Medical Clinic, collecting personal, demographic, and medical background information.
See template
See template
NEW PATIENT INTAKE FORM (With TriCare Insurance)
PDF template
Comprehensive medical intake form for new patients, collecting detailed personal and medical history information.
See template
See template
NEW Patient Pediatric Orthopaedic And Sports Medicine Medical History Form
PDF template
Comprehensive medical history form for pediatric patients in orthopaedic and sports medicine practice, capturing patient details, medical history, and family health information.
See template
See template
Medical Examination Form Examining Physician Must Fill Out
PDF template
A comprehensive medical assessment form for evaluating an individual's fitness for missionary service, requiring detailed physical examination and medical history.
See template
See template
Curricular Action Workflow New Program Proposal Form Guide
PDF template
A comprehensive guide for submitting and processing new academic program proposals within an educational institution.
See template
See template
NEW ELBOW PATIENT INTAKE FORM
PDF template
Medical intake form for patients experiencing elbow-related symptoms, designed to gather comprehensive information about the patient's condition and medical history.
See template
See template
NEW HIP PATIENT INTAKE FORM
PDF template
Comprehensive medical intake form for new patients experiencing hip-related symptoms or concerns.
See template
See template
New Patient Intake Form
PDF template
Comprehensive medical intake form for new patients at Rowan Tree Medical, collecting personal, medical, and contact information.
See template
See template
HIPAA AUTHORIZATION FOR MEDICAL RECORDS
PDF template
A form authorizing the release of patient medical records with specific conditions and consent parameters.
See template
See template
Demographic Form
PDF template
Comprehensive patient intake form collecting personal, contact, insurance, and medical information for Centeno-Schultz Clinic.
See template
See template
New Additional Insured Endorsement Forms Will Impact Contractors, Project Owners, Lessees
PDF template
Overview of new ISO insurance endorsement forms affecting Additional Insured status and risk management in the construction industry.
See template
See template
Volunteer Participation Agreement And Acknowledgement Of Risks
PDF template
A legal document for volunteers to acknowledge risks and waive liability when participating in research activities at the university.
See template
See template
Patient Information Form
PDF template
A comprehensive medical intake form collecting patient personal, insurance, and workplace injury details for healthcare providers.
See template
See template
NOAA Form 57 10 05 Medical Form For Minors
PDF template
A comprehensive medical information and consent form for minors participating in NOAA ship voyages, capturing health details, emergency contacts, and parental permissions.
See template
See template
NFDA INSURANCE FORM PACKET
PDF template
A collection of forms and guidance for funeral homes to manage insurance policy assignments for preneed and at-need funeral arrangements.
See template
See template
NFHS Medical Release Form For Wrestler To Participate With Skin Lesion(S)
PDF template
A standardized medical form developed by NFHS Sports Medicine Advisory Committee to manage skin lesions and communicable skin disorders in wrestling.
See template
See template
Nashville Fairgrounds Speedway Registration Form
PDF template
Registration and contract form for race car drivers participating in Nashville Fairgrounds Speedway racing events for the 2022 season.
See template
See template
Roswell Park Cancer Institute Volunteer Application Form
PDF template
Comprehensive form for potential volunteers to provide personal, contact, and background information for Roswell Park Cancer Institute.
See template
See template
Arizona National Interest Waiver Program Transfer Form
PDF template
A transfer form for healthcare professionals participating in Arizona's National Interest Waiver program to change their service site location.
See template
See template
Preparticipation Physical Evaluation PHYSICAL EXAMINATION FORM
PDF template
Comprehensive medical form for evaluating an individual's physical fitness and health status prior to participating in sports or athletic activities.
See template
See template
New Jersey Medical Power Of Attorney
PDF template
A legal document allowing an individual to designate an agent to make healthcare decisions on their behalf in New Jersey.
See template
See template
NJPEC 1634 19 Therapy Services Request Form
PDF template
A healthcare form for requesting and documenting therapy services, including patient and provider information, diagnosis, and treatment details.
See template
See template
PREPARTICIPATION PHYSICAL EVALUATION (Interim Guidance) HISTORY FORM
PDF template
Comprehensive medical history form for athletes to assess health status and potential medical concerns prior to sports participation.
See template
See template
HEALTH, ACCIDENT, DISABILITY CLAIM FORM
PDF template
Comprehensive claim form for health, accident, and disability insurance claims from National Teachers Associates Life Insurance Company.
See template
See template
Part I Medical History And Release Form
PDF template
A comprehensive medical history form for participants in the National Leadership Challenge, designed to aid medical treatment and emergency response.
See template
See template
Neuromodulation Pre Authorization Support Resources
PDF template
Comprehensive guide for healthcare professionals seeking pre-authorization support for neuromodulation therapy, including contact information and process details.
See template
See template
Namibian Motorsport Federation Accident Report Form
PDF template
A comprehensive form for documenting accidents and medical incidents during motorsport events in Namibia.
See template
See template
New Mexico Uniform Prior Authorization Form
PDF template
A comprehensive form for healthcare providers to request prior authorization for medical services, procedures, or treatments.
See template
See template
Informed Consent, Release Agreement, And Authorization
PDF template
A legal document for participant consent, medical authorization, and risk acknowledgment for Scouting activities and expeditions.
See template
See template
Emergency Contact Form
PDF template
A comprehensive form for collecting student emergency contact details, medical information, and parental consent for medical treatment.
See template
See template
NOAA Form 57 10 20 OMAO Privacy And Consent Form
PDF template
Privacy act statement for collecting health and medical records at the National Oceanic and Atmospheric Administration (NOAA)
See template
See template
No Fault Insurance Form
PDF template
A form for filing a no-fault insurance claim with personal and injury details for insurance processing.
See template
See template
Texas Standard Prior Authorization Request Form For Prescription Drug Benefits
PDF template
A standardized form for requesting prior authorization of prescription drug benefits in Texas, used by various healthcare and insurance providers.
See template
See template
Common Nomination Form For Gratuity, General Provident Fund And Central Government Employees Group I
PDF template
A comprehensive form for Central Government employees to nominate beneficiaries for gratuity, provident fund, and group insurance benefits.
See template
See template
Nomination Form
PDF template
A form for nominating individuals for selection into the YCS Athletic Hall of Fame based on athletic achievements, coaching impact, or community support.
See template
See template
Non ACGME Fellowship Application
PDF template
A comprehensive application form for medical professionals seeking specialized fellowship training in various oncology and medical subspecialties.
See template
See template
Toquaht Nation Government Non Insured Health Benefit Application Form
PDF template
Application form for Toquaht Nation citizens to request health benefits funding for various medical services and expenses.
See template
See template
Non Medication Preauthorization Request
PDF template
A form for healthcare providers to request preauthorization for non-medication medical services and procedures from the Motion Picture Industry Health Plan (MPI).
See template
See template
Private Medical Consultations Price List
PDF template
Comprehensive pricing guide for private medical services, consultations, certificates, and travel-related medical procedures
See template
See template
Trust Policy Form
PDF template
A comprehensive guide for setting up a trust policy, outlining key considerations, beneficiary selection, and trustee appointment.
See template
See template
Northwell Health, Health Welfare Flex Benefit Program Summary Plan Description
PDF template
Comprehensive overview of short-term and long-term disability options for Northwell Health employees administered by Sedgwick and The Hartford.
See template
See template
Incident Claim Form
PDF template
A form for reporting non-vehicular related claims involving injury or property damage within the City of West Linn
See template
See template
REGISTRATION FORM
PDF template
Registration form for filing health care directives with the North Carolina Secretary of State, including various medical and end-of-life documents.
See template
See template
Northeast Community Center Liability Waiver
PDF template
A legal document waiving liability for participants and their children using Northeast Community Center facilities and activities.
See template
See template
North Grove Equestrian Park Equine Release And Waiver Of Liability, Assumption Of Risk, And Indemnit
PDF template
A legal document releasing North Grove Equestrian Park from liability for potential injuries or damages related to horseback riding and equine activities.
See template
See template
2024 2025 Northside ISD Medical History
PDF template
Annual medical history form required for student athletes to participate in school sports activities
See template
See template
Northside Boxing Club Membership Form Waiver
PDF template
Comprehensive membership form for boxing club participants, including personal information, medical history, and liability waiver.
See template
See template
Requisition Form For Surgical Pathology, Cytopathology, And Hematopathology
PDF template
A form for requesting additional ancillary studies on archived pathology cases more than 30 days after initial sign-out.
See template
See template
Application For Entry Into Norfolk Open Studios 2023
PDF template
Application form for artists to participate in the Norfolk Open Studios event, allowing individual and group entries to showcase their work.
See template
See template
Surprise Billing Protection Form
PDF template
A document explaining patient protections against unexpected out-of-network medical billing and requesting consent for potential additional charges.
See template
See template
Notice Of Emergency Procurement
PDF template
A document detailing an emergency medical procurement for a life-flighted patient at Utah Valley Medical Center
See template
See template
Excess Secondary Insurance Plan For Sports Club Athletes
PDF template
Insurance policy document outlining coverage details for San Diego State University sports club athletes, explaining secondary insurance provisions and claim procedures.
See template
See template
Authorization Request Form
PDF template
Medical service authorization request form for providers to submit routine and urgent pre-service requests for patient care.
See template
See template
Novi Parks, Recreation Cultural Services Waiver Form
PDF template
A comprehensive liability waiver for participation in City of Novi recreational activities and events, covering in-person and online programs.
See template
See template
The Report Form
PDF template
A reporting form for Optimist International clubs to document their New Optimist Welcome (NOW) Program membership recruitment efforts.
See template
See template
Consultation Referral Form
PDF template
A medical referral form for patients seeking specialized consultations in sleep, pulmonary, and allergy evaluations.
See template
See template
Designation (Family And Medical Leave Act)
PDF template
Official form for employers to designate and communicate Family and Medical Leave Act (FMLA) leave status and entitlements to employees.
See template
See template
National Pancreas Foundation Center Audit Form
PDF template
A comprehensive document outlining reporting capabilities, responsibilities, and qualifications for centers participating in the National Pancreas Foundation program.
See template
See template
PATIENT INTAKE FORM
PDF template
Comprehensive patient demographic and health assessment form for chiropractic wellness center intake process.
See template
See template
Patient Intake Form
PDF template
Comprehensive patient intake form for prosthetics services, collecting medical history, contact details, and amputation information.
See template
See template
Patient Intake Form
PDF template
Comprehensive intake form for patients seeking prosthetic services, capturing medical history, contact information, and amputation details.
See template
See template
Patient Intake Form
PDF template
Confidential form for collecting patient personal and contact information for healthcare purposes.
See template
See template
Narrow Ridge Earth Literacy Center Confidential Health Information And Medical Release Form
PDF template
Comprehensive medical history questionnaire for participants in Narrow Ridge Earth Literacy Center activities, including medical release authorization.
See template
See template
NRPA Congress Volunteer Registration Form
PDF template
Volunteer registration form for the National Recreation and Park Association (NRPA) Congress and Exposition in Houston, Texas.
See template
See template
Advertising Book Order Form
PDF template
Order form for purchasing advertising space in a championship show program for a color guard event
See template
See template
Natick Soccer Club 2023 Fall Classic Tournament Medical Release Form
PDF template
Medical and liability release form for youth soccer tournament participants, allowing medical treatment and acknowledging participation risks.
See template
See template
NATIONAL SCIENCE FOUNDATION POLAR PHYSICAL EXAMINATION
PDF template
Medical examination form for individuals participating in polar research or expeditions, including comprehensive health assessment.
See template
See template
Pathology Fellowship Application
PDF template
A comprehensive application form for medical professionals seeking a fellowship in pathology specialties at the University of Chicago (NorthShore)
See template
See template
NSGFA MEDICAL HISTORY FORM
PDF template
A comprehensive medical history and emergency contact form for players, collecting personal and medical information for emergency purposes.
See template
See template
John H. Daniels Fellowship Application Form
PDF template
Application form for a fellowship supporting research and scholarship in equestrian, angling, and field sports literature and culture.
See template
See template
Internship Application Form
PDF template
Comprehensive application form for students seeking an internship opportunity at the National Sporting organization.
See template
See template
North Texas Heart Center Medical Test Request Form
PDF template
Medical test request form for cardiology examinations at North Texas Heart Center with patient and diagnostic details.
See template
See template
Northwest University Athletics Excess Insurance Information
PDF template
Comprehensive insurance guidelines for Northwest University student athletes detailing excess insurance coverage requirements and procedures for athletic injury claims.
See template
See template
New Student Athlete Health History Questionnaire Form
PDF template
Confidential medical history questionnaire for student-athletes at Northwest University, focusing on cardiovascular risk factors and health screening.
See template
See template
Medical Examination Form Nurse Aide
PDF template
A comprehensive medical history and examination form for students entering the Nurse Aide program at Virginia Western Community College.
See template
See template
Medical Rehabilitation Nurses Section Referral Form
PDF template
A form for documenting medical rehabilitation referrals for injured employees through the North Carolina Industrial Commission.
See template
See template
CLINICAL ASSESSMENT FORM FIRST YEAR
PDF template
A comprehensive healthcare assessment form for collecting patient medical information, history, and current health status for first-year health sciences students.
See template
See template
Nurse Assistant Program Application Checklist
PDF template
Comprehensive checklist and requirements for students applying to the Nurse Assistant Program at Citrus College.
See template
See template
NURSING INSTRUCTOR CONFIDENTIALITY AGREEMENT
PDF template
A confidentiality agreement for nursing instructors outlining the handling of sensitive information at Windsor Regional Hospital.
See template
See template
Allied Health And Nursing Student Medical Form
PDF template
Medical form for Allied Health and Nursing students at Montgomery College to document health status and capabilities.
See template
See template
Spinraza Pre Authorization Form
PDF template
A medical pre-authorization form for requesting Spinraza medication treatment, used for documenting patient details and motor ability assessments.
See template
See template
Nutritional Referral Form
PDF template
Medical referral form for nutrition therapy services, used by physicians to refer patients for specialized nutritional counseling.
See template
See template
CMS 1500 Claim Form Instructions
PDF template
Comprehensive instructions for completing the CMS-1500 medical claim form with detailed field requirements and change history.
See template
See template
Managed Service Provider Request For Proposal
PDF template
Request for proposals from qualified Managed IT Services Providers to provide IT services to the Naugatuck Valley Council of Governments.
See template
See template
Authorization To Use And Disclose Protected Health Information
PDF template
A form authorizing Nathaniel Witherell to disclose or obtain patient health information for various purposes.
See template
See template
NWCD Requisition Form
PDF template
A medical requisition form for cardiac and vascular diagnostic procedures from North West Cardio Diagnostics.
See template
See template
Northwest Dance And Acro Registration Form
PDF template
Registration form for dance and acro classes with student and parent/guardian information, class selection, and liability release.
See template
See template
Certificate Of Insurance
PDF template
Detailed instructions for submitting a proof of liability insurance certificate with specific coverage requirements for New World Symphony.
See template
See template
Member Medical Reimbursement Claim Form
PDF template
A claim form for Wellcare By Fidelis Care members to request reimbursement for out-of-pocket medical expenses.
See template
See template
Continuation Of Disability Claim Form
PDF template
A form for reporting ongoing disability status, medical treatments, and work return details for an insurance claim.
See template
See template
NYIT College Of Osteopathic Medicine Enrollment Form
PDF template
Insurance enrollment form for medical students at NYIT College of Osteopathic Medicine to select coverage options and list dependents.
See template
See template
Disability Claim Form
PDF template
Comprehensive form for employees to report disability, medical information, and related benefit claims.
See template
See template
NYS School Health Examination Form
PDF template
Required health examination form for New York State school students documenting medical history and physical assessment.
See template
See template
Required NYS School Health Examination Form
PDF template
Comprehensive health examination form for New York State school students documenting medical history, physical exam, and health status.
See template
See template
NYS OfficialS ACCIDENT REPORT FORM
PDF template
Official form for documenting accidents and injuries during school sports competitions in New York State.
See template
See template
UnitedHealthcare Community Plan Of New York Specialist Referral Form
PDF template
A referral form for UnitedHealthcare Community Plan of New York members to obtain specialist services with specific guidelines and requirements.
See template
See template
Record Of Employment
PDF template
Official form for documenting employment status for unemployment insurance purposes in New York State.
See template
See template
American Arbitration Association SumUM Arbitration Request
PDF template
A legal form for requesting arbitration in uninsured or underinsured motorist insurance disputes through the American Arbitration Association.
See template
See template
City Of Oakley Recreation Program Registration Form
PDF template
Registration form for City of Oakley recreation programs and activities for families and minors
See template
See template
ACORD Cancellation Form
PDF template
A standardized document used to officially terminate an insurance policy and provide formal documentation of cancellation.
See template
See template
Oberlin College Employer Contribution Amounts Health Savings AccountHealth Reimbursement Account
PDF template
Details employer contributions to health savings accounts for Oberlin College employees in 2024, including contribution amounts and IRS limits.
See template
See template
Patient Medical History Form
PDF template
A comprehensive form for capturing patient's current health status, medical conditions, medications, and medical history.
See template
See template
Team Form 2022
PDF template
A form for registering Scout teams for an event, with details about team composition and participant information.
See template
See template
OB Pre Registration Form
PDF template
A comprehensive patient information form for expectant mothers to pre-register for maternity services at Howard County Medical Center.
See template
See template
English Patient Intake Form
PDF template
A comprehensive medical intake form for collecting patient personal and contact information.
See template
See template
OBS 0901 COVID19RPP Test Requisition Form
PDF template
A comprehensive medical form for requesting COVID-19 and respiratory pathogen panel (RPP) testing, collecting patient and clinical information.
See template
See template
Observation Experience Policy OBSERVATION AGREEMENT FORM
PDF template
Form for individuals seeking to observe healthcare professionals at a medical facility, outlining health requirements and confidentiality agreements.
See template
See template
Employee Medical Condition Questionnaire
PDF template
Comprehensive medical history and health status form for employees, covering medical conditions, treatments, and workplace accommodations
See template
See template
NEW PATIENT INTAKE FORM
PDF template
Comprehensive medical intake form capturing patient health history, nutrition, lifestyle, and wellness information.
See template
See template
Waiver Service Request Form
PDF template
A form and guide for documenting and processing requests for changes or new services in a waiver program.
See template
See template
Trinity College Outdoor Programs Medical History Form
PDF template
A comprehensive medical history form for participants in Trinity College outdoor programs, designed to assess health risks and preparedness for wilderness activities.
See template
See template
Recurring Premium Reimbursement Form
PDF template
Form for requesting reimbursement of recurring insurance premiums through OneExchange
See template
See template
Miami Dade College Off Campus Activity Student Agreement Form
PDF template
A legal agreement for students participating in off-campus activities, acknowledging risks and releasing the college from liability.
See template
See template
Off Campus Event Risk Assessment Form
PDF template
A comprehensive form for evaluating risks and safety protocols for off-campus university events and activities.
See template
See template
IWU University Sponsored Off Campus Travel Form
PDF template
A liability release and consent form for students participating in off-campus university-sponsored travel activities.
See template
See template
Off Campus Activity Trip Leader Form
PDF template
A form for university staff to request approval and document details for an off-campus educational activity or trip.
See template
See template
Office Environment Assessment
PDF template
A comprehensive assessment tool for evaluating healthcare facility physical accessibility, appearance, space adequacy, and record-keeping practices.
See template
See template
Congressional Youth Advisory Council Legal Guardian Authorization And Media Release Form
PDF template
Legal consent and media release document for youth participation in Congressional Youth Advisory Council program administered by Congresswoman Veronica Escobar.
See template
See template
IBEW Local No. 683 Health Welfare Fund Weekly Disability Benefits Claim Form
PDF template
Claim form for obtaining weekly disability benefits from the IBEW Local No. 683 Health & Welfare Fund, providing compensation for disabled workers.
See template
See template
Official Health Records Request
PDF template
A form for students to request release of immunization and health records from Herkimer College.
See template
See template
Official Indiana Animal Bites Report
PDF template
Official state form documenting details of an animal bite incident, including victim and animal information for potential rabies exposure.
See template
See template
CITY OF OCONTO FALLS VOLUNTEER FORM
PDF template
A form for registering volunteers and obtaining legal release for participation in City of Oconto Falls activities.
See template
See template
WAIVER, INDEMNIFICATION, AND MEDICAL TREATMENT AUTHORIZATION CONSENT FORM
PDF template
Legal document releasing liability for participants in a cultural diversity colloquium sponsored by Texas A&M Rangel College of Pharmacy.
See template
See template
OHF Screening Declaration Form
PDF template
Official screening and declaration form for hockey officials and members to report criminal background and potential disciplinary issues.
See template
See template
Applied Behavior Analysis (ABA) Clinical Service Request
PDF template
A healthcare form for requesting Applied Behavior Analysis clinical services, used for initial or concurrent treatment requests.
See template
See template
MINOR PARTICIPANT AGREEMENT FORM
PDF template
Legal consent form for parents/guardians to allow minor children to participate in camp and retreat center activities, including risk acknowledgment and publicity waiver.
See template
See template
Olustee Fun Run Waiver Form
PDF template
Waiver form for participants in a community running event, outlining event rules and liability release.
See template
See template
Followup Patient Intake Form
PDF template
A comprehensive medical form for tracking patient status, medications, pain levels, and post-operative health details.
See template
See template
TRAVEL FORM Observership Program
PDF template
A travel form for participants in the Open Medical Institute's Observership Program, detailing travel arrangements to Austria.
See template
See template
TRAVEL FORM Observership Program
PDF template
Travel documentation form for participants in the Observership Program, requiring travel details and ticket information.
See template
See template
One Medical Passport Downtime Instructions
PDF template
Instructions for hospital staff to follow during extended One Medical Passport system downtime, providing alternative procedures for booking requests and document submission.
See template
See template
OMSI Outdoors Health And Medical Form
PDF template
A comprehensive health and medical form for students and adults participating in OMSI Outdoors programs, collecting personal, medical, and emergency contact information.
See template
See template
Services Agreement Fee Disclosure
PDF template
A services agreement detailing the terms of retirement plan administration and recordkeeping for a 403(b) Tax-Deferred Annuity Plan.
See template
See template
ONE Program Patient Intake Form
PDF template
A comprehensive medical intake form for assessing patient risk factors related to opioid medication use and potential interactions.
See template
See template
Youth Protection Program Online Participation Agreement And Waiver Form
PDF template
A consent form for youth program participation that includes online activity waivers and risk acknowledgments for University of Central Florida programs.
See template
See template
Riverview Annual Membership Registration Instructions
PDF template
Step-by-step instructions for purchasing and completing an annual membership registration process for Riverview leagues.
See template
See template
Online Will And Legal Form Preparation
PDF template
An online service offering employees the ability to create legal documents like wills, living wills, and powers of attorney through a secure platform.
See template
See template
MIT Overnight Program Medical Release Form
PDF template
A medical release form required for minors participating in the MIT Overnight Program, collecting medical and emergency contact information.
See template
See template
Ontario Works Medical Travel Form
PDF template
A form for social services clients to claim medical travel expenses and transportation costs for reimbursement.
See template
See template
Direct Reimbursement Claim Form
PDF template
A form for requesting reimbursement for vision services from providers outside the Davis Vision network, covering examinations and eyewear expenses.
See template
See template
EPO REFERRAL FORM
PDF template
A referral form for healthcare providers to request out-of-network specialist services through Common Ground Healthcare (CGHC)
See template
See template
Out Of Network Reimbursement Instructions
PDF template
Detailed instructions for submitting out-of-network healthcare reimbursement claims with VBA, including required documentation and submission methods.
See template
See template
Vision Plan Out Of Network Claim Form
PDF template
Form for employees to submit out-of-network vision care expenses for reimbursement from their employer's vision plan.
See template
See template
UNC Ophthalmology Referral Form
PDF template
A comprehensive referral form for patients seeking ophthalmology services at UNC Health locations.
See template
See template
WFU Outdoor Pursuits Medical Form
PDF template
A comprehensive medical form for WFU Outdoor Pursuits participants collecting personal, emergency contact, and insurance information.
See template
See template
Volunteer Service Agreement
PDF template
Official form for volunteers to agree to service terms with New York State Parks and Recreation system
See template
See template
Patient Intake Form
PDF template
Comprehensive medical intake form for collecting patient personal, contact, and insurance information for medical treatment.
See template
See template
Patient Intake Form
PDF template
Comprehensive medical intake form for collecting patient personal, contact, and insurance information with consent and assignment sections.
See template
See template
Diaper Request Form
PDF template
A form for TennCare and CoverKids members to request diaper coverage for children under 2 years old, with specific guidelines for diaper allocation.
See template
See template
Referral Form
PDF template
A medical referral form for patient consultation and transfer of medical information between healthcare providers.
See template
See template
OPT OUT AFFIDAVIT
PDF template
A form for healthcare practitioners to formally opt out of Medicare billing and payment systems for a two-year period.
See template
See template
Voluntary Waiver Of Health Insurance For Enrollment In Opt Out Program
PDF template
A voluntary form allowing City of Somerville retirees to waive health insurance coverage in exchange for a monetary opt-out payment.
See template
See template
New Prescription Mail In Order Form
PDF template
A form for submitting prescription medication orders via mail with patient and payment details
See template
See template
ILWU PMA Welfare Plan Prescription Drug Program
PDF template
Supplemental summary plan description for prescription drug benefits for ILWU-PMA Welfare Plan participants, detailing eligibility and prescription acquisition methods.
See template
See template
Oracle Software Configuration Service Request Approval Stepper
PDF template
Instructions for submitting and processing Oracle software configuration service requests within an organization's information technology workflow.
See template
See template
Division Of Oral Medicine And Dentistry New Patient Intake Form
PDF template
A comprehensive medical intake form used by oral medicine and dentistry practices to collect patient health history and contact information.
See template
See template
ParentGuardian Consent Form
PDF template
Consent form for parents/guardians of participants under 18 years old to participate in the Duke of Edinburgh's International Award program.
See template
See template
American College Of Surgeons Order Form
PDF template
Order form for purchasing publications and products from the American College of Surgeons with payment and shipping instructions.
See template
See template
Oregon Vehicle Title And Registration Application
PDF template
Official Oregon state form for vehicle title registration and ownership transfer with legal certifications and insurance declarations.
See template
See template
Frequently Asked Questions Professional Indemnity
PDF template
Comprehensive overview of professional indemnity insurance covering legal costs, damages, and incidences of professional liability.
See template
See template
Medical History Form
PDF template
Comprehensive medical form for collecting patient's personal and family health information, medical conditions, medications, and social history.
See template
See template
ORL Research Internship Application Instructions
PDF template
Application guidelines and form for research internship at the Leni & Peter W. May Department of Orthopaedics Research Laboratories
See template
See template
VisitorClient Accident Reporting Form
PDF template
A form for documenting details of a visitor or client accident for risk management purposes.
See template
See template
NEW PATIENT QUESTIONNAIRE
PDF template
Comprehensive medical intake form for new patients seeking orthopaedic surgery consultation, collecting patient medical history, goals, and current health information.
See template
See template
Orthopedics Medical History Form
PDF template
Comprehensive medical history form for documenting orthopedic patient's injury, pain, and medical condition details.
See template
See template
Consent To Treat Form
PDF template
A patient consent form authorizing medical treatment, information release, and assignment of benefits at a medical practice.
See template
See template
UTHSC Orthodontic Referral Form
PDF template
A comprehensive medical referral form for orthodontic evaluation and treatment at the University of Tennessee College of Dentistry.
See template
See template
OSF System Laboratory Client Clinical (Green) Requisition Form Instructions
PDF template
Comprehensive instructions for completing a clinical laboratory requisition form with detailed field guidance and billing requirements.
See template
See template
OSF System Laboratory Client CytologyPathology Requisition Form Instructions
PDF template
Detailed instructions for submitting cytology and surgical pathology specimens to OSF System Laboratory with specific guidelines for form completion.
See template
See template
Osher Institute Membership Enrollment Form
PDF template
Enrollment form for joining the Osher Institute, including liability waiver, media release, and payment information.
See template
See template
NEW PATIENT INTAKE FORM
PDF template
Comprehensive medical intake form for new patients seeking spine-related medical care, capturing patient history, pain details, and symptom assessment.
See template
See template
Medical Form
PDF template
Confidential medical form for collecting student health information prior to educational travel programs, enabling emergency preparedness and medical screening.
See template
See template
Patient Intake Form
PDF template
Comprehensive form for collecting patient personal, medical, and insurance information for healthcare providers.
See template
See template
Pedicab Medical Form
PDF template
A medical examination form to determine physical fitness for pedicab operation, completed by a licensed physician.
See template
See template
Patient Intake Form
PDF template
Comprehensive medical intake form for collecting patient medical history, pain assessment, and personal health information.
See template
See template
Health Examination Form
PDF template
A comprehensive medical history and physical examination form for students entering the Occupational Therapy Assistant program at Delgado Community College.
See template
See template
Record Of Other Insurance Form
PDF template
A comprehensive form for collecting student and family insurance and employment details for the Foothill-DeAnza Community College District.
See template
See template
Excess Accident Medical Expense Insurance Claim Requirements Guidance
PDF template
Guidelines for submitting medical insurance claims for sports-related injuries with detailed documentation requirements for students.
See template
See template
Domain Name Service Request Form (OTS 39)
PDF template
Form for requesting domain name services from the Louisiana Office of Technology Services, including domain creation, modification, and removal.
See template
See template
Membership Application And Agreement
PDF template
Application form for membership in On Target Sports LLC with legal certification for firearm ownership eligibility.
See template
See template
Outdoor Sport Facility Rental Application Form
PDF template
Application form for renting outdoor sport facilities in the City of Richmond, including booking details and rental terms.
See template
See template
Event Planning In An Outdoor Space Resource Guide
PDF template
Comprehensive guide for planning events in outdoor campus spaces, covering policies, catering, food service, insurance, and equipment requirements.
See template
See template
Out Of Network Prior Authorization Form
PDF template
A form for requesting prior authorization for out-of-network medical services from Neighborhood Health Plan
See template
See template
Out Of Network Referral Form
PDF template
A form for requesting authorization to see an out-of-network healthcare provider with detailed patient and service information.
See template
See template
Out Of Network Vision Services Claim Form
PDF template
Claim form for reimbursement of vision services obtained from providers outside the Blue View Vision network.
See template
See template
Out Of State Immunizations Record Transfer Request (680 Form) Instructions
PDF template
Instructions for transferring out-of-state immunization records for a child with the Florida Department of Health in St. Johns County.
See template
See template
Medical Diagnostic Test Requisition
PDF template
A comprehensive medical test order form for healthcare practitioners to request various diagnostic tests including hematology, urine, microbiology, and specialized screenings.
See template
See template
Medical Power Of Attorney
PDF template
Legal document authorizing a designated agent to make medical decisions on behalf of a patient who is a minor or incapacitated adult.
See template
See template
Outpatient Order Form For Procedural Visits Only (PVO)
PDF template
Medical order form for requesting specific tests, procedures, and services at a healthcare facility for outpatient visits.
See template
See template
Outpatient Physician Requisition Form
PDF template
A medical form used to request various diagnostic tests and surgical clearance for outpatient medical services.
See template
See template
Outpatient Referral Form
PDF template
A comprehensive referral form for patients seeking outpatient services at Children's Hospital Los Angeles, collecting physician, patient, clinical, and insurance information.
See template
See template
Outpatient Referral Form
PDF template
Medical referral form for patients seeking outpatient services at Children's Hospital Los Angeles.
See template
See template
Legacy Rehabilitation Services Referral Form
PDF template
Medical referral form for rehabilitation services across multiple Legacy Health locations in Oregon and Washington.
See template
See template
OUTPATIENT THERAPY PATIENT INTAKE FORM
PDF template
A comprehensive form for collecting patient medical information, injury history, and current health status for outpatient therapy services.
See template
See template
Outside Employment Waiver Form
PDF template
A form for city employees to request permission for outside employment and waive city liability for potential injuries or incidents.
See template
See template
Outside Scholarship Form
PDF template
Form for student-athletes to report outside scholarships and financial aid in compliance with NCAA regulations.
See template
See template
Declaration Of Trust
PDF template
A legal document for assigning a life insurance policy to trustees, establishing the terms of trust for the policy.
See template
See template
Overseas Treatment Benefit Application Form 2024
PDF template
Application form for members seeking medical treatment coverage outside their home country under the Executive and Comprehensive Plans.
See template
See template
Voluntary Audit Form
PDF template
Guide explaining the process of completing a voluntary premium audit form for insurance policy premium adjustments.
See template
See template
Referral Form
PDF template
A medical referral form for veterinary patients detailing clinical information and diagnostic history.
See template
See template
Referral Form
PDF template
A comprehensive medical referral form for veterinary patients, capturing detailed patient and clinical information for specialist consultation.
See template
See template
Owner Builder Building Permit Acknowledgment
PDF template
Legal document outlining responsibilities and risks for property owners acting as their own contractors when obtaining a building permit.
See template
See template
Owner Builder Declaration
PDF template
Legal document outlining responsibilities and risks for property owners acting as their own contractor during construction projects.
See template
See template
Employee Enrollment Form
PDF template
A comprehensive form for employees to enroll in or waive health insurance coverage with detailed personal and employment information.
See template
See template
Accident Report Form
PDF template
A comprehensive form for documenting transportation-related accidents, including provider, member, and incident details.
See template
See template
Pre Authorization Form Revision
PDF template
Notice of revision to the pre-authorization/prior approval request form with new form number and submission guidelines.
See template
See template
Emergency Medical Form
PDF template
A form enabling parents to authorize emergency medical treatment for children when parents cannot be reached during youth athletic activities.
See template
See template
Removal Of Benefit Riders AndOr Dependents
PDF template
A form for policy owners to remove specific insurance riders or dependent coverage from their Trustmark insurance policy.
See template
See template
Activity Participation Waiver
PDF template
A comprehensive liability waiver for university-sponsored activities covering risks, health certification, policy compliance, and legal release
See template
See template
PAC Physical Examination Form
PDF template
Comprehensive medical assessment form for documenting a child's physical health, medical history, and screening results.
See template
See template
Incident Report Form
PDF template
A comprehensive form for documenting injuries or incidents occurring during sports club activities, events, or premises.
See template
See template
IHCP Prior Authorization Request Form Instructions
PDF template
Detailed instructions for completing a prior authorization request form for Indiana Health Coverage Programs, covering submission requirements and field details.
See template
See template
New Patient Intake Form
PDF template
Comprehensive medical form for new patients to document pain history, symptoms, and pain characteristics for pain management assessment.
See template
See template
Prior Authorization Form
PDF template
Comprehensive instructions for completing a Medicaid prior authorization request form with detailed field guidance.
See template
See template
INSURANCE CLAIM FORM
PDF template
Insurance claim form for reporting tank-related releases or environmental incidents at business locations.
See template
See template
Imaging Consultation Services Form
PDF template
Medical imaging consultation form for patient radiographic services, including patient and referral information, consent, and fee schedule.
See template
See template
Notarized Parental Consent Form
PDF template
A form allowing parents to grant permission for a minor to travel and authorize medical decisions during a mission project.
See template
See template
Prescription Reimbursement Claim Form
PDF template
A form for submitting prescription medication reimbursement claims, detailing patient and pharmacy information for insurance processing.
See template
See template
PAPERWORK REQUEST FORM
PDF template
A form for requesting medical paperwork with payment options and submission methods for Leawood Pediatrics.
See template
See template
AHCA B P 222 Prescription Drug Program Direct Member Reimbursement Form
PDF template
Form for members to request reimbursement for out-of-pocket prescription drug expenses through their healthcare plan.
See template
See template
PAP SLIDE SUBMISSION FORM
PDF template
A form for submitting gynecologic cytology slides for pathology review and analysis.
See template
See template
Activity Consent Form And Approval By Parent Or Legal Guardian
PDF template
A comprehensive form for parents/guardians to provide consent and medical information for a child's participation in an activity or program.
See template
See template
School Parental Consent Form (Grades PK 12)
PDF template
A comprehensive form for collecting student medical, contact, and insurance information for school admission purposes.
See template
See template
Parental Consent Form
PDF template
A consent form for parents or legal guardians to authorize a minor's volunteer participation with Basset Hound Rescue of Southern California.
See template
See template
Innovia Foundation Photo Contest Parental Consent Form
PDF template
Consent form for parents or legal guardians to allow minors to participate in Innovia Foundation's 2023 photo contest.
See template
See template
Parental Guardian Consent Form Waiver Of Liability
PDF template
A consent form allowing a parent or guardian to add minor children to a primary member's fitness center membership while waiving liability
See template
See template
Parental Consent Medical Release Form
PDF template
A comprehensive form for parents/guardians to provide consent and medical information for a child's participation in church activities.
See template
See template
CSD Parent Contact Form
PDF template
A form for parents to provide contact information for potential participation in research studies related to children.
See template
See template
PARENTGUARDIANSTUDENT INFORMATION FORM
PDF template
A comprehensive form for collecting student, parent, and guardian contact and medical insurance details for athletic purposes.
See template
See template
Insurance Information
PDF template
Guidelines for sport-related injury insurance claims and reporting procedures for students at Chattanooga State.
See template
See template
St. James Preschool ParentPhysician Medical Form 20212022
PDF template
Medical form for child enrollment at St. James Preschool, requiring parent and physician details and health verification.
See template
See template
PARENTS INSURANCE FORM
PDF template
A form for collecting parent/guardian insurance information for student athletes participating in intercollegiate sports.
See template
See template
Standardized Prior Authorization Request Form
PDF template
A standardized form for submitting prior authorization requests to multiple health plans in Massachusetts, designed to streamline the administrative process for healthcare providers.
See template
See template
Accessible Parking Form
PDF template
Application form for students, faculty, and staff to obtain an accessible parking permit due to mobility impairments or medical conditions.
See template
See template
Parking Accommodation Medical Form
PDF template
Medical form used to verify disability status and facilitate parking accommodations at the University of Michigan under ADAAA guidelines.
See template
See template
Application For Use Of Village Property For Municipal Parking Lots
PDF template
Application form for obtaining permission to use municipal parking lots in the Incorporated Village of Westhampton Beach
See template
See template
Park Passport
PDF template
An interactive form encouraging children to explore Bismarck's parks by answering location-specific questions with potential prize rewards.
See template
See template
School Year 2018 19 Parks Playgrounds ProgramEmergency Contact Form
PDF template
Registration form for youth recreational programs at Alameda parks, providing emergency contact information for children in kindergarten through 5th grade.
See template
See template
City Of Taneytown Department Of Parks Recreation Proposed Project Or Service Request Form For Unsol
PDF template
A form for submitting proposed projects or services for consideration by the Taneytown Parks & Recreation Department and Advisory Board.
See template
See template
Proposed Project Or Service Request Form For Unsolicited Proposals
PDF template
A form for submitting proposed projects or service requests to the City of Taneytown Department of Parks & Recreation
See template
See template
Refund Request Form
PDF template
A form for requesting refunds for park, recreation, or neighborhood services activities or programs
See template
See template
Fee Scholarship Eligibility Form
PDF template
Application form for low-income residents to receive scholarships for Parks and Recreation programs in Bellingham, Washington.
See template
See template
NEW PROJECT PROPOSAL FORM
PDF template
A comprehensive form for submitting new project proposals within a park system, requiring review and approval from the Department of Planning and Development.
See template
See template
Producers Health Benefits Plan Participation Agreement
PDF template
A participation agreement for employers to join the Producers' Health Benefits Plan, outlining contributions and trust agreement terms.
See template
See template
Participant Medical Form
PDF template
Medical form for children's summer recreational program documenting health status and medical clearance from a licensed healthcare provider.
See template
See template
Participant Information Medical Form
PDF template
Comprehensive form for collecting participant and parent/guardian information for performing arts activities
See template
See template
Participant Release And Waiver Of Liability Form
PDF template
Legal document releasing Optimist Club from liability for a minor participant's activities and potential injuries.
See template
See template
ParticipantVisitor Liability Release And Waiver Form
PDF template
A liability release form for participants and visitors of Saving Grace Animals for Adoption, a non-profit dog rescue organization.
See template
See template
PARTICIPANT TRAVEL FORM
PDF template
A comprehensive form for students, chaperones, and directors to complete for group travel, including personal and emergency contact information and travel insurance options.
See template
See template
Participant Liability Release, Hold Harmless And Indemnification Form
PDF template
A legal document releasing liability for participants in activities at the Brian Bent Memorial Aquatics Complex under Coronado Unified School District supervision.
See template
See template
Participation Agreement And Waiver Form
PDF template
Legal document releasing liability for participation in a program or activity, signed by parent or guardian on behalf of a participant.
See template
See template
Participation Agreement And Waiver Form
PDF template
Legal document releasing liability for participation in a program or activity, typically used by organizations to protect against potential legal claims.
See template
See template
Participation Cancellation Form
PDF template
A form used to cancel participation in a Waukegan Park District program or lesson, detailing cancellation policies and required information.
See template
See template
Participant Agreement Form
PDF template
A legal document outlining participant consent, risk acknowledgment, and liability release for an organized activity or program.
See template
See template
Programs Special Events Participant Evaluation Form
PDF template
Evaluation form for assessing participant satisfaction with Wake Forest Parks & Recreation Department programs and services.
See template
See template
Exchange Student Application Packet Part II Visa, Finances, And Insurance Certification
PDF template
Application packet for international exchange students detailing required documentation for visa, finances, and insurance for the Fall 2023 semester at Baruch College.
See template
See template
Risk, Incentives, And Contracts Partnerships In Rio De Janeiro, 18701891
PDF template
A research paper examining partnership contracts in late 19th-century Brazil, analyzing the impacts of liability structures on business partnerships.
See template
See template
Standing Order RequestCancellation Form
PDF template
A form for requesting medical transportation services with options for service type, pickup/dropoff details, and special needs accommodation.
See template
See template
Patient Referral Form
PDF template
A medical referral form for scheduling a Modified Barium Swallow Study with specific documentation requirements.
See template
See template
Checklist For Pathology Consultation
PDF template
A detailed checklist for submitting materials and documentation for pathology consultation at MD Anderson Cancer Center.
See template
See template
Pathology Consultation Request
PDF template
A comprehensive form for submitting pathology consultation materials and patient information for diagnostic review.
See template
See template
Standardized Application For Pathology Fellowships
PDF template
Comprehensive application form for medical professionals seeking specialized pathology fellowship training across various subspecialties.
See template
See template
Pathology Consultation Request
PDF template
A detailed medical form for submitting pathology specimens and requesting consultation from Mayo Clinic Laboratories.
See template
See template
Pathology Specimen Transport Guide
PDF template
Comprehensive guide for properly handling and transporting pathology specimens to RPCI Laboratories with specific packaging and labeling requirements.
See template
See template
PATIENT MEDICAL HISTORY FORM
PDF template
A comprehensive form for collecting patient personal and medical information, including previous physicians, pharmacies, and insurance details.
See template
See template
Patient Information Medical History Form
PDF template
Comprehensive medical intake form for collecting patient personal and contact information, medical history, and demographic details.
See template
See template
Patient Billing Inquiry Form
PDF template
A form for patients to submit billing questions, statements, and account-related inquiries to the Finance Department.
See template
See template
Patient Complaint Form
PDF template
A form for patients to file complaints about privacy policies or procedures at California State University, East Bay Student Health & Counseling Services.
See template
See template
Patient Confidential Medical History Form
PDF template
Comprehensive patient medical history form gathering information about health status, medical conditions, medications, and family history.
See template
See template
Consent Form
PDF template
A legal document allowing publication of medical information for educational purposes with explicit privacy and consent guidelines.
See template
See template
CONSENT TO PUBLISH FORM
PDF template
A form for obtaining consent from patients or study participants to publish their identifiable details in a medical journal or research article.
See template
See template
Privacy Rule Of Patient Consent Agreement
PDF template
A consent form for medical treatment and information disclosure at Pacific Northwest Recovery and Counseling, outlining patient rights and treatment terms.
See template
See template
Patient Contact Form
PDF template
Form for patients to authorize contact methods and designate individuals who may receive medical information.
See template
See template
Patient Contact Form
PDF template
Comprehensive form for collecting patient personal information, contact details, medical history, and symptom assessment.
See template
See template
Demographic Insurance Form
PDF template
Comprehensive form for collecting patient personal, emergency contact, medical provider, and insurance information.
See template
See template
Patient Demographic Insurance Billing Form
PDF template
A comprehensive form for patient demographic information, insurance details, and billing for diagnostic services.
See template
See template
NEW PATIENT INTAKE FORM
PDF template
Comprehensive form for collecting new patient demographic and contact information for medical practice
See template
See template
Patient Intake Form
PDF template
Comprehensive patient registration and medical history form for Swank Chiropractic Sports Medicine & Wellness Center
See template
See template
Patient Medical History Form
PDF template
Comprehensive medical history form for patient intake, covering personal and family medical information, symptoms, and lifestyle factors.
See template
See template
CONSENT FORM
PDF template
Legal document granting Massachusetts Medical Society permission to publish patient medical material anonymously in The New England Journal of Medicine.
See template
See template
Patient Interview Form
PDF template
Comprehensive patient intake form collecting personal, demographic, and medical contact information for healthcare providers.
See template
See template
MEDICAL FORM
PDF template
A comprehensive medical form for collecting patient personal information, contact details, and healthcare status.
See template
See template
PATIENT INTAKE FORM
PDF template
Comprehensive form for collecting patient personal, insurance, and medical history information for healthcare providers.
See template
See template
Patient Intake Form
PDF template
Comprehensive medical intake form collecting patient personal information, medical history, medication details, and allergies for healthcare purposes.
See template
See template
PATIENT INTAKE FORM
PDF template
Comprehensive form for collecting patient personal, medical, insurance, and contact information for healthcare purposes.
See template
See template
Initial Intake Form
PDF template
Comprehensive form for collecting patient personal, contact, insurance, and medical visit information.
See template
See template
ONE Program Patient Intake Form
PDF template
Comprehensive intake form for assessing patient risk factors and medical history related to opioid medication use
See template
See template
PATIENT INTAKE FORM
PDF template
Comprehensive patient intake form for chiropractic services, collecting personal, medical, and insurance information.
See template
See template
Family Medicine Patient Intake Form
PDF template
Comprehensive medical intake form for patients to report current symptoms, health concerns, and medical history
See template
See template
Chase Lay, MD Associates Patient Information Form
PDF template
Comprehensive medical history and contact form for facial plastic surgery consultation
See template
See template
Operation Sight Intake Form
PDF template
Form for documenting details of charitable cataract surgery cases under the ASCRS Foundation's Operation Sight program.
See template
See template
Patient Intake Form
PDF template
Comprehensive medical intake form for collecting patient personal, medical, and health history information.
See template
See template
Patient Intake Form
PDF template
Comprehensive patient registration form for medical application requiring personal, contact, and insurance information for OMMA (Oklahoma Medical Marijuana Authority) submission.
See template
See template
PATIENT INTAKE FORM
PDF template
Comprehensive medical form for collecting patient health history, personal background, and lifestyle information.
See template
See template
PATIENT INTAKE FORM
PDF template
A standard form for collecting patient personal, contact, and medical visit information for healthcare providers.
See template
See template
Patient Intake Form
PDF template
Comprehensive medical intake form for collecting patient health history, contact information, and medical details.
See template
See template
PTOT Patient Intake Form
PDF template
A comprehensive medical intake form for patients seeking physical, occupational, or speech therapy services at Beauregard Memorial Hospital.
See template
See template
Patient Intake Form
PDF template
Comprehensive patient information form for dental practice intake and demographic data collection.
See template
See template
Patient Data Form
PDF template
Comprehensive patient demographic and personal information collection form for healthcare services.
See template
See template
Patient Intake Form
PDF template
Comprehensive medical intake form collecting patient health history, personal information, and consent for treatment.
See template
See template
Patient Intake Form
PDF template
Comprehensive medical intake form for a plastic surgery practice collecting patient personal, contact, and referral information.
See template
See template
Patient Intake And History Form
PDF template
Comprehensive patient medical intake form for collecting personal and health history information at Meeker Family Health Center.
See template
See template
Patient Intake Form
PDF template
Comprehensive medical intake form for collecting patient health history, current symptoms, work status, and personal medical background.
See template
See template
Patient Information Form
PDF template
Comprehensive medical intake form collecting patient personal details, medical history, and insurance information.
See template
See template
PATIENT INTAKE FORM
PDF template
Comprehensive medical intake form collecting patient personal information, health history, family medical background, and current health concerns.
See template
See template
NEW PATIENT INTAKE FORM
PDF template
Comprehensive form for collecting new patient personal, medical, insurance, and emergency contact information.
See template
See template
Medical History Form
PDF template
Comprehensive medical history form capturing patient health details, medical conditions, and personal health information.
See template
See template
PATIENT MEDICAL HISTORY FORM
PDF template
A comprehensive medical history form for collecting patient personal, medical, and family health information.
See template
See template
Patient Medical History Form
PDF template
Comprehensive medical history form for patients to document health conditions, medications, allergies, and family medical history.
See template
See template
Patient Medical History Form Pre Anesthesia Clinic
PDF template
Comprehensive medical history questionnaire for patients preparing for surgical procedures, collecting detailed health information across multiple medical domains.
See template
See template
Patient Referral Form
PDF template
A comprehensive form for patients seeking specialist medical referrals through We Care Manatee health services.
See template
See template
Patient Referral Form
PDF template
A comprehensive form for veterinarians to refer patients to VCA California Veterinary Specialists for specialized medical services.
See template
See template
PATIENT Refund Request Form
PDF template
A form for patients to request a refund for medical services, to be submitted to patient accounts.
See template
See template
Clinic Patient Registration Form
PDF template
A comprehensive medical form for collecting patient personal, contact, and health information for clinic registration purposes.
See template
See template
PATIENT REGISTRATION FORM
PDF template
Comprehensive form for collecting patient personal, contact, insurance, and payment responsibility information for medical or dental services.
See template
See template
Patient Registration Form
PDF template
Comprehensive patient information and insurance registration document for healthcare services.
See template
See template
Patient Registration Form (ECW)
PDF template
A comprehensive form for collecting patient personal, contact, and emergency information for healthcare providers.
See template
See template
Patient Registration Form
PDF template
A form for collecting patient insurance details and establishing financial responsibilities for medical services.
See template
See template
Patient Registration Form
PDF template
Comprehensive form for collecting patient personal information, contact details, insurance, and demographic data for healthcare providers.
See template
See template
Patient Registration Form
PDF template
Comprehensive form for collecting patient personal, contact, employment, emergency contact, and insurance information for healthcare providers.
See template
See template
ECRMC Patient Feedback Form
PDF template
A form for patients to provide feedback or file a complaint about their healthcare experience at El Centro Regional Medical Center (ECRMC).
See template
See template
PATIENT STANDING ORDER REQUEST FORM
PDF template
A medical form for requesting laboratory tests with options for one-time and standing orders from NorthShore University HealthSystem.
See template
See template
PATIENT STANDING ORDER REQUEST FORM
PDF template
A form for physicians to submit laboratory test orders for patients, with options for one-time and standing orders.
See template
See template
PHAS Empowered Patient Online Toolkit Insurance Form
PDF template
A comprehensive document for collecting and organizing personal insurance details across multiple insurance types and providers.
See template
See template
Patient Voice Feedback Form
PDF template
A form for patients to provide feedback, compliments, or concerns about healthcare services and staff at NEW Health facilities.
See template
See template
PATS Verification Of Attendance
PDF template
A form for documenting patient travel and accommodation details for reimbursement and healthcare travel support.
See template
See template
Plains Lions Pavilion Rental 2024
PDF template
Rental rates and guidelines for the Plains Lions Pavilion in Plains Township, Pennsylvania, including pricing for large and small pavilions.
See template
See template
City Of El Lago Pavilion Rental Agreement
PDF template
A rental agreement for using the City of El Lago pavilion, detailing event terms, fees, and liability conditions.
See template
See template
Medical Form A And B PAX Abroad
PDF template
Comprehensive medical history and physical examination form for foreign exchange student applicants, to be completed by a licensed physician.
See template
See template
Paxman Hub Enrollment Form
PDF template
Comprehensive enrollment form for patient information, insurance, and treatment details for Paxman medical services.
See template
See template
Foreign Travel Insurance Form
PDF template
Form for registering and obtaining mandatory travel insurance for university-sponsored international group travel
See template
See template
Payment Plan Agreement
PDF template
A formal agreement outlining payment terms for medical services at Partnership Health Center, establishing a schedule for resolving outstanding medical account balances.
See template
See template
UAB E MPLOYEE PAYROLL DEDUCTION AUTHORIZATION
PDF template
Form for UAB employees to authorize payroll deductions for Campus Recreation membership with various membership types and rates.
See template
See template
FacultyStaff Payroll Deduct Cancellation Form
PDF template
A form for faculty and staff to cancel their Campus Recreation payroll deduction and membership.
See template
See template
Payroll Deduction Cancellation Form
PDF template
A form for members to cancel or modify campus recreation and wellness membership payroll deductions and membership status.
See template
See template
NYSUT Member Benefits Payroll Deduction Authorization
PDF template
A form allowing NYSUT members to authorize payroll deductions for various member benefits programs.
See template
See template
NEW ENROLLMENTCHANGE FORM
PDF template
A form for employees to enroll in or modify flexible spending account (FSA) and dependent care spending account benefits.
See template
See template
PINE BEACH YACHT CLUB RENTAL APPLICATION AGREEMENT
PDF template
Application and agreement for renting the Pine Beach Yacht Club facility for private events.
See template
See template
Release And Waiver Of Liability, Assumption Of Risk And Indemnity Agreement
PDF template
Legal document releasing liability for participants in Porsche Club of America events and activities
See template
See template
PhysicianS Medical Evaluation For Assisted Living
PDF template
Comprehensive medical assessment form for patients seeking admission to or continuing care in an assisted living facility.
See template
See template
MO HealthNet Primary Care Health Home Discharge Protocol
PDF template
Protocol for discharging patients from a Primary Care Health Home, outlining procedures for submission and communication of discharge forms.
See template
See template
New Patient Intake Form
PDF template
Comprehensive medical intake form for new patients seeking primary care at Alice Peck Day Memorial Hospital's multi-specialty clinic.
See template
See template
PATIENT MEDICAL HISTORY FORM
PDF template
A comprehensive medical form for collecting patient health information, medical conditions, and current medications.
See template
See template
Pre Travel Form
PDF template
Comprehensive form for collecting personal and travel details to assess health risks and preparation for international travel.
See template
See template
Child Life Fellowship Application Form
PDF template
Application form for candidates seeking a fellowship in child life services at UNC Hospitals, requiring professional and academic details.
See template
See template
Referral Form UNC Hospitals Dental Clinic
PDF template
A specialized referral form for patients with specific medical conditions requiring dental care at UNC Hospitals Dental Clinic.
See template
See template
Miscellaneous Cancellation Form
PDF template
A form for employees to cancel insurance or annuity policies through their employer's benefits office.
See template
See template
Miscellaneous Cancellation Form
PDF template
A form for UNC Health Care System employees to cancel insurance or annuity policies with specific details about policy types and premium amounts.
See template
See template
Rheumatology New Patient ReferralConsultation
PDF template
A comprehensive referral form for new patients seeking rheumatology consultation, including patient and provider information.
See template
See template
Patient Demographic Form
PDF template
Comprehensive form for collecting patient personal, contact, and medical referral information for healthcare providers.
See template
See template
Sleep Center Referral Form
PDF template
Medical referral form for sleep disorder diagnosis and testing, used by healthcare providers to request sleep studies and consultations.
See template
See template
Owner Builder Declaration Form
PDF template
A legal form informing property owners of their responsibilities and risks when obtaining an owner-builder building permit in California.
See template
See template
PDS Cancel Form
PDF template
A form for cancelling non-GAP warranty products with options for refund and various cancellation reasons
See template
See template
REQUISITION PEACE DIAGNOSTIC IMAGING
PDF template
Medical form for patient information, clinical details, and procedure requisition for diagnostic imaging services.
See template
See template
Emergency Patient Referral Form
PDF template
A comprehensive form for referring a pet patient to an emergency veterinary clinic, capturing veterinarian, client, and patient details.
See template
See template
Medical History Form Forma De Historia Mdica
PDF template
A bilingual medical history form for collecting pediatric patient health information and medical background.
See template
See template
Incoming Referral Form
PDF template
A comprehensive form for collecting patient demographics, insurance details, and referral information for medical practices.
See template
See template
Pediatric Health Risk Assessment Form
PDF template
A health risk assessment form for pediatric patients under Partnership HealthPlan of California to understand a child's health and wellness needs.
See template
See template
Pediatric Health Risk Assessment Form
PDF template
A health assessment form to collect information about a child's health, wellness needs, and potential difficulties in daily activities.
See template
See template
Pediatric Patient Intake Form
PDF template
Comprehensive medical intake form for pediatric patients to collect personal, insurance, and medical history information.
See template
See template
Pediatric Referral Form
PDF template
Comprehensive medical form for pediatric patients seeking dermatology consultation, capturing patient information, referral details, and specific skin condition assessments.
See template
See template
PEDIATRIC PATIENT REFERRAL FORM
PDF template
A medical form used to collect patient information and referral details for pediatric medical consultation.
See template
See template
Pediatric Vaccine Order Form
PDF template
Comprehensive order form listing various pediatric vaccines with their CPT codes, manufacturers, and packaging details.
See template
See template
Physician Order Form For Pediatric Imaging Services
PDF template
A comprehensive form for ordering pediatric diagnostic imaging services with patient and clinical details
See template
See template
Physician Referral Service Form
PDF template
A comprehensive medical referral document for patient transfer between healthcare providers, capturing patient and insurance details.
See template
See template
Post Employment Health Plan (PEHP) Claim Form
PDF template
Form for requesting health plan reimbursements for medical expenses or insurance premiums after employment separation.
See template
See template
PELVIC EXAMINATIONS CONSENT FORM
PDF template
A medical consent form for patients undergoing pelvic examinations, detailing the nature of the examination and patient consent.
See template
See template
PELVIC EXAMINATIONS CONSENT FORM
PDF template
A medical consent form for patients undergoing pelvic examinations, detailing the nature of the examination and patient consent.
See template
See template
GUIDANCE FOR CLUB APPROVED CLINICS FOR COMPLIANCE WITH THE AMERICAN CLUB PRE EMPLOYMENT MEDICAL EXAM
PDF template
Guidance document for clinics conducting pre-employment medical examinations for seafarers working on American Club vessels.
See template
See template
NRECA Long Term Disability Plan Summary Plan Description
PDF template
A summary plan description detailing the long-term disability benefits provided by the National Rural Electric Cooperative Association (NRECA) for eligible participants.
See template
See template
Penguin Swim Enrollment
PDF template
Enrollment form for parent-child swim classes for ages 3-6 during Session VII of 2024 at Pomeroy Recreation & Rehabilitation Center.
See template
See template
FORM OF PENSION BENEFIT ELECTION
PDF template
A form for selecting pension benefit options, including single life and joint survivor annuity choices for retirees.
See template
See template
Incident Report Form Percutaneous Injury Bloodborne Pathogen AndOr Body Fluid Exposure
PDF template
Form for documenting workplace or medical training-related incidents involving potential bloodborne pathogen exposure or bodily fluid contact.
See template
See template
Perinatal Hepatitis B Prevention Initial Report Delivery Form
PDF template
A medical form for reporting and tracking infants born to mothers with Hepatitis B surface antigen positive status.
See template
See template
Department Of Periodontics Referral Form
PDF template
Medical referral form for periodontal examination and treatment, used to collect patient dental information and treatment history.
See template
See template
WAIVER OF LIABILITYPERMISSIONMEDICAL RELEASE FORM
PDF template
A comprehensive form for students staying overnight at Smith College, requiring parental consent and liability release.
See template
See template
Permission Form For Youth Outing
PDF template
A form allowing parents/guardians to grant permission for youth to attend an outing and provide medical consent in case of emergency.
See template
See template
CLAIM FORM
PDF template
Insurance claim form for students with international visa status, covering injury and medical claims.
See template
See template
Personal Automobile Policy Forms And Endorsements
PDF template
Comprehensive reference guide for personal automobile insurance policy forms and endorsements across different states.
See template
See template
Personal Effects Claim Form
PDF template
Insurance claim form for reporting loss, damage, or theft of personal items during travel, used to request compensation from Chubb insurance.
See template
See template
PATIENT INJURYMEDICAL HISTORY FORM
PDF template
A comprehensive form documenting patient details and medical information following a vehicle accident.
See template
See template
Personal Liability Release Form
PDF template
Liability release and consent form for student participants at the North Carolina Technology Student Association Regional Competitive Events Conference.
See template
See template
Loss Or Damage Report Form Personal
PDF template
A comprehensive form for reporting property loss or damage claims to NFU Mutual, providing detailed instructions for claim submission.
See template
See template
Personal Medical History Form
PDF template
Comprehensive medical history form for students to document health conditions, allergies, and medical background for program enrollment.
See template
See template
Personal Survey Form
PDF template
Form for documenting radiation exposure and contamination during radioactive material handling.
See template
See template
Assumption Of Risk, Waiver And Release Of Liability, And Indemnity Agreement
PDF template
Legal document outlining risk assumption and liability release for personal training services and facility use.
See template
See template
Personal Vehicle Travel Form
PDF template
A comprehensive travel safety and liability form for university clubs and organizations outlining driver and vehicle requirements.
See template
See template
Patient Intake Form
PDF template
A comprehensive medical intake form for patients undergoing PET/CT imaging, collecting patient medical history, current health status, and pre-scan details.
See template
See template
Petition To Return Health Evaluation Form
PDF template
Form for students seeking to return to UNC Charlotte after a medical withdrawal, requiring health provider documentation of recovery and readiness to resume studies.
See template
See template
Registered Food Business Booking Form
PDF template
A form for registered food businesses to apply for a stall at the Malmesbury Carnival, including business details, insurance, food safety, and operational compliance.
See template
See template
Pfizer EnCompass Enrollment Form For INFLECTRA And RUXIENCE
PDF template
Enrollment form for Pfizer medications with patient and insurance information collection for Inflectra and Ruxience prescriptions.
See template
See template
Pfizer EnCompass Enrollment Form For INFLECTRA (Infliximab Dyyb) For Injection And RUXIENCE (Rituxim
PDF template
Enrollment form for patients seeking information and assistance for specific Pfizer medications, including insurance verification and potential co-pay assistance.
See template
See template
Form PFL 1 Applying For Paid Family Leave Military
PDF template
A form for requesting paid family leave to assist family members of military personnel on active duty or impending active duty abroad.
See template
See template
Paws For Life USA, Inc Client Application Part B Medical History Form
PDF template
Medical history form for clients seeking service dog training, requiring physician documentation of patient's medical conditions and authorization for information release.
See template
See template
Proposal Form Motorcycle
PDF template
Insurance proposal form for motorcycle coverage by Liberty Insurance in Singapore, requiring detailed personal and driving information.
See template
See template
14th International Conference On Preimplantation Genetic Diagnosis Hotel Booking Form
PDF template
Hotel reservation form for attendees of the 14th International Conference on Preimplantation Genetic Diagnosis in Chicago, USA.
See template
See template
Inventory Of Radioactive Sealed Sources Devices
PDF template
A comprehensive form for tracking and documenting radioactive sealed sources and devices for regulatory compliance.
See template
See template
General Liability Insurance Form Update (PGL1)
PDF template
Update to General Liability Insurance form allowing insurance agents and brokers to validate insurance documentation.
See template
See template
Pharmacy Pre Authorization Form General Requests
PDF template
A form for healthcare providers to request pre-authorization for medication coverage from an insurance provider.
See template
See template
Informed Consent, Release Agreement, And Authorization
PDF template
Legal document for participant consent and medical authorization for Boy Scouts of America activities, covering emergency medical treatment and risk acknowledgment.
See template
See template
Consent To Disclose Personal Health Information
PDF template
A legal form authorizing the disclosure of personal health information in compliance with the Personal Health Information Protection Act (PHIPA)
See template
See template
Photograph Inventory Form
PDF template
A form for documenting and tracking patient photographs in a clinical research setting, including details about photographic documentation of medical examinations.
See template
See template
Prior Authorization Request Form
PDF template
A form for requesting prior authorization for specialty medical services through Positive Healthcare in California.
See template
See template
Phoenix PBM Pre Authorization Form
PDF template
A form for healthcare providers to request pharmacy benefit pre-authorization for medication coverage through Phoenix Benefits Management.
See template
See template
Student Health Center Document
PDF template
Document related to student health services at North Carolina A&T State University.
See template
See template
School Sports Pre Participation Examination Part 1
PDF template
Medical history and physical examination form for students participating in school sports activities.
See template
See template
School Sports Pre Participation Examination Part 1 Student Or Parent Completes
PDF template
Medical history and health screening form for students participating in school sports activities.
See template
See template
Pre Participation Physical Evaluation Form
PDF template
Medical form for evaluating a student's fitness to participate in school sports and athletic activities
See template
See template
Preparticipation Physical Evaluation History Form
PDF template
Comprehensive medical history questionnaire for athletes preparing for sports participation, covering health status, prior medical conditions, and potential health risks.
See template
See template
Required NYS School Health Examination Form
PDF template
Comprehensive health examination form for students in New York State, covering medical history and health assessments.
See template
See template
Preparticipation Physical Evaluation PHYSICAL EXAMINATION FORM
PDF template
Comprehensive medical examination form for athletes to assess physical fitness and health status prior to participation in sports activities.
See template
See template
PHYSICAL EXAMINATION FORM
PDF template
Comprehensive medical examination form for NCAA athletes and students, documenting health history and current medical status.
See template
See template
Physical Examination Form
PDF template
Comprehensive medical examination form for students, including health screening and sports clearance details.
See template
See template
NORTH CEDAR COMMUNITY SCHOOL DISTRICT HEALTH SERVICES MEDICAL EXAMINATION FORM
PDF template
Comprehensive medical examination form for students, capturing health history, physical examination details, and screening information.
See template
See template
Physical Examination Form
PDF template
Medical form documenting a student's health status and physical examination required by Saint Louis Archdiocese Health Advisory Committee for school enrollment.
See template
See template
Physical Examination Form
PDF template
Comprehensive medical examination form for students, including general health assessment and athletic participation clearance.
See template
See template
Physical Examination Form
PDF template
Comprehensive physical examination form for medical clearance and athletics participation at Virginia Military Institute
See template
See template
School Sports Pre Participation Examination Part 1 Student Or Parent Completes
PDF template
Medical history and examination form required for student-athletes participating in school sports in Oregon
See template
See template
Physical Examination Form
PDF template
A form to be completed by a healthcare provider detailing a participant's physical examination and medical details.
See template
See template
Physical Examination Form For Driver
PDF template
Medical examination form to assess a driver's physical fitness and ability to safely operate a vehicle, specifically for school bus drivers.
See template
See template
Physical Examination Form For Driver Applicant
PDF template
A comprehensive medical examination form to assess a school bus driver's physical fitness and ability to safely operate a vehicle.
See template
See template
PHYSICAL EXAMINATION FORM
PDF template
Comprehensive medical evaluation form for students participating in school sports activities
See template
See template
YMCA Camp Takodah PHYSICAL EXAMINATION FORM
PDF template
Medical form for assessing a child's health and fitness for participation in summer camp activities.
See template
See template
Alabama Independent School Association Physical Examination Form
PDF template
A comprehensive medical examination form required for students participating in interscholastic athletics in Alabama.
See template
See template
Sports Clearance Form
PDF template
Medical examination form for intercollegiate and NCAA athletes to document health status and clearance for sports participation.
See template
See template
Nursing Student Health Examination Form
PDF template
A comprehensive health examination form for nursing students documenting medical clearance, TB testing, and immunization records.
See template
See template
Preparticipation Physical Evaluation PHYSICAL EXAMINATION FORM
PDF template
Comprehensive medical screening form for assessing an individual's physical health and fitness for participation in activities.
See template
See template
HISTORY FORM
PDF template
Comprehensive medical history and health screening form for athletes to complete prior to participation in sports activities.
See template
See template
ALABAMA INDEPENDENT SCHOOL ASSOCIATION PHYSICAL EXAMINATION FORM
PDF template
A comprehensive medical examination form for students participating in interscholastic athletics, completed by a physician to certify student fitness for sports.
See template
See template
Preparticipation Physical Evaluation Medical History
PDF template
A comprehensive medical history form required for student athletes to participate in school sports activities, collecting health information and parental consent.
See template
See template
Arizona Interscholastic Association Annual Preparticipation Physical Evaluation
PDF template
Medical screening form for student-athletes to assess physical fitness and health conditions prior to sports participation.
See template
See template
Physical Examination Form Pre K Grade 5
PDF template
Medical form for recording student health history, physical examination details, and vaccination records for pre-kindergarten through fifth-grade students.
See template
See template
Physical Therapy Overview
PDF template
Comprehensive overview of physical therapy services, treatment approaches, and insurance information for patients at a student health center.
See template
See template
Sound Health Wellness Trust Physical Therapy Pre Authorization Request Form
PDF template
A medical form used to request pre-authorization for physical therapy services from Sound Health & Wellness Trust.
See template
See template
Student Physical Education Medical Clearance Form
PDF template
Medical form for assessing student's physical capabilities and participation in physical education activities.
See template
See template
PhysicianS Approval Form
PDF template
A form requiring physician verification of a patient's medical fitness to participate in physical activity programs at a fitness center
See template
See template
PhysicianS Approval Form
PDF template
A medical form for health verification and clearance for participation in fitness programs, required for members with specific health conditions or over 70 years old.
See template
See template
Physician Authorization Form
PDF template
Medical form for documenting participant health status and program participation eligibility for special recreation services.
See template
See template
PhysicianS Evaluation Form
PDF template
Medical assessment form for individuals with developmental disabilities, documenting health status, diagnoses, medications, and medical support needs.
See template
See template
Physician Examination Form
PDF template
A comprehensive medical form for camp participation requiring detailed health assessment by a licensed medical professional.
See template
See template
Physician Referral Form
PDF template
A medical referral form for patients being considered for Transcranial Magnetic Stimulation (TMS) therapy, primarily for Major Depressive Disorder.
See template
See template
Home Care Referral Form
PDF template
Comprehensive referral form for home healthcare services, collecting patient information, medical history, and service requests.
See template
See template
PhysicianS Referral Form
PDF template
A medical form for physicians to refer patients to a fitness evaluation and preventive exercise program at McHenry County College.
See template
See template
Physician Report Form
PDF template
A comprehensive medical examination form for students entering healthcare training programs to verify physical fitness and health status.
See template
See template
In Home Care Permit Medical Affidavit Form
PDF template
A medical affidavit form used to apply for residential parking permits for individuals requiring healthcare-related parking accommodations.
See template
See template
HEALTH FORM
PDF template
Medical form for assessing a child's fitness to participate in camp activities, documenting health history, immunizations, and physical examination details.
See template
See template
PIAB Medical Assessment Form (Form B)
PDF template
A standardized medical report template used by Ireland's Personal Injuries Assessment Board (PIAB) for documenting medical details in personal injury compensation claims.
See template
See template
Patient Interview Form
PDF template
Comprehensive medical intake form for patient demographics, medical history, and diagnostic information for gastroenterology clinic.
See template
See template
Patient Interview Form
PDF template
Comprehensive medical form for collecting patient demographic, contact, medical history, and personal health information.
See template
See template
Prevention Initiative Parent Interview Form
PDF template
A confidential interview form used to collect detailed information about a child and their family for program enrollment and eligibility assessment.
See template
See template
Pre K 12 Educator Tuition Program Approval Form
PDF template
A form for pre-k to 12 educators seeking approval for tuition program enrollment at East Stroudsburg University.
See template
See template
Notice Of Claim For Short Term Disability Benefits
PDF template
A form for employees to file a claim for short-term disability benefits with insurance details and medical information.
See template
See template
Dental AndOr Vision Option Election Form
PDF template
Form for electing dental and vision insurance coverage for retired laborers in Northern California.
See template
See template
S2 Treatment Provider Declaration Form
PDF template
A form for healthcare providers to document details of planned medical treatment for patients seeking cross-border healthcare within the European Economic Area.
See template
See template
NEW PATIENT INTAKE FORM
PDF template
Comprehensive medical intake form for new patients seeking plastic surgery services at Wang Ambulatory Care Center in Boston.
See template
See template
CHRONIC ILLNESS BENEFIT APPLICATION FORM
PDF template
Application form for patients seeking chronic illness benefits through Platinum Health medical scheme, requiring detailed personal and medical information.
See template
See template
PLAT COMPREHENSIVE CHRONIC ILLNESS BENEFIT APPLICATION FORM
PDF template
Application form for patients seeking chronic illness benefits from Platinum Health medical scheme, requiring detailed personal and medical information.
See template
See template
Attending PhysicianS Statement Of Disability
PDF template
Medical form used by physicians to document and certify a patient's disability status and work limitations for insurance purposes.
See template
See template
Hockey Canada Medical Information Sheet
PDF template
A comprehensive medical information and health screening form for hockey players to capture medical history, emergency contacts, and potential health conditions.
See template
See template
USAV YOUTH JUNIOR VOLLEYBALL PLAYER MEDICAL RELEASE FORM
PDF template
Medical release and emergency contact form for youth and junior volleyball players participating in sanctioned competitions and practices.
See template
See template
YOUTH JUNIOR VOLLEYBALL PLAYER MEDICAL RELEASE FORM
PDF template
A comprehensive medical release and consent form for youth and junior volleyball players, detailing medical information, emergency contacts, and participation permissions.
See template
See template
Hockey Canada Medical Information Sheet
PDF template
Comprehensive medical information form for hockey players to document health history and potential medical conditions.
See template
See template
Olds Minor Hockey Association Player Refund Request Policy
PDF template
Policy detailing refund eligibility, process, and conditions for withdrawal from Olds Minor Hockey Association programs.
See template
See template
OLDS MINOR HOCKEY ASSOCIATION PLAYER REFUND REQUEST POLICY
PDF template
Policy outlining the conditions and process for refunding hockey registration fees for players unable to complete a season.
See template
See template
Transfer Request Form
PDF template
Official form for transferring a soccer player between teams within the PA West Soccer Association
See template
See template
Orange County WomenS Soccer League Resignation Transfer Form
PDF template
Official form for soccer players to resign from a team or transfer between teams in the Orange County Women's Soccer League.
See template
See template
Requisition Form PlexAPRTM
PDF template
A diagnostic test requisition form for PlexAPR testing procedure.
See template
See template
Professional Liability Insurance Form
PDF template
Insurance enrollment form for Texas retired teachers returning to work in public schools, providing professional liability coverage.
See template
See template
PROFESSIONAL LIABILITY INSURANCE FORM
PDF template
Insurance application for retired teachers returning to work in public schools, providing professional liability coverage through the Texas Retired Teachers Association.
See template
See template
Patient Intake Form
PDF template
Comprehensive medical intake form for collecting patient demographic, contact, insurance, and referral information for physical therapy services.
See template
See template
CHILDWARD RELEASE FORM
PDF template
A release form granting Princeton University permission to record and use a child's image and biographical data for non-commercial purposes.
See template
See template
Family Medical Leave Request Form
PDF template
Form for employees to request leave under the Family and Medical Leave Act for personal or family health reasons.
See template
See template
Medical History Intake Form
PDF template
Comprehensive medical intake form for collecting patient medical background, current symptoms, and health history.
See template
See template
POLICY CHANGE FORM TEXAS AUTOMOBILE INSURANCE PLAN ASSOCIATION
PDF template
A form used to modify automobile insurance policy details, including vehicle and operator information for the Texas Automobile Insurance Plan Association.
See template
See template
Lackawanna Trail Athletic Association Booster Club Policies
PDF template
Detailed policies and procedures for requesting funds, reimbursements, and bill payments for athletic teams and coaches.
See template
See template
University Housing Policy And Procedures Manual Personal Liability Claims
PDF template
Guidelines for reporting and managing personal liability claims involving injury or property damage in university housing settings
See template
See template
University Housing Policy And Procedures Manual Purchasing Information Technology Equipment
PDF template
Establishes procedures for requesting and purchasing information technology equipment within University Housing units.
See template
See template
Accident Reports Policy
PDF template
Policy requiring employees to report workplace injuries within 24 hours and complete an accident report form to maintain insurance eligibility.
See template
See template
Policy Change Form
PDF template
A comprehensive form for policyholders to request changes to their insurance coverage, including termination, dependent modifications, and benefit adjustments.
See template
See template
Policy Change Form
PDF template
A comprehensive form for modifying insurance coverage, including terminating coverage, adding/removing dependents, and adjusting benefits.
See template
See template
Policy Change Form
PDF template
A form used to modify insurance policy details including address, driver, vehicle, and coverage information.
See template
See template
Policy Change Request
PDF template
A form for requesting changes to an existing insurance policy, to be submitted via fax or email to Richards Insurance.
See template
See template
POLICYHOLDER REQUEST CHANGE FORM
PDF template
A form for policyholders to request changes to their insurance coverage, including name changes, beneficiary updates, and coverage modifications.
See template
See template
Policy Change Form
PDF template
A comprehensive form for making changes to an existing insurance policy, including address, driver, vehicle, and coverage details.
See template
See template
DriverS Declaration Form
PDF template
A form for adults who transport youth during diocesan events, requiring driver and vehicle details, license and insurance verification.
See template
See template
FPR002 Campground And Cabin Booking Refunds
PDF template
Policy establishing guidelines for refund requests for campground and cabin bookings in Owen Sound facilities.
See template
See template
Policy For Housestaff Travel Reimbursement
PDF template
Policy detailing travel expense reimbursement for medical residents presenting at conferences with CME credits.
See template
See template
Service Request
PDF template
Form for making changes to an insurance policy, including name, address, premium mode, and non-forfeiture options.
See template
See template
Tier 1 Large Scale Renewables Program Request For Proposals RESRFP23 1
PDF template
Policy document outlining eligibility, termination conditions, and proposal submission requirements for renewable energy contract proposals.
See template
See template
POM 821.71 Physical Examination Requirements
PDF template
A personnel operations memorandum establishing physical examination requirements for active duty and Ready Reserve Corps officers and candidates seeking commission in the USPHS Commissioned Corps.
See template
See template
Pool Parks RentalUse Agreement
PDF template
Agreement for renting recreational facilities and parks in the Weed, California area, including details about facility selection, contact information, and user responsibilities.
See template
See template
Lions Park Pool Party Agreement Form
PDF template
Agreement form for booking a pool party at Lions Park with specific time slots, admission details, and package options for summer 2024.
See template
See template
Pool Pass Scholarship Request 2021
PDF template
A scholarship request form for obtaining reduced-cost pool passes for families demonstrating financial need.
See template
See template
Goldsboro Parks Recreation Pools 2022 Parental Consent Form
PDF template
A form allowing parents to authorize approved supervisors to care for children at local public pools without direct parental supervision.
See template
See template
Youth Programs Winter Portfolio Prep Registration
PDF template
Registration form for high school students participating in a winter portfolio preparation program at Massachusetts College of Art and Design.
See template
See template
Patient Discharge Form
PDF template
A form used to document patient discharge details, care instructions, and follow-up services.
See template
See template
Parental Consent Form
PDF template
A consent form allowing parents/guardians to authorize a minor's participation in the Postmark Hotel Call to Artists program.
See template
See template
Declaration Of Medical Condition
PDF template
Medical certification form for peace officer candidates in Montana documenting physical qualification for service.
See template
See template
Pfizer Dermatology Patient Access Form
PDF template
A multi-page form for patient information, prescription selection, and insurance details for Pfizer dermatology medications.
See template
See template
Prescription And Patient Support Enrollment Form
PDF template
Comprehensive patient enrollment form for Pfizer dermatology medications, capturing patient and insurance information for prescription support.
See template
See template
PREPARTICIPATION PHYSICAL EVALUATION HISTORY FORM
PDF template
Comprehensive medical history form for athletes to assess health status and potential medical concerns prior to sports participation.
See template
See template
Preparticipation Physical Evaluation (Interim Guidance) Physical Examination Form
PDF template
Medical examination form for assessing an individual's fitness to participate in sports activities, including comprehensive health screening questions.
See template
See template
Preparticipation Physical Evaluation PHYSICAL EXAMINATION FORM
PDF template
Comprehensive medical evaluation form for athletes to assess physical fitness and potential health risks prior to participation in sports activities.
See template
See template
Competitor Medical History
PDF template
A comprehensive medical history form for competitors to provide health details for safety and medical screening purposes.
See template
See template
Medical Form
PDF template
A comprehensive medical history form for event participants, collecting personal health information and emergency contact details.
See template
See template
TRUST PREFERRED PROVIDER ORGANIZATION (PPO) PROGRAM REFERRAL FORM
PDF template
A form for referring patients to non-PPO healthcare providers when services are medically necessary and not available within the TRUST network.
See template
See template
MEDICAL HISTORY FORM
PDF template
Comprehensive medical history form for collecting patient health information, medical conditions, recent symptoms, and personal details.
See template
See template
Practice Location Fact Sheet
PDF template
A form for physicians to provide detailed information about their practice location and its alignment with university missions.
See template
See template
Patient Information And Medical Information Form
PDF template
A comprehensive medical reporting form for documenting patient medical details, demographic information, and disease reporting requirements in Florida.
See template
See template
Patient Information And Medical Information Form
PDF template
Comprehensive medical reporting form for collecting patient personal, medical, and provider information for health tracking and disease reporting in Florida.
See template
See template
FCL Pre Authorization Form
PDF template
A medical insurance pre-authorization form for requesting approval of medical procedures and services
See template
See template
Pre Authorization Form
PDF template
A form for requesting pre-authorization for medical procedures or treatments from GBG Assist insurance provider.
See template
See template
Admission Request Note
PDF template
A comprehensive form for requesting medical admission and insurance coverage, capturing patient and medical details for hospital admission.
See template
See template
Pre Authorization Form (PAF)
PDF template
A form used by insured members to request pre-approval for non-emergency hospitalization and medical procedures through Allianz EFU health insurance.
See template
See template
Pre Authorization Form
PDF template
A form for requesting pre-authorization for medical procedures and treatments through TieCare insurance.
See template
See template
Pre Authorization Form
PDF template
A form allowing credit card charges for medical services when insurance reimbursement is received.
See template
See template
Precollege Programs Information And Consent Form
PDF template
A consent and medical information form for students participating in the Fashion Institute of Technology (FIT) Precollege Programs.
See template
See template
Predetermination Request Form
PDF template
A medical form used to request pre-approval for medical treatments, procedures, or services from a health insurance provider.
See template
See template
BN 688 1117, Routine Pregnancy Claim Form
PDF template
A claim form for processing routine pregnancy and childbirth claims through American Fidelity Assurance Company.
See template
See template
Pregnancy Recovery Leave Request Form
PDF template
A form for employees requesting leave to recover from pregnancy-related events who do not qualify for Family Medical Leave.
See template
See template
Policyholder Payroll Audit Report
PDF template
A comprehensive form for reporting payroll details, employee information, and subcontractor details for insurance policy purposes.
See template
See template
Preparticipation Physical Evaluation HISTORY FORM
PDF template
Medical history form for athletes to assess health and fitness for sports participation, including medical conditions and heart health screening.
See template
See template
History Form Preparticipation Physical Evaluation
PDF template
A comprehensive medical history form for students participating in school sports to assess their physical fitness and potential health risks.
See template
See template
Athletic Participation Form
PDF template
A comprehensive medical screening form for students participating in interscholastic athletics, collecting personal and medical information.
See template
See template
Pre Participation Physical Examination Medical History Form
PDF template
A comprehensive medical history form for students participating in school sports, collecting health information and screening for potential medical concerns.
See template
See template
Preparticipation Physical Evaluation History Form
PDF template
Comprehensive medical history questionnaire for athletes to assess health status and potential medical concerns prior to sports participation.
See template
See template
PREPARTICIPATION PHYSICAL EVALUATION HISTORY FORM
PDF template
Comprehensive medical history questionnaire for athletes to assess health status and potential medical concerns prior to sports participation.
See template
See template
PhysicianS PREPOST Bout Exams
PDF template
Medical examination form for athletes participating in boxing, MMA, kickboxing, and elimination tournaments to assess physical fitness for competition.
See template
See template
Equine Pre Purchase Form
PDF template
Comprehensive veterinary form for prospective horse buyers to document medical history, examination details, and potential additional testing.
See template
See template
PRESCRIPTION AND SERVICE REQUEST FORM FOR CINQAIR (Reslizumab) Injection 100mg10mL
PDF template
Medical form for prescribing Cinqair medication, collecting patient and insurance information, and requesting support services.
See template
See template
Prescription Claim Reimbursement Form
PDF template
A form for submitting prescription medication claims for reimbursement by a pharmacy services provider.
See template
See template
Prescription Drug Claim Form
PDF template
A form for submitting prescription drug claims and receiving pharmacy benefits reimbursement.
See template
See template
Prescription Drug Claim Form
PDF template
Form for members to request reimbursement for prescription medication expenses with various claim scenarios.
See template
See template
Prescription Drug Claim Form
PDF template
A form for submitting prescription drug claims to Blue Cross Blue Shield for reimbursement or processing.
See template
See template
Prescription Pre Authorization Request Form
PDF template
A medical form used to request pre-authorization for prescription medications from Sound Health & Wellness Trust.
See template
See template
Prescription Drug Reimbursement Form
PDF template
Form for submitting prescription drug reimbursement claims to an insurance provider, including details about medication and patient information.
See template
See template
PRESCRIPTION AND ENROLLMENT FORM
PDF template
A comprehensive form for patients to provide personal, insurance, and healthcare provider information for medical enrollment purposes.
See template
See template
Prescription Drug Reimbursement Form
PDF template
Form for submitting prescription drug reimbursement claims, including patient and pharmacy information, with certification of medication receipt and eligibility.
See template
See template
Prescription Drug Reimbursement Form
PDF template
A form for submitting prescription drug reimbursement claims with patient, pharmacy, and member information.
See template
See template
Preventative Health Care Examination Form
PDF template
Medical form for documenting student health history, physical examination, and medical recommendations.
See template
See template
PCP CHANGE February 2014
PDF template
A form for members of Health Plan of San Mateo (HPSM) health insurance programs to select or change their primary care physician and update their address.
See template
See template
Referral Form Submission Instructions
PDF template
Comprehensive instructions for submitting medical referrals including patient demographics, service details, and pre-authorization requirements.
See template
See template
Member Refund Request Form
PDF template
A form for members to request refunds for medical expenses through Prime Cure medical scheme.
See template
See template
CHILDWARD RELEASE FORM
PDF template
A legal document granting Princeton University permission to record and use media of a child/ward for non-commercial purposes.
See template
See template
Medical History Form
PDF template
Comprehensive form for student medical background, enrollment status, and demographic information with tuberculosis screening and family health history sections.
See template
See template
PROPERTY SELF INSURANCE PROGRAM TRANSIT (BUS 28 COVERAGE C) PRIOR APPROVAL FORM
PDF template
A form for prior approval of property shipments over $100,000 or involving household moves under the University of California's self-insurance program.
See template
See template
PrismRA Test Requisition Form
PDF template
A medical test requisition form for the PrismRA diagnostic test, collecting patient and provider information for genetic testing.
See template
See template
Data Protection Consent Form For Consulting And Support
PDF template
A document outlining how Swiss Life processes personal data for consulting and support purposes, with details on privacy protection and data handling.
See template
See template
Online Privacy Policy Agreement
PDF template
Privacy policy detailing data collection, usage, and user rights for Harpenau Insurance's online services and website.
See template
See template
Notice Of Privacy Practices
PDF template
A document outlining how medical information may be used, disclosed, and accessed while protecting patient privacy.
See template
See template
PRIVATE PROPERTY INSURANCE Terms And Conditions No. 0801.01
PDF template
Insurance terms and conditions for real estate, moveable property, and third-party liability insurance provided by BTA Baltic Insurance Company.
See template
See template
Medical Form For The Priya Jewish Reproduction Fund TestingTreatment Summary
PDF template
Comprehensive medical form for documenting fertility testing, medical history, and treatment plans for reproductive healthcare.
See template
See template
Proposed Amendments N.J.A.C. 114 40.2 And 43.3
PDF template
Proposed regulatory changes for life insurance, annuity, and variable contract form filing requirements in New Jersey.
See template
See template
PROCEDURALSURGICAL PROCTORPRECEPTOR EVALUATION FORM
PDF template
A comprehensive form for evaluating medical practitioner's procedural and surgical competence across multiple expertise domains.
See template
See template
Campus Procurement Annual Accessibility Report Academic Year 1213
PDF template
Annual report detailing the development of Section 508 compliance processes and procedures for procurement activities.
See template
See template
Producer Controlled Insurer Information Report Form
PDF template
Annual reporting form for property and casualty insurers detailing producer relationships and financial information
See template
See template
Producer Appointment Request Form
PDF template
A form used by insurance professionals to request appointment as a producer, requiring personal and professional background information.
See template
See template
CASSCA VOLUNTEER REQUEST FORM
PDF template
A volunteer agreement form for students participating in a university activity, outlining responsibilities and liability waivers.
See template
See template
Important Notices To The Applicant
PDF template
Legal notice outlining an applicant's duty of disclosure when applying for a general insurance contract, including potential consequences of non-disclosure.
See template
See template
Professional Referral Form
PDF template
A professional form for healthcare providers to refer patients to the Center for TMJ and Sleep Disorders for medical evaluation.
See template
See template
Professional Persons Feedback Form
PDF template
A form for submitting complaints or comments about healthcare professionals, organizations, or policies with detailed feedback collection.
See template
See template
Program Checklist
PDF template
A comprehensive checklist for reviewing and approving academic program proposals across different categories and types.
See template
See template
Program Compliance Form
PDF template
A form used to document and track complaints and violations related to the WIC (Women, Infants, and Children) Program.
See template
See template
Shasta County HHSA Program Diagnosis And Discharge Form
PDF template
A form used by healthcare professionals to document patient diagnosis, medical conditions, and discharge details for mental health programs.
See template
See template
Program Evaluation Form
PDF template
A comprehensive form for collecting feedback and assessment details about a program or event after its completion.
See template
See template
Ventura College Program Of Study Declaration Form
PDF template
Form for students to declare their academic program of study at Ventura College for federal financial aid eligibility.
See template
See template
Program Plan Declaration Form
PDF template
A form for students to add, update, or delete their current academic program and degree type at the college.
See template
See template
Program Proposal Form
PDF template
A form for submitting program proposals to a park district, detailing program specifics and requirements.
See template
See template
Program Proposal Form
PDF template
A fillable PDF form for submitting program proposals to Mount Pleasant Community Center in Vancouver.
See template
See template
Program Proposal Form
PDF template
A form for proposing and submitting continuing legal education (CLE) programs to the Massachusetts Bar Association with details about program format, speakers, and content.
See template
See template
Program Proposal Form
PDF template
A form for submitting program proposals to the Avon Recreation and Parks Department for potential class or activity offerings.
See template
See template
Program Proposal Form
PDF template
A form for submitting a new program proposal to a recreation or parks department, detailing program specifics and intended participants.
See template
See template
Research Program Application Guide
PDF template
Guide for students applying to research programs at University of the South Pacific (USP) and Fiji National University (FNU)
See template
See template
2025 Plan Year Draft QIS Progress Report Form
PDF template
A form for healthcare issuers to report on their quality improvement strategy progress for the 2025 plan year.
See template
See template
Project ELEVATE Enrollment Form 2023
PDF template
Enrollment form for individuals participating in Dignity Works Here Project ELEVATE program, collecting personal and support information.
See template
See template
Project ELEVATE Medical Form
PDF template
A comprehensive medical history and emergency contact form for individuals participating in Project ELEVATE at RCC.
See template
See template
Disability Claim Form
PDF template
A comprehensive form for employees to file a disability claim, documenting medical condition, work status, and physician certification.
See template
See template
Proof Of School Dental Examination Form
PDF template
Official form for documenting student dental health status and treatment needs for Illinois schools.
See template
See template
Proof Of Health Insurance Form
PDF template
Form for students in the M.D. program to provide proof of health insurance coverage or enroll in the university's student health insurance plan.
See template
See template
Proof Of Insurance Form
PDF template
Form for verifying medical and emergency insurance coverage for students, faculty, and staff traveling internationally.
See template
See template
Proof Of Insurance Form
PDF template
Official document used to verify vehicle insurance coverage at the time of an offense in Ohio.
See template
See template
Hematopathology Requisition
PDF template
A comprehensive medical test request form for hematopathology testing with patient, physician, and insurance information.
See template
See template
Illinois Department Of Insurance Consumer Complaint Form
PDF template
Official form for filing insurance-related complaints with the Illinois Department of Insurance for auto, home, property, or commercial insurance issues.
See template
See template
Risk Management Property Damage Claim Form
PDF template
A form for reporting and documenting property damage incidents within an organization's risk management process.
See template
See template
PROPERTY DAMAGE REPORT FORM
PDF template
A comprehensive form for documenting property damage incidents, including details about the loss, damaged property, and involved parties.
See template
See template
Property Damage Report Form (Other Than Auto)
PDF template
A detailed form for reporting property damage incidents, capturing details about the damage, location, type of loss, and estimated costs.
See template
See template
PROPERTY INVENTORY FORM
PDF template
A form for documenting property details, purchase information, and valuation for insurance claim purposes
See template
See template
PROPERTY INVENTORY FORM
PDF template
A comprehensive form for documenting credit cards, vehicles, and theft-prone items for personal record-keeping and potential insurance purposes.
See template
See template
Property Inventory Record
PDF template
A comprehensive form for documenting personal belongings, their details, and values to assist in potential theft or loss scenarios.
See template
See template
Dogwood Crossing Exhibition Proposal Form
PDF template
A comprehensive form for artists or artist groups to submit exhibition proposals to Dogwood Crossing Art Gallery.
See template
See template
FUSF Proposal Form General Awards Track
PDF template
A comprehensive proposal form for researchers seeking funding from the Focused Ultrasound Surgery Foundation's General Awards Track.
See template
See template
Research Proposal Form
PDF template
A comprehensive research proposal template for scientific studies at Maroof International Hospital Research Department.
See template
See template
PROPOSAL FORM QUICK QUOTE FORM
PDF template
Insurance proposal form for taxi businesses covering 1-4 vehicles, detailing duty of disclosure and personal information handling.
See template
See template
PolicyholderS Change And Service Request
PDF template
A form for making changes to a life insurance policy, including coverage modifications, beneficiary updates, and contact information changes.
See template
See template
Prosthetic Devices Referral Form
PDF template
A comprehensive form for collecting client information, referral details, and measurements for prosthetic device customization with integrated heating system.
See template
See template
Patient Referral Form
PDF template
A referral form for dental patients seeking prosthodontic or general dentistry services at a dental practice or clinic.
See template
See template
Temporary Information Authorization And Release
PDF template
A medical form for releasing medical information to the National Rifle Association's Competitive Shooting Sports Protest Committee
See template
See template
Intercollegiate Athletics Eligibility Requirements
PDF template
Guidelines for student-athlete participation, academic requirements, and competition eligibility at Johnson & Wales University.
See template
See template
Provider Doctor Claim Inquiry
PDF template
A form for healthcare providers to request review of a previously adjudicated medical claim with Blue Cross Blue Shield of North Carolina.
See template
See template
Provider ContractAmendment Inquiry Form
PDF template
Form for healthcare providers to join AmeriHealth Caritas Florida's network across multiple health plan options
See template
See template
Provider Evaluation Form
PDF template
A confidential form used to assess a healthcare provider's professional qualifications, abilities, and potential issues for network participation.
See template
See template
Provider Incident Report Form
PDF template
A form for documenting and reporting healthcare-related incidents, including details about harm, root cause, and prevention strategies.
See template
See template
Provider Inquiry Form
PDF template
A confidential form for healthcare providers to submit claims, coordination of benefits, and related inquiries to Independent Health insurance.
See template
See template
Provider Re Enrollment Form Following A Withdrawal
PDF template
A form for healthcare providers to assess and recommend a student's return to Binghamton University after a medical or psychological withdrawal.
See template
See template
Inquiry Form
PDF template
A form for submitting inquiries related to medical services, enrollment, and claims payment for NJ FamilyCare program.
See template
See template
Nevada System Of Higher Education Academic Program Proposal Form
PDF template
A form used to propose new academic degree programs, majors, or certificates within the Nevada System of Higher Education.
See template
See template
AUTHORIZATION, RELEASE, WAIVER INDEMNITY AGREEMENT
PDF template
Legal document outlining participant risks, insurance, and liability terms for city recreational activities and facilities.
See template
See template
PR Youth Scholarship Application Form
PDF template
Scholarship application for youth activities and support, providing funding for summer camps, sports, and necessary supplies for children up to 18 years old.
See template
See template
Group Disability Insurance Disability Claim Instructions
PDF template
Comprehensive instructions for filing a disability insurance claim with Prudential, detailing required documentation and submission process.
See template
See template
Public Schools Athletic League Interscholastic Athletics Parental Consent Form
PDF template
A consent form for parents/guardians allowing students to participate in school sports activities, acknowledging risks and responsibilities.
See template
See template
Preparticipation Physical Evaluation History Form
PDF template
Medical history and health screening form for students participating in sports activities, to be completed before physical examination.
See template
See template
RELEASE OF LIABILITY, WAIVER OF CLAIMS AND INDEMNITY AGREEMENT
PDF template
Legal document waiving rights and releasing organizations from liability for participation in military community recreation activities.
See template
See template
RELEASE OF LIABILITY, WAIVER OF CLAIMS AND INDEMNITY AGREEMENT PSP Recreation Programs
PDF template
Legal document waiving rights and releasing Canadian Forces Morale and Welfare Services from liability for recreational program participation
See template
See template
Fellowship Application Form
PDF template
Application form for psychiatric fellowship programs at NYU Medical Center, covering personal information, education, and professional details.
See template
See template
Electronic Data Interchange (EDI) Submission Enrollment Packet
PDF template
A comprehensive guide for electronic claims submission to Louisiana Medicaid, explaining Submitter ID and Provider ID processes.
See template
See template
PATIENT INTAKE FORM
PDF template
A comprehensive medical intake form for workers' compensation patients, capturing personal, insurance, and medical history details.
See template
See template
MEDICAL GENOMICS LABORATORY PTEN PHENOTYPIC CHECKLIST FORM
PDF template
A detailed medical form for documenting clinical and genetic information related to PTEN-associated syndromes like Cowden syndrome and Bannayan-Riley-Ruvalcaba syndrome.
See template
See template
New Patient Intake Form
PDF template
Comprehensive medical intake form for collecting patient personal information, contact details, medical history, and health concerns.
See template
See template
Postgraduate Training Program Enrollment Form
PDF template
Official form for enrolling and documenting postgraduate medical training for osteopathic medical residents in California.
See template
See template
MEDICAL HISTORY FORM
PDF template
Comprehensive medical history form capturing patient's personal health information, previous conditions, treatments, and current health status.
See template
See template
Paul Tickner Safaris Booking Form
PDF template
A comprehensive booking form for travelers registering for a safari expedition, collecting personal and travel details.
See template
See template
Understanding Our Mutual Obligations For Dental Insurance
PDF template
A document explaining dental insurance benefits, patient obligations, and the relationship between dental practice and insurance providers.
See template
See template
NOMINATION FORM COMMUNITY HEALTH PROMOTION RECOGNITION
PDF template
A nomination form for recognizing community health promotion programs by the Nebraska State Board of Health.
See template
See template
Department Of Psychiatry Fellowship Application Form
PDF template
Application form for psychiatry fellowship programs at NYU covering various subspecialties and requiring comprehensive candidate information.
See template
See template
Patient Intake Form
PDF template
Comprehensive medical intake form for collecting patient personal, contact, and health information at a medical practice.
See template
See template
PVT ProgramEventFundraising Activity Proposal Form
PDF template
A form for submitting proposed volunteer programs, events, or fundraising activities to Park Authority management for approval.
See template
See template
Medical Service Authorization Request Form
PDF template
A form used to request medical service authorization for PrimeWest Health members, requiring detailed provider and patient information.
See template
See template
Short Term Disability Claim Form
PDF template
A form for employees to file a short-term disability insurance claim with details about their disability and work status.
See template
See template
Fort Parker State Park CanoeKayakPaddle Board Parental Consent
PDF template
A consent form for parents/guardians to authorize minor children to use watercraft at Fort Parker State Park.
See template
See template
PWD Shuttle Service Request Form
PDF template
Form for students with disabilities to request specialized shuttle transportation services at Montclair State University.
See template
See template
Velodrome Authorized Motor Vehicle Registration
PDF template
A registration form for motor-pacers seeking authorization to enter the velodrome with specific vehicle and insurance requirements.
See template
See template
PPL400PWSC 200 Participation Agreement
PDF template
A legal agreement between a home builder and Professional Warranty Service Corporation (PWSC) governing program participation and warranty terms.
See template
See template
Delmarva Shorebirds Job Application Form
PDF template
Employment application for potential gameday staff positions at the Delmarva Shorebirds baseball organization
See template
See template
Questions And Answers Regarding Parental Consent And Notification Requirements For Access To Public
PDF template
Guidance document explaining parental consent requirements for accessing public benefits and insurance programs for students with disabilities.
See template
See template
Invoice Form V2.2
PDF template
Invoice form for billing medical simulation services with cost breakdown for internal and external participants.
See template
See template
Endocrinologist Quarterly Evaluation Checklist
PDF template
Quarterly medical monitoring form for commercial motor vehicle drivers with diabetes seeking federal exemption from standard medical requirements.
See template
See template
DBPR EL 4504 Employee Leasing Company Quarterly Report Form
PDF template
Quarterly reporting form for employee leasing companies in Florida, detailing financial and insurance compliance requirements.
See template
See template
Accident Waiver And Release Of Liability Form
PDF template
Legal document releasing Luvin Arms Animal Sanctuary from liability during volunteer activities and sanctuary visits.
See template
See template
Artist Waiver Form For Alumni Art Exhibit
PDF template
Waiver form for artists submitting artwork to an alumni art exhibit, outlining submission requirements and liability terms.
See template
See template
Disability Form
PDF template
A comprehensive form for documenting an employee's disability status, medical details, and work-related information for insurance or employer records.
See template
See template
5K Race Waiver For Runners, Walkers And Mixed Teams
PDF template
Legal waiver for participants in a 5K run/walk event, releasing organizers from liability and acknowledging physical risks.
See template
See template
PATIENT INTAKE FORM
PDF template
A comprehensive patient intake form collecting personal, contact, insurance, and medical authorization details for healthcare services.
See template
See template
Patient Intake Questionnaire Speech (Pediatric)
PDF template
Comprehensive medical and developmental questionnaire for children with potential speech and language concerns.
See template
See template
Account And Program Registration Form
PDF template
A registration form for participating in City of Raleigh Parks, Recreation and Cultural Resources programs, collecting participant and emergency contact information.
See template
See template
ARCHITECTS AND ENGINEERS PROFESSIONAL LIABILITY INSURANCE APPLICATION
PDF template
An insurance application form for architects and engineers to obtain professional liability coverage through a claims made and reported policy.
See template
See template
Randall ChildrenS HospitalSpecialty Referral
PDF template
A comprehensive medical referral form for various pediatric specialty services at Randall Children's Hospital across Oregon and Washington locations.
See template
See template
Frisco ISD Sports Participation Online Forms
PDF template
Step-by-step guide for parents to complete online sports participation forms for Frisco Independent School District athletes
See template
See template
Referral Form
PDF template
A comprehensive referral form for collecting detailed information about a child, their medical history, and family background for support services.
See template
See template
Rental Application
PDF template
Application form for renting facilities and rooms managed by Roscommon Area Recreation Authority, including pricing and facility details.
See template
See template
Youth Release Form
PDF template
Release form for youth participation in Mid-America Regional Assembly event, including medical authorization and parental consent.
See template
See template
RBC Proposal Form
PDF template
A proposal form for submitting changes to risk-based capital methodology and documentation for insurance regulators.
See template
See template
RBC Proposal Form
PDF template
Proposal form for submitting changes to Risk-Based Capital (RBC) regulations and instructions across different insurance sectors.
See template
See template
PATIENT MEDICAL HISTORY FORM
PDF template
Comprehensive medical history document for collecting patient health information, medical conditions, and social history details.
See template
See template
Health Intake Form
PDF template
Comprehensive medical history and health assessment form for new patients of the Riordan Clinic.
See template
See template
A RESOLUTION OF THE TOWNSHIP OF NORTH BRUNSWICK ACCEPTING AND ADOPTING THE CENTRAL JERSEY MUNICIPAL
PDF template
A township resolution adopting the Central Jersey Municipal Joint Insurance Fund's 2024 Safety Incentive Program to ensure workplace safety and compliance.
See template
See template
Rawls College Of Business Incident Report Template Guidelines
PDF template
A confidential template for documenting security incidents within the Rawls College of Business, with guidelines for reporting and tracking potential security events.
See template
See template
RC SERVICE AGREEMENT FORM
PDF template
Form for submitting emergency vehicle repair claims under a service agreement warranty.
See template
See template
Readmission Review Form
PDF template
A comprehensive form for reviewing patient hospital readmissions, tracking reasons for return, and assessing discharge follow-up procedures.
See template
See template
Release Of Liability, Assumption Of Risk, And Indemnity Agreement
PDF template
Legal document releasing liability for participation in an event, assuming risks, and indemnifying the event organizers.
See template
See template
Reasonable Accommodation Medical Authorization Form
PDF template
A form for employees to request workplace accommodations by providing medical documentation about a disability or medical condition.
See template
See template
Application To Request A Reasonable Accommodation Of A Disability
PDF template
A formal application for employees to request workplace accommodations for disabilities, requiring details from both the employee and their medical professional.
See template
See template
Recreation Facilities Booking Form
PDF template
A comprehensive form for requesting facility bookings at City of Whitehorse recreation centers and venues
See template
See template
Recreation Contractor Service Agreement
PDF template
A service agreement between Bainbridge Island Metropolitan Park & Recreation District and a recreational service contractor for providing instructional services.
See template
See template
Student Recreation Fee Refund Request Form
PDF template
Form for University of Iowa employees to request a refund of student recreation fees if they already have a Recreational Services membership.
See template
See template
Donated Leave Program Recipient Affidavit Form
PDF template
A form for employees to request donated leave time from colleagues during a serious health condition or injury.
See template
See template
Record Of Employment
PDF template
A form for documenting employment status for unemployment insurance claims in New York State
See template
See template
Employment Application
PDF template
A comprehensive employment application form for students seeking work at Colorado State University Pueblo's ThunderWolf Recreation department.
See template
See template
Volunteer Registration Form
PDF template
Registration form for volunteers with Carroll County Department of Recreation & Parks, including liability waiver and background check requirements.
See template
See template
City Of New York Parks Recreation Membership Registration Form
PDF template
Registration form for membership to New York City Parks & Recreation centers with detailed membership conditions and rules.
See template
See template
Town Of Cobourg Recreation Facility Rental Agreement Form
PDF template
A comprehensive form for renting recreational facilities in the Town of Cobourg, covering various indoor and outdoor venues and equipment requirements.
See template
See template
Recreation Insurance Form
PDF template
Insurance form for participants in the Hammonton Recreation Program, covering medical liability and insurance information.
See template
See template
Santee Recreation Registration Teen Center Membership Form
PDF template
Registration form for participating in City of Santee recreation programs and activities, including participant details and medical information.
See template
See template
Volunteer Application Form
PDF template
A comprehensive volunteer application form for the City of Hamilton's Recreation Division, collecting personal information and volunteer preferences.
See template
See template
Rec Sports Room Equipment Reservation Process
PDF template
Comprehensive guide for reserving university recreational sports facilities and spaces for events, covering both internal and external group requests.
See template
See template
Recreational Swim Enrollment
PDF template
Enrollment form for recreational swim classes for children aged 6 months to 12 years, offering multiple session options from October to December 2024.
See template
See template
Tournament Field Rental Agreement
PDF template
A rental agreement for using athletic fields in the City of Brenham for tournaments and recreational activities.
See template
See template
Payroll Deduction Form
PDF template
A form for VCU employees to set up payroll deductions for Recreation and Well-Being membership with terms and conditions.
See template
See template
Recommendation For A Reduced Course Load Due To An Illness Or Medical Condition
PDF template
A form allowing students to request reduced course load or withdrawal due to medical conditions, with medical provider documentation.
See template
See template
SCAN Referral Authorization Request Form
PDF template
A medical service referral and authorization form for SCAN Health Plan to request prior approval for medical services or procedures
See template
See template
LCR.FORM.11 Referring Veterinarian Information Form
PDF template
Form for submitting animal laboratory samples and patient information to Virginia Tech Animal Laboratory Services.
See template
See template
COMMONWEALTH DERMATOLOGY REFERRAL REQUEST FORM
PDF template
A medical referral form for patients seeking dermatological services, to be completed by a healthcare professional.
See template
See template
Referral Form
PDF template
A comprehensive form for referring children for developmental health evaluation and potential intervention services.
See template
See template
Aetna Better Health Of Florida Referral Form
PDF template
A referral form for healthcare providers to refer patients to specialists or diagnostic services within the Aetna Better Health of Florida network.
See template
See template
REFERRAL FORM
PDF template
Medical referral form for home health services detailing patient information, medical needs, and service requirements.
See template
See template
Referral Form
PDF template
A form used by healthcare providers to refer a patient to another medical professional or service for specialized care or consultation.
See template
See template
Department Of Human Genetics Referral Form
PDF template
Comprehensive referral form for genetic consultation and screening, listing various genetic conditions and required documentation for scheduling.
See template
See template
COMMUNITYCARE REFERRALAUTHORIZATION FORM
PDF template
A medical referral and authorization form for Medicaid patients seeking healthcare services through the CommunityCARE program
See template
See template
Referral Form CT Endoscopy
PDF template
A comprehensive referral form for veterinary diagnostic procedures including CT scan, endoscopy, and internal medicine consultation.
See template
See template
Medical Respite Referral Request Form
PDF template
A comprehensive referral form for medical respite services, used to evaluate patient eligibility for admission to a medical respite program.
See template
See template
Client Referral Form
PDF template
A comprehensive form for collecting client personal, contact, insurance, and referral information for healthcare or social services.
See template
See template
Patient Referral Form
PDF template
A comprehensive patient referral form for medical consultations and appointments related to ear, nose, and throat medical services.
See template
See template
Patient Referral Form
PDF template
A medical referral form for functional vision evaluation with multiple diagnostic and symptom checkboxes for vision-related concerns.
See template
See template
Medical Form For Neuropsychological Assessment
PDF template
A comprehensive medical form for requesting neuropsychological assessments, including patient information, referral reasons, and assessment details.
See template
See template
Walker Memory Center Referral Form
PDF template
Medical referral form for memory evaluation and neuropsychological testing at Walker Memory Center.
See template
See template
Referral Form
PDF template
A comprehensive patient referral form for healthcare services with sections for patient information, insurance details, referral source, and service needs.
See template
See template
Referral Form
PDF template
Medical referral form for transferring patient information between healthcare providers for specialty consultation or treatment.
See template
See template
Sutter Specialty Services Referral Form
PDF template
A referral form for patients seeking specialty medical services through Sutter Health network with detailed patient, physician, and insurance information.
See template
See template
EDRC 253 REFERRAL FORM
PDF template
Comprehensive medical referral form used to collect patient demographics, insurance information, and clinical details for healthcare services.
See template
See template
Physician Referral Form
PDF template
A form for healthcare providers to refer patients to other medical departments or providers with patient and referral contact details.
See template
See template
HSD Property Control Contractor Form C 063 IT
PDF template
Form for tracking and managing transfer, donation, destruction, or recycling of IT equipment valued under $5,000
See template
See template
NORTHERN CINCINNATI UPWARD SPORTS REFUND REQUEST FORM
PDF template
Form for requesting a refund for sports program registration with specific conditions and fee structure.
See template
See template
SCVAA Refund Refund Request Form
PDF template
A form for requesting refunds for youth sports program participation with specific terms and conditions.
See template
See template
Building Or Shelter Refund Request Form
PDF template
Form for requesting refunds for building or shelter rentals from the Billings Parks and Recreation Department.
See template
See template
Refund Request Form
PDF template
A form for members and program participants to request refunds for memberships or programs at the New Canaan Community YMCA.
See template
See template
Refund Request Form
PDF template
A form for participants to request a refund for a program, with details about the refund process and required information.
See template
See template
Refund Guidelines Request Form
PDF template
Official guidelines and request form for obtaining refunds for park and recreation programs and activities.
See template
See template
Rio Linda Elverta Recreation And Park District Refund Request
PDF template
A form for requesting refunds for recreational programs at the Rio Linda Elverta Recreation and Park District.
See template
See template
Refund Request Form
PDF template
Form for requesting refunds for intramural sports, fitness classes, membership, and locker rental at the Malley Center.
See template
See template
NEW CANAAN YMCA CREDITREFUND REQUEST
PDF template
A form for participants to request refunds or credits for membership, programs, or camp sessions at the New Canaan YMCA.
See template
See template
Refund Request Form
PDF template
Form for requesting refunds for youth sports program registration with specific conditions and guidelines.
See template
See template
Refund Request Form State Employees
PDF template
A form for state employees to request refunds of insurance premium overpayments with W-2 tax adjustment provisions.
See template
See template
Refund Request Form
PDF template
Official form for requesting refunds for parks and recreation activities with specific guidelines and submission instructions.
See template
See template
RefundTransfer Request Form
PDF template
A form for requesting refunds or transfers for park district program registrations with specific eligibility and processing guidelines.
See template
See template
RefundTransfer Request Form
PDF template
A form for requesting refunds or transfers for park district activities with specific refund policy guidelines.
See template
See template
Refund Transfer Request Form
PDF template
A form for requesting refunds or transfers for recreation and community service programs in the City of Los Altos.
See template
See template
REFUSE Insurance Form INTERNATIONAL
PDF template
Form for international students to waive mandatory student insurance by providing alternative coverage documentation.
See template
See template
REFUSE Insurance Form (Montana Medicaid)
PDF template
A form for students to waive student health insurance coverage and acknowledge non-coverage by Montana Medicaid at the Curry Health Center.
See template
See template
REFUSE Insurance Form (U.S. Citizens)
PDF template
A form for students to declare existing private health insurance coverage and waive university-provided insurance requirements.
See template
See template
Regence BlueShield Incident Report
PDF template
A form for reporting medical incidents or injuries that may affect insurance claims processing for Regence BlueShield in Washington State.
See template
See template
MEMBER REIMBURSEMENT FORM
PDF template
A comprehensive form for members to submit healthcare service reimbursement claims, including details about patient, services, and insurance coverage.
See template
See template
Member Reimbursement Form
PDF template
A comprehensive form for members to submit healthcare service reimbursement claims, including details about patient, services, and coverage.
See template
See template
Registration Form
PDF template
A comprehensive registration form for participating in park district programs with program selection and liability waiver.
See template
See template
Registration Form
PDF template
A form for registering households and family members for park and recreation programs with payment and contact information.
See template
See template
ATHLETE WAIVER MEDIA RELEASE FORM
PDF template
Comprehensive form for athlete registration, medical information, emergency contacts, and liability waiver for cheerleading activities.
See template
See template
REGISTRATION APPEAL MEDICAL VERIFICATION OR MEDICAL CARETAKER VERIFICATION FORM
PDF template
A form for students to request course withdrawal or GPA adjustment due to medical circumstances, requiring medical provider verification.
See template
See template
REGISTRATION FORM
PDF template
A comprehensive registration form for recreational activities that collects participant and emergency contact information, including liability waivers and medical consent.
See template
See template
Kayaking Registration Form
PDF template
Registration form for kayaking activities offered by Alameda Recreation and Park Department, including participant and contact details.
See template
See template
Alameda Recreation And Park Department Registration Form
PDF template
Registration form for recreation classes and activities offered by Alameda Recreation and Park Department for various age groups and programs.
See template
See template
LSA LSC Adult Soccer Medical Release Form And Waiver Hold Harmless Agreement
PDF template
Medical release form and liability waiver for adult soccer players detailing personal and emergency contact information and medical consent.
See template
See template
Bismarck Parks And Recreation District Program Registration Form
PDF template
Registration form for Bismarck Parks and Recreation District adult and youth programs with refund policy details.
See template
See template
LSA LSC Youth Soccer Medical Release Form And Waiver Hold Harmless Agreement
PDF template
Medical release and consent form for youth soccer players, including emergency contact and medical information
See template
See template
ESCC Indoor Winter Art Walk Registration Form
PDF template
Registration form for local and regional artisans to display original work at an indoor art event on a college campus.
See template
See template
Recreation Program Registration Form
PDF template
Registration form for participating in recreation programs, collecting participant and emergency contact information and including a liability release.
See template
See template
Youth Medical Release Form And Waiver Hold Harmless Agreement
PDF template
A medical release and waiver form for youth soccer players, documenting medical information and parental consent for participation.
See template
See template
Anchorage Parks Recreation Program Registration Form
PDF template
A comprehensive registration form for participating in Anchorage Parks and Recreation programs, including participant details, waiver, and payment information.
See template
See template
Recreation Program CRCC Membership Form
PDF template
Registration form for recreational programs and community center membership in Carbondale, Colorado, with program policies and membership details.
See template
See template
Insurance Referral And Financial Responsibility Form
PDF template
A document outlining patient insurance participation, referral requirements, and financial responsibilities for medical services at Eye Associates of Utica.
See template
See template
Guidelines For Reimbursement Of NAIC Travel Expenses
PDF template
Detailed policy outlining travel expense reimbursement procedures for NAIC-related travel and eligible participants.
See template
See template
ECHN REHABILITATION SERVICES MEDICAL HISTORY
PDF template
A comprehensive form for collecting patient medical history, current health conditions, and relevant health information for rehabilitation services.
See template
See template
Hopelink Reimbursement Form
PDF template
Guidelines for requesting reimbursement for parking, bridge tolls, and ferry expenses related to medical appointments.
See template
See template
Reimbursement Of Orthodontic Expenses
PDF template
Guidelines for reimbursing orthodontic expenses based on IRS rules and service agreements, detailing monthly reimbursement processes.
See template
See template
Release And Indemnification Agreement For Minors
PDF template
A legal document granting parental permission for minor's participation in Bay View activities and waiving liability for potential injuries or damages.
See template
See template
Release And Indemnification Agreement For Minors
PDF template
A legal document granting parental permission for minor participation in Bay View activities and waiving liability for potential injuries or damages.
See template
See template
RELEASE AND INDEMNIFICATION AGREEMENT FORM UTRGV CELLO FESTIVAL
PDF template
A legal document releasing the institution from liability for potential injuries or damages during participation in the Cello Festival event.
See template
See template
Salk Institute Volunteer Waiver
PDF template
Legal document waiving liability for volunteers participating in Salk Science and Music Series event, assuming all risks of participation.
See template
See template
Participant Liability Release And Waiver Form
PDF template
A comprehensive liability release form for participants in cheer and dance events, covering personal and minor participant involvement.
See template
See template
Volunteer Signup
PDF template
A legal document outlining liability release and waiver for volunteers participating in Next Step STORM activities.
See template
See template
Show Me Acro LLC Release Form
PDF template
Registration and liability release form for students participating in gymnastics and performing arts programs at Show-Me Acro LLC.
See template
See template
Agreement And Release Of Liability Form
PDF template
A legal document that releases Ohio University from liability for potential injuries during a university-sponsored program or camp.
See template
See template
North Shore Winter Club Release Agreement
PDF template
Legal document waiving claims and assuming risks for participation in club activities, specifically hockey-related events.
See template
See template
North Shore Winter Club Release Agreement
PDF template
Legal document waiving rights to sue or claim compensation for potential injuries or damages during club activities.
See template
See template
Release Of Liability, Waiver Of Claims, Assumption Of Risks And Indemnity Agreement
PDF template
Legal document waiving rights and assuming risks for participation in gymnastics activities with Gymnastics BC.
See template
See template
Off Campus Event Policy Form 2
PDF template
A legal document releasing California State University, Fresno from liability for potential risks during off-campus academic events.
See template
See template
Release Of Liability And Accident Waiver Form
PDF template
Legal document releasing liability for participants in log construction training activities, covering potential risks and injuries.
See template
See template
RELEASE OF LIABILITY, PROMISE NOT TO SUE, ASSUMPTION OF RISK AND AGREEMENT TO PAY CLAIMS
PDF template
Legal document releasing California State University, Fullerton from liability for potential injuries or damages during an activity or related travel.
See template
See template
HCC Risk Management Student Waiver Form
PDF template
A comprehensive liability waiver and release form for students participating in domestic travel programs through Houston Community College.
See template
See template
DOHEO Medical Release Form For ADA Purposes
PDF template
A medical authorization form allowing disclosure of medical information to determine disability accommodations under the Americans with Disabilities Act (ADA).
See template
See template
Contract Of Release And Waiver Of Liability
PDF template
A legal document releasing liability for participants in military-style training activities with acknowledgment of inherent risks.
See template
See template
Consent Form
PDF template
A consent form for participants or parents/guardians to authorize entry into the USCCB Religious Liberty Essay Contest for individuals under and over 18 years old.
See template
See template
PROP LEASERENTAL AGREEMENT TERMS CONDITIONS
PDF template
A comprehensive rental agreement outlining terms and conditions for leasing props, including liability, property protection, and renter responsibilities.
See template
See template
Rental Agreement
PDF template
A rental agreement for municipal facilities in Norwood Young America, covering event space rental, fees, and policies
See template
See template
Rental Agreement Form
PDF template
A rental agreement form for skiing and snowboarding equipment rental, including personal information and liability waiver.
See template
See template
Pavilion Rental Agreement
PDF template
Comprehensive rental agreement for pavilion facilities in Norwood Young America, covering fees, deposits, event details, and alcohol regulations.
See template
See template
Rental Agreement Form
PDF template
A rental form for equipment rental from Cirrus Research plc, covering terms of equipment usage and insurance responsibilities.
See template
See template
Rental Agreement
PDF template
Legal document outlining rental terms, responsibilities, and liability waivers for equipment rental from Above All Party Rentals.
See template
See template
Wellesley Public Schools Rental Agreement
PDF template
Comprehensive terms and conditions for renting school facilities in Wellesley, including payment, permit, and insurance requirements.
See template
See template
Mountain High Online Rental Form
PDF template
A liability release and rental agreement form for ski and snowboard equipment rental at Mountain High resort.
See template
See template
Town House School Guidelines Rental Agreement Form
PDF template
Rental guidelines and agreement for the Town House School facility managed by Kennebunkport Historical Society, detailing usage rules and responsibilities.
See template
See template
Reporting Accidents
PDF template
Procedure for reporting and documenting accidents that occur on school property or at school-sponsored events.
See template
See template
Request For Mexican Automobile Insurance
PDF template
Form for obtaining Mexican automobile insurance for UC Santa Barbara vehicles traveling to Mexico, as required by Mexican law.
See template
See template
PolicyCertificate Information Updates
PDF template
A form for updating policy details, mailing address, and beneficiary information with Washington National Insurance Company.
See template
See template
Family And Medical Leave Request Form
PDF template
A form for employees to request family or medical leave, detailing reasons for absence and relevant employee information.
See template
See template
Request For Certificate Of General Liability Insurance
PDF template
A form for Boy Scouts of America units to request a general liability insurance certificate for authorized activities.
See template
See template
REQUEST FOR POLICY CHANGE FORM
PDF template
A form for requesting changes to an existing insurance policy with Pacific Life Assurance Co., Ltd.
See template
See template
Request For Reimbursement From FSA Or HRA Form
PDF template
A form used to request reimbursement for eligible healthcare and dependent care expenses through a Flexible Spending Account (FSA) or Health Reimbursement Arrangement (HRA)
See template
See template
Aflac Benefit Services Request For Reimbursement Form
PDF template
A form for requesting reimbursement from a Flexible Spending Account (FSA) for medical care expenses.
See template
See template
Request For Reinstatement Of Policy Contract
PDF template
A form for requesting reinstatement of an insurance policy, requiring detailed personal and medical information.
See template
See template
Request For UC Certificate Of Insurance
PDF template
A form used by University of California departments to obtain a certificate of insurance for agreements, contracts, or permits.
See template
See template
MEDICAID HOSPICE DISCHARGE FORM
PDF template
Official form documenting the discharge of a patient from a Medicaid hospice program, including reasons for termination of services.
See template
See template
Anatomic Pathology Requisition Form
PDF template
Medical requisition form for submitting biopsy and pathology specimens with patient and provider information for diagnostic testing.
See template
See template
COVID 19 RNA AND ANTIBODY DETECTION REQUISITION FORM
PDF template
Medical form for collecting patient information and requesting COVID-19 RNA and antibody testing
See template
See template
Ultrasound AndOr Mammography Requisition
PDF template
Instructions and patient preparation guidelines for various ultrasound and mammography examinations with patient information section.
See template
See template
RequisitionPre Authorization Form
PDF template
A form for requesting additional medical testing at Regional Medical Laboratory, including patient and insurance information verification.
See template
See template
Investigator Initiated Research Grant Application Form
PDF template
A comprehensive form for researchers seeking funding and approval for investigative research projects from Paragon28.
See template
See template
RESEARCH INQUIRY WALSH LAB
PDF template
A research inquiry form for collecting patient information and medical history for potential participation in a Walsh Lab study.
See template
See template
Research Volunteer Application
PDF template
Application form for potential research volunteers at the University of Texas Health Science Center San Antonio's Department of Anesthesiology Division of Research.
See template
See template
Fontbonne University Resident Medical Information
PDF template
Comprehensive medical information and immunization requirements for first-time resident students at Fontbonne University.
See template
See template
RADIOLOGY LEAVE REQUEST FORM
PDF template
A comprehensive form for radiology residents to request various types of leave with multiple approval levels.
See template
See template
ResidentResponsible Party Agreement
PDF template
Comprehensive agreement for billing, payment, and medication authorization for a senior living resident
See template
See template
Standardized Application For Pathology Fellowships
PDF template
A comprehensive application form for pathology residents seeking specialized fellowship training in various pathology subspecialties.
See template
See template
Resolution 2015 01 Confidentiality Of Benefits And Insurance Information
PDF template
A resolution establishing guidelines for accessing and protecting confidential benefits and insurance information in compliance with federal privacy laws.
See template
See template
Medical Society Of New Jersey Resolution Submission Form
PDF template
A form for medical society members to submit proposed resolutions on healthcare policy and related topics.
See template
See template
4 H Experience Attendance Sheet
PDF template
A form for recording participant details and attendance at 4-H events or meetings.
See template
See template
MEDICAL DENTAL APPOINTMENT FORM
PDF template
A comprehensive form for documenting a child's medical or dental appointment details including patient information, appointment specifics, and medical recommendations.
See template
See template
OSHA Medical Evaluation Form
PDF template
A confidential medical questionnaire for employees required to use respirator masks, assessing their medical readiness for mask fitting.
See template
See template
Hospital Discharge Intake Form
PDF template
A form for evaluating patient eligibility for short-term respite care after hospital discharge, including medical stability and independence requirements.
See template
See template
Retail Prescription Drug Claim Form
PDF template
Claim form for federal employees and retirees to submit prescription drug expenses for reimbursement.
See template
See template
Photograph Inventory Form
PDF template
Form for submitting retaken photographs to a Reading Center with patient and photographic details.
See template
See template
Dental AndOr Vision Option Election Form
PDF template
Form for electing optional dental and vision insurance coverage for retired laborers.
See template
See template
RETIREE ACH AUTHORIZATION FORM
PDF template
A form authorizing HealthTrust to process monthly medical and dental contribution payments via automated bank transfer.
See template
See template
Enrollment Form
PDF template
Insurance enrollment form for University of California employees and retirees seeking accidental death and dismemberment coverage through Prudential Insurance
See template
See template
RETIREE HEALTH COVERAGE CONTACT FORM
PDF template
A form for collecting updated contact and personal information for retirees to maintain health coverage communication.
See template
See template
Retiree Death Benefit Program Highlights
PDF template
A death benefit program offering $1,000 to $10,000 in coverage for retirees and spouses with guaranteed issue and fixed rates.
See template
See template
RETIREE DENTAL VISION ENROLLMENT FORM
PDF template
Form for retirees to enroll in dental and vision insurance coverage through Emory Benefit Plans.
See template
See template
Reimbursement Form
PDF template
A form for requesting reimbursement for medical care, supplies, and healthcare expenses from an insurance provider.
See template
See template
Faculty And Staff Retirement Checklist
PDF template
A comprehensive guide for faculty and staff retirement preparation at Seminole State College, outlining key steps for retiring employees.
See template
See template
Faculty And Staff Retirement Checklist
PDF template
Comprehensive retirement checklist for Seminole State College faculty and staff, providing step-by-step instructions for retirement planning and documentation.
See template
See template
Retirement Plan And Disability Waiver Form
PDF template
Form for waiving waiting period for retirement and disability coverage when transferring employment to Northeastern
See template
See template
Retirements And Retiree Benefits
PDF template
Comprehensive guide for Pittsburg State University employees detailing retirement eligibility, benefits, and process for retiring staff and faculty.
See template
See template
Direct Reimbursement Claim Form
PDF template
A form for submitting vision care service reimbursement claims for out-of-network providers through Davis Vision.
See template
See template
COMMON WELL ENROLLMENT CONSENT FORM
PDF template
A consent form for patients to authorize sharing of medical information through the CommonWell health information network for continuity of care.
See template
See template
Revised ProceduralSurgical Consent Form Frequently Asked Questions
PDF template
Document explaining revisions to a medical consent form and addressing frequently asked questions about signature and content changes.
See template
See template
Participation Agreement And Waiver Form
PDF template
A legal document for parents/guardians to authorize and acknowledge risks for a child's participation in a University of Michigan program or camp.
See template
See template
Patient Medical History Form
PDF template
Comprehensive medical history document capturing patient's medications, allergies, past medical conditions, surgical history, family health history, and lifestyle details.
See template
See template
Diving Medical Exam Overview For The Examining Physician
PDF template
Medical examination document assessing fitness for scientific diving certification at the University of New Hampshire.
See template
See template
Physical Activity Participation Waiver
PDF template
A liability waiver and consent form for participants in an online physical activity program, addressing risks and electronic communication consent.
See template
See template
REQUEST FOR PROPOSAL (RFP) BID SOLICITATION DOCUMENT
PDF template
Request for proposal for athletic apparel and equipment agreement for Northwest Arkansas Community College's athletic programs.
See template
See template
Owner Controlled Insurance Program (OCIP) Manual
PDF template
A comprehensive manual detailing insurance program requirements and responsibilities for the New Ukiah Courthouse construction project.
See template
See template
Managed Service Provider Request For Proposal
PDF template
Request for Proposal for selecting a Managed IT Services Provider for a school district serving approximately 520 students.
See template
See template
GRAIN WAREHOUSE CERTIFICATE OF INSURANCE FORM NO. RGW 302
PDF template
Instructions for completing a certificate of insurance for public grain warehouses in Texas, required for licensing and compliance.
See template
See template
VantageCare RHS Plan Claim Form
PDF template
Form for submitting medical expense reimbursement claims to the VantageCare RHS Plan administered by Meritain Health.
See template
See template
Volunteer Agreement Form
PDF template
Legal document outlining volunteer responsibilities and liability waivers for Rimrock Humane Society volunteers.
See template
See template
Service Request Form
PDF template
A form for requesting research services from the Radioimmunoassay and Biomarker Core at The Smilow Center for Translational Research.
See template
See template
PARENTAL CONSENT FORM (RIDERS)
PDF template
A consent form allowing parents to authorize their child to travel in a private vehicle with other parents for a specific activity.
See template
See template
RIDOH State Health Laboratories Test Requisition
PDF template
A comprehensive medical test requisition form for submitting patient specimens to Rhode Island State Health Laboratories for various diagnostic tests.
See template
See template
Design Competition Entry Form 2024
PDF template
Entry form for a creative design competition to decorate Rik Bear and create a badge design for Pawprint Family.
See template
See template
Outpatient Physician Visit Referral Form
PDF template
A medical referral form used to schedule patient appointments and transfer clinical information between healthcare providers.
See template
See template
Incident Report
PDF template
A comprehensive form for documenting and reporting critical incidents involving service recipients, detailing medical, legal, and social aspects of the event.
See template
See template
RINGETTE BC MEDICAL FORM
PDF template
A confidential medical form for Ringette BC athletes to collect personal health and emergency contact information.
See template
See template
Liability Waiver And Release Form (Minor Child)
PDF template
A legal document releasing Harvard University from liability for potential injuries or damages during ice skating activities for a minor child.
See template
See template
Retiree Health Care Cancellation Form
PDF template
A form for state retirees to cancel their or their spouse's health care coverage with the Rhode Island Office of Employee Benefits.
See template
See template
DANCEDANCEPOMS TEAM RISK ACKNOWLEDGEMENT
PDF template
A comprehensive risk acknowledgement and responsibility document for high school dance and poms team athletes and their parents/guardians.
See template
See template
Risk Acknowledgement And Emergency Contact Form
PDF template
A university form documenting participant risk acknowledgement, emergency contact information, and medical authorization for university-sponsored programs.
See template
See template
Wrestling Risk Acknowledgement
PDF template
A comprehensive document outlining safety procedures, risks, and responsibilities for student-athletes participating in high school wrestling.
See template
See template
Texas AM University San Antonio Risk Assessment Matrix
PDF template
A comprehensive risk assessment tool for evaluating potential hazards and risks associated with university events and activities.
See template
See template
Texas AM International University Risk Management And Insurance Matrix
PDF template
A comprehensive matrix for identifying, assessing, and managing potential risks associated with university activities.
See template
See template
Unconditional And Full General Release And Covenant Not To Sue
PDF template
A legal release form for participants of a university-sponsored trip, waiving liability and acknowledging risks.
See template
See template
Risk Management Policy
PDF template
A policy to protect the interests of Associated Students, Inc. by providing a safe environment and managing organizational risks.
See template
See template
Accident Claim Form
PDF template
A claim form for submitting accident-related insurance claims with specific filing instructions and requirements.
See template
See template
4 H Risk Management Checklist For Meetings And Events
PDF template
A comprehensive checklist for identifying and managing potential risks in 4-H meetings and events to ensure participant safety.
See template
See template
IncidentAccident Report Form
PDF template
A comprehensive form for documenting accidents, injuries, and property damage within a school district setting.
See template
See template
NAIC Uniform Risk Retention Group Registration Form
PDF template
Official registration form for Risk Retention Groups operating under the Federal Liability Risk Retention Act of 1986
See template
See template
Protection Declaration Form
PDF template
Insurance declaration form for policy underwriting with specific provisions for cancer survivors applying for mortgage protection insurance.
See template
See template
CLIENT BILL REQUISITION FORM
PDF template
A medical form for ordering laboratory tests with patient and practitioner information collection fields.
See template
See template
Insurance Bill Requisition Form
PDF template
A medical laboratory test request form for collecting patient information, test orders, and billing details.
See template
See template
Insurance Bill Requisition Form
PDF template
A comprehensive form for collecting patient and practitioner information for medical laboratory testing and insurance billing purposes.
See template
See template
RM 41 Risk Management Property Insurance Claim Form
PDF template
A form for submitting property damage or loss claims to the Office of Risk Management for insurance reimbursement.
See template
See template
Activity Liability Waiver And Release Agreement
PDF template
Legal document for students to acknowledge risks and release liability for participating in college-sponsored activities or events.
See template
See template
Party Booking Form
PDF template
Form for booking a children's party at the Rockhampton Museum of Art, including details about venue hire, fees, and terms of service.
See template
See template
Recognized Museum Program Application Workbook
PDF template
Comprehensive application guide for museums seeking recognition through a structured evaluation process involving core and supporting evidence.
See template
See template
Medical Expense Reimbursement Form
PDF template
Step-by-step guide for submitting a medical expense reimbursement claim using a PDF form on the Benserco website.
See template
See template
Iowa 4 H Medical InformationRelease Form
PDF template
A comprehensive medical information and emergency contact form for non-4-H club youth participants.
See template
See template
Roanoke Parks And Recreation Program Instructor Application
PDF template
Application for individuals interested in teaching recreational programs and courses for Roanoke Parks and Recreation Department.
See template
See template
RoboCamp RIT Medical And Health Insurance Form
PDF template
Comprehensive medical history and health information form for students attending RoboCamp at RIT
See template
See template
Rock Wall Waiver Form
PDF template
Liability waiver and rules of conduct for participants using the rock climbing wall at Hulsey Wellness Center.
See template
See template
North Carolina High School Athletic Association Sport Preparticipation Examination Form
PDF template
A medical screening form for student-athletes to assess their health and fitness for sports participation.
See template
See template
ROMEO Research Proposal Form
PDF template
A comprehensive form for submitting research proposals to ROMEO Ophthalmology, detailing project specifics, contributors, and data management plans.
See template
See template
PERMITFACILITY USE AGREEMENT WEED COMMUNITY CENTER
PDF template
A legal agreement for using the Weed Community Center, outlining indemnification and insurance requirements for facility renters.
See template
See template
Community Room Rental Agreement Form And Payment
PDF template
A rental agreement for using the Geos Institute's community room, outlining terms, conditions, and pricing for event space rental.
See template
See template
Registration Form
PDF template
A registration form for various organizational entities to participate in a specific program or event.
See template
See template
Release Of Liability, Waiver Of Claims, Assumption Of Risks And Indemnity Agreement
PDF template
Legal document waiving liability for participants in a county shuttle bus event, acknowledging potential risks and releasing the organization from claims.
See template
See template
ROW And FOP Contractor Requirements
PDF template
Detailed requirements for contractors seeking to work on right-of-way and fiber optic projects in the City of Lincoln.
See template
See template
Patient Intake Form
PDF template
Confidential form for collecting comprehensive patient personal, medical, work, and insurance information for physical therapy services.
See template
See template
Hospice Referral Form
PDF template
A comprehensive form for initiating hospice care referral, collecting patient medical, personal, and insurance information.
See template
See template
NEW PATIENT REGISTRATION FORM
PDF template
Comprehensive medical intake form for new patients, including personal information, insurance details, and arbitration agreement.
See template
See template
Rio Rapids SC Request For Refund
PDF template
A form for requesting refunds from Rio Rapids Soccer Club under specific circumstances, with approval required from registrar and treasurer.
See template
See template
RRU Participant Feedback Form
PDF template
A bilingual form for reviewing participant performance and updating individual rehabilitation plans with recommendations and projected completion dates.
See template
See template
Motor Vehicle Procedure Manual Registration Commercial Motor Vehicle Insurance
PDF template
Official procedure manual for collecting and managing commercial motor vehicle insurance requirements in Florida.
See template
See template
Group LTD Insurance Cancellation Form
PDF template
Form for employees to cancel voluntary long-term disability insurance coverage at the University of Tennessee
See template
See template
EMPLOYEE MEDICAL RELEASE FORM
PDF template
A form authorizing an employer to obtain and review medical information related to an employee's ability to perform job tasks safely.
See template
See template
Application For Benefits Fraud Warning
PDF template
Legal document providing state-specific warnings about insurance claim fraud and potential criminal penalties for false claims.
See template
See template
Individual Travel RegistrationWaiver Form
PDF template
A comprehensive form for student travel registration, liability waiver, and emergency contact information for university-sponsored trips.
See template
See template
Recreational Trails Program Billing Form
PDF template
Official billing form for submitting expenses related to the Recreational Trails Program grant in New Hampshire.
See template
See template
The Recreational Trails Program Development Projects Implementation Billing Requirements
PDF template
Guidelines for implementing recreational trail projects funded through the Illinois Department of Natural Resources Recreational Trails Program grant assistance.
See template
See template
Participant And Volunteer Accident Waiver And Release Of Liability
PDF template
A legal document releasing liability for participants and volunteers in a bicycle riding event, outlining risks and assumption of responsibility.
See template
See template
Checklist Instructions For Filing An Application For The Radiologic Technology Program
PDF template
Instructions and requirements for applying to the Radiologic Technology Program at El Camino College for the Spring 2025 semester.
See template
See template
Golf Ball Submission Form
PDF template
A detailed form for submitting golf ball specifications for USGA evaluation and potential inclusion in the Conforming Ball List.
See template
See template
RUAA Interview Form
PDF template
A comprehensive survey documenting individual experiences and observations about a specific stream's characteristics and usage patterns.
See template
See template
Patient Enrollment Form
PDF template
Enrollment form for patients seeking treatment with RUCONEST for hereditary angioedema (HAE)
See template
See template
Insurance Form Number One
PDF template
Administrative rules governing insurance forms used by the State Fire Marshal for fire loss reporting and information requests.
See template
See template
Huerfano County Community Center Rental Agreement
PDF template
Official document outlining rental rules, fees, and responsibilities for using the Huerfano County Community Center in Walsenburg, Colorado.
See template
See template
Financial Assistance Application Form
PDF template
Comprehensive form for patients to apply for financial assistance, collecting detailed personal, employment, and income information.
See template
See template
Accident Waiver And Release Of Liability Form
PDF template
Legal document releasing liability for participants in a 5K run/walk event organized by the Wisconsin Section of the American Water Works Association.
See template
See template
RV Rental Insurance Application
PDF template
Insurance application for RV rental businesses covering liability and physical damage for recreational vehicles
See template
See template
Allergy Reimbursement Claim Form
PDF template
A form for submitting claims for allergy treatments and medications for reimbursement by an insurance provider.
See template
See template
Prescription Drug Reimbursement Coordination Of Benets Claim Form
PDF template
A form for submitting prescription drug reimbursement claims and coordinating medical benefits for pharmacy services.
See template
See template
Preparticipation Physical Evaluation Physical Examination Form
PDF template
Comprehensive medical screening form for athletes to assess physical fitness and health status prior to participation in sports activities.
See template
See template
Rotary Youth Leadership Academy District 7670 Application
PDF template
Application form for high school students to participate in Rotary Youth Leadership Academy leadership development program in western North Carolina.
See template
See template
BW RYSTIGGO V.I23
PDF template
Medical referral and patient information form for Rystiggo (rozanolixizumab-noli) treatment for Generalized Myasthenia Gravis
See template
See template
Accidental Injury Claim Form
PDF template
Insurance claim form for reporting and processing an accidental injury claim with Aflac
See template
See template
Initial Disability Checklist
PDF template
A comprehensive form for filing a disability insurance claim, collecting details about the nature of disability, patient, and policyholder information.
See template
See template
Long Term Care Continuing Claim Form
PDF template
A claim form for submitting long-term care insurance claims through Aflac, requiring detailed policyholder and patient information.
See template
See template
Continuing Disability Claim Form
PDF template
A claim form for filing a continuing disability insurance claim with Aflac, requiring policyholder and patient information.
See template
See template
Event Attendance Form
PDF template
A form for recording participant names and signatures for events organized by the Student Activities Association.
See template
See template
Safe Sport Incident Report Form
PDF template
A form for reporting misconduct incidents within The First Tee organization, covering various types of potential inappropriate behavior.
See template
See template
Cadet Initial Entry Training (CIET) Medical Operations Pre Participation Physical Form Medical Hi
PDF template
Comprehensive medical history form for cadets participating in initial entry training, capturing health conditions, injuries, and personal medical information.
See template
See template
STUDENT VEHICLE REGISTRATION FORM
PDF template
Form for students to register their vehicles and parking permits at Bethel University in Tennessee.
See template
See template
Informed Consent For Immunization With COVID 19 Vaccine
PDF template
A medical consent form for receiving COVID-19 vaccination, including patient personal and medical information.
See template
See template
NISRA Facility Request Form
PDF template
A facility rental form for various rooms at the Sage Therapeutic Recreation Center, offering spaces for meetings, events, and celebrations with tiered pricing categories.
See template
See template
Sagewell Healthcare Benefits Trust FAQ
PDF template
Detailed FAQ document explaining the structure, administration, and key details of the Sagewell Healthcare Benefits Trust group insurance arrangement.
See template
See template
Sail Caribbean Medical Form
PDF template
A comprehensive medical form required for students participating in Sail Caribbean adventures, collecting health history and emergency contact information.
See template
See template
Student International Experience Petition Form
PDF template
Form for faculty and students to propose and document international academic experiences at Northeast Ohio Medical University.
See template
See template
SALES ORDER FORM
PDF template
A form for ordering surgical implants and equipment with detailed item tracking and customer information.
See template
See template
Liability Waiver Form
PDF template
A legal document that releases Polk County Public Libraries and related parties from liability for participation in an activity and grants photo usage rights.
See template
See template
Same Day Delivery Form
PDF template
Form allowing patients to receive medical devices on the day of evaluation, with information about potential insurance authorization and financial responsibilities.
See template
See template
Auto Accident Report Form
PDF template
A comprehensive form for documenting details and steps to take following an automobile accident.
See template
See template
SAMPLE ASSUMPTION OF RISK RELEASE
PDF template
A legal document that releases event sponsors from liability and acknowledges participant's voluntary assumption of risks during an event.
See template
See template
SAMPLE CLUB SOFTBALL BUDGET FORM
PDF template
Detailed budget breakdown for a softball club, including expenses for various categories like supervision, equipment, travel, and lodging.
See template
See template
Ohio Cancellation Form
PDF template
Form documenting termination of insurance agents for various reasons including lack of production and retirement.
See template
See template
Sample Certificate Of Insurance
PDF template
Insurance certification document outlining minimum coverage requirements for a grant agreement with details on liability and insurance provisions.
See template
See template
Consent To Participate In A Research Study
PDF template
Consent form template for adult participants in a social behavioral research study at the University of North Carolina at Pembroke.
See template
See template
Consent To TattooPierce
PDF template
A legal consent form detailing risks, requirements, and patient acknowledgment for tattoo and piercing procedures in Montana.
See template
See template
Sample Discharge Form
PDF template
A comprehensive discharge form for shelter guests documenting medical conditions, transportation needs, and post-evacuation services
See template
See template
Sample Emergency Action Plan
PDF template
A comprehensive emergency preparedness document detailing contact information, emergency procedures, and roles for managing potential incidents.
See template
See template
Sample Evaluation Form
PDF template
A comprehensive form for evaluating a continuing education program's effectiveness and participant experience.
See template
See template
Health Care Benefits Renewal
PDF template
A renewal form for health care benefits from the Texas Health and Human Services Commission for individuals to update their personal and financial information.
See template
See template
Sample Incident Investigation Form
PDF template
Guidelines for investigating and documenting incidents involving guests or employees, focusing on professional response and thorough documentation.
See template
See template
Sample Incident Reporting Audit Form
PDF template
A comprehensive form for documenting and tracking incidents, their internal reporting contacts, policy references, insurance details, and external regulatory reporting requirements.
See template
See template
Letter Of Intent For Business Asset Acquisition
PDF template
A legal document outlining the potential terms for acquiring a business's assets, book of business, and insurance company appointments.
See template
See template
Medical Release Form
PDF template
A medical clearance document for patients seeking to start a personalized fitness training program, requiring physician review and approval of exercise activities.
See template
See template
Parental Consent Form
PDF template
A legal document granting consent for a minor to volunteer with TreePeople, including liability release and media usage permissions.
See template
See template
Sample Passive Consent Form
PDF template
A consent form for parents/guardians to allow their child's participation in a school program and optional evaluation survey.
See template
See template
Referral Form (Sample Format)
PDF template
A standardized form for documenting patient referrals between healthcare service providers with client authorization.
See template
See template
Rental Agreement, Release And Assumption Of Risks
PDF template
A comprehensive rental agreement that includes risk assumption, liability release, and insurance acknowledgment for renting an interactive inflatable unit.
See template
See template
Volunteer Process Form
PDF template
A form for approving non-paid guest lecturers within a university department's volunteer program.
See template
See template
SAMPLE SUBMISSION FORM WALSH LAB
PDF template
A medical research form for collecting family genetic sample information and consent for genetic studies.
See template
See template
Program Evaluation Form
PDF template
A survey form for collecting participant feedback about library programs and events.
See template
See template
Irvine Unified School District Drive Up COVID 19 PCR Testing Authorization Form
PDF template
Authorization form for Irvine Unified School District employees to receive COVID-19 PCR testing at Sand Canyon Urgent Care Medical Center.
See template
See template
City Of Santa Monica Registration Form
PDF template
Registration form for community classes, programs, camps, and activities in Santa Monica, California.
See template
See template
SB0357 Viatical Disclosure Form Act
PDF template
Legislative act requiring disclosure forms and defining terms related to viatical settlement purchases in Montana.
See template
See template
Massachusetts Workers Compensation Assigned Risk Pool Special Bulletin No. 09 03
PDF template
Bulletin detailing new procedures for requesting and obtaining workers' compensation insurance certificates in the Massachusetts Assigned Risk Pool.
See template
See template
SB 551 Member Enrollment
PDF template
Enrollment form for members to provide personal and medical insurance information for the Oregon Educators Benefit Board (OEBB)
See template
See template
Survivor Benefit Application Form
PDF template
An application form for survivors to claim pension benefits for a deceased account holder
See template
See template
Parental Consent Form To Receive Health Care Services
PDF template
A comprehensive form for parents to provide consent and medical information for student health care services at school-based clinics.
See template
See template
Patient Assessment Form (New Patients Only)
PDF template
Comprehensive medical intake form for new patients at Stony Brook Surgical Associates, collecting patient demographic and health information.
See template
See template
REPORT OF ACCIDENT
PDF template
A comprehensive form documenting details of an accident, including personal information, injury specifics, and medical treatment
See template
See template
HOSPICE ORDER FORM
PDF template
A medical form for referring a patient to hospice care services, including patient information, orders, and physician details.
See template
See template
UVA Biorepository Tissue Research Facility (BTRF) Scanning Service Request Form
PDF template
A form for researchers to request slide scanning services at the University of Virginia's Biorepository & Tissue Research Facility.
See template
See template
Jimtown Athletic Program Advertising Purchase Order Form
PDF template
A form for purchasing advertising space in Jimtown High School's athletic program for various editions and ad placements.
See template
See template
Scarecrow Competition Entry Form
PDF template
A local competition inviting participants to create Alice in Wonderland-themed scarecrows across different age categories, with public display and judging.
See template
See template
SCCDawson Park Event Application Instructions
PDF template
Instructions for reserving park amenities for events at Suncadia, including fees, restrictions, and application process.
See template
See template
Claim Form For Expat Insurance Packages
PDF template
A comprehensive claim form for expatriates to report damages across multiple insurance package types, requiring detailed policy and incident information.
See template
See template
DCOM Student Scholarly Activity And Research Project Form OMS I II
PDF template
A form for medical students to document and obtain approval for scholarly research activities with mentor and institutional review board guidance.
See template
See template
H.E.L.P. The Lawrence J. Dippold Health Education Loan Program
PDF template
Scholarship program providing financial assistance for health-related career training at Guthrie Cortland Medical Center
See template
See template
City Of Lincoln Recreation Scholarship Application Form
PDF template
A scholarship application for youth recreation programs to help families experiencing financial hardship participate in city activities.
See template
See template
Washburn University Art Scholarship Application
PDF template
Scholarship application for incoming and current students pursuing art-related degrees at Washburn University
See template
See template
Parks And Recreation Youth Scholarship Application
PDF template
A scholarship program to assist families with economic hardships in accessing sporting and cultural activities for children ages 5-16 in Billings.
See template
See template
College Scholarship Application
PDF template
A scholarship program offering two awards of $3,000 and $2,000 for Barrington high school seniors or current college students.
See template
See template
SCHOLARSHIP FORM
PDF template
Application for youth recreation program scholarships for families receiving public assistance.
See template
See template
2018 Youth Scholarship Program Guidelines And Information
PDF template
A scholarship program by Chico Area Recreation and Park District to provide reduced recreation program fees for children from families with financial need.
See template
See template
Scholarship Application For Individuals Pursuing A Career In The Healthcare Field
PDF template
A scholarship application for students pursuing careers in healthcare, sponsored by Lawrence General Hospital Medical Staff.
See template
See template
Financial Scholarship Application
PDF template
A scholarship application for individuals with disabilities seeking financial assistance for adaptive sports lessons and activities.
See template
See template
School District Student AccidentIncident Report Form
PDF template
A comprehensive form for documenting student accidents or incidents within a school district, capturing details of the event, location, and actions taken.
See template
See template
PREVENTATIVE HEALTH CARE EXAMINATION FORM
PDF template
A comprehensive health examination form for students entering Kentucky public schools, documenting medical history, immunizations, and health screenings.
See template
See template
Pupil Personal Accident Report Form
PDF template
A comprehensive form for reporting and claiming medical expenses for student accidents at school
See template
See template
School Waiver Form Extracurricular Activities
PDF template
A school waiver form for students participating in sports and extracurricular activities, outlining liability and insurance requirements.
See template
See template
VSU Participation Agreement And Waiver Form (Minor Participant)
PDF template
A comprehensive waiver and release form for minors participating in university programs, covering liability and medical protocols.
See template
See template
Special Consideration Medical Form
PDF template
A medical form for students seeking special consideration due to acute illness or injury at the University of Canterbury.
See template
See template
Adult Minor Medical Release
PDF template
Medical release and emergency contact form for participants in international travel or mission trips
See template
See template
Take Charge Follow Up, Diagnostic, And Treatment Training (ODH Form No. 274C)
PDF template
Training document for healthcare professionals on completing the Take Charge! Follow up, Diagnostic, and Treatment form.
See template
See template
PRESCRIPTION SUBMISSION FORM
PDF template
A form for submitting and tracking pharmaceutical prescriptions with specific endorsement and signing requirements.
See template
See template
Boston Scientific Spinal Cord Stimulation Pre Authorization Form
PDF template
A medical form for pre-authorization of spinal cord stimulation procedures, used to document patient, physician, and procedure details for insurance approval.
See template
See template
Commercial Automobile Application
PDF template
An insurance application form for commercial automobile coverage detailing business operations and vehicle information.
See template
See template
San Diego County Public Health Laboratory Test Requisition Form
PDF template
A comprehensive form for submitting medical test specimens to the San Diego County Public Health Laboratory with patient and specimen details.
See template
See template
Dock Rental Form
PDF template
Guidelines and process for renting dock slips within the Sorrento community, including required documentation and administrative procedures.
See template
See template
Student Transfer Request Form Medical, Emotional, Or Social Adjustment
PDF template
A form for requesting student school transfer based on medical, emotional, or social adjustment needs, requiring documentation from a healthcare provider.
See template
See template
Release Of Liability, Waiver Of Claims, Assumption Of Risks And Indemnity Agreement
PDF template
Legal document waiving liability for risks associated with skiing and snowboarding activities at Optimist Hill ski resort in Saskatchewan.
See template
See template
Wateree Hounds Waiver And Indemnity Release Season 2020.2021
PDF template
Legal document releasing Wateree Hounds from liability during equestrian activities and trail rides.
See template
See template
Certificate Of Insurance Hold Harmless Tracking Form
PDF template
Form for event organizers to provide liability insurance documentation and hold harmless agreement for City of Bellevue special events.
See template
See template
Maryland Uniform Consultation Referral Form
PDF template
A comprehensive form for medical consultation and referral between healthcare providers, capturing patient, carrier, and referral details.
See template
See template
Volunteer Assumption Of Risk Release Of Liability And Indemnity Agreement
PDF template
Legal document for volunteers at Second Harvest Food Bank of Orange County, outlining risk assumption and liability release for volunteer participation.
See template
See template
CWP Policy And Procedure Manual
PDF template
Comprehensive manual detailing forms, policies, and procedures for workforce development program administration.
See template
See template
Group Insurance Disability Claim Form
PDF template
A comprehensive form for submitting a disability insurance claim by an employee, physician, and employer or plan administrator.
See template
See template
Medical Claim Form
PDF template
A comprehensive medical claim form for reimbursement of medical expenses through Seib Insurance & Reinsurance Company in Qatar.
See template
See template
SEI Educational ProgramProject Proposal
PDF template
A form for proposing educational programs or projects that demonstrate sustainability and educational value to students at Western Carolina University.
See template
See template
Medical Assessment Form (PA 635)
PDF template
A form used by the Pennsylvania Department of Public Welfare to assess an individual's medical condition and ability to participate in employment and training activities.
See template
See template
Self Service Storage Producer Limited Lines Initial License Application (Business Entity)
PDF template
Application for obtaining a limited lines insurance license for self-service storage producers in Maryland.
See template
See template
SENECA MEDICAL FORM
PDF template
Medical form for collecting student health information, tuberculosis screening, and immunization history at Seneca College.
See template
See template
PBCI SENIOR MEDICAL TRAVEL FORM
PDF template
Comprehensive medical screening form for senior travel participants detailing health status, medical history, and emergency contact information.
See template
See template
Childcare Liability Waiver Form
PDF template
A comprehensive document outlining childcare policies, procedures, and a legal liability waiver for a fitness center's childcare services.
See template
See template
Service Agreement And Financial Policy
PDF template
A comprehensive service and financial policy document outlining service rates, insurance expectations, and patient financial responsibilities for mental health services.
See template
See template
Diventures Service Agreement
PDF template
A service agreement for equipment repair and maintenance at Diventures dive centers, including liability release and service terms.
See template
See template
Diventures Service Agreement
PDF template
A service agreement for scuba and diving equipment repair, including liability release and service details.
See template
See template
Community Resources For Corrections Service Agreement Form A05
PDF template
A service agreement form for external associates working with the Georgia Department of Corrections, detailing service terms and liability assurances.
See template
See template
QBC Hematology System Service Agreement
PDF template
A service agreement for QBC hematology diagnostic equipment repair and replacement services with single or double swap options.
See template
See template
City Of Mountain Home Service Project Proposal
PDF template
Application form for proposing and scheduling community service projects with the City of Mountain Home Parks & Recreation Department.
See template
See template
Service Request Form
PDF template
A form for making changes to an insurance policy, including beneficiary, name, address, ownership, and coverage modifications.
See template
See template
Service Request Form
PDF template
A form for members to request changes to their insurance contract, including address updates, name changes, and lost contract replacement.
See template
See template
Veterinary Muscle And Nerve Test Request Form
PDF template
A specialized form for veterinarians to request detailed muscle and nerve diagnostic tests for animals.
See template
See template
Veterinary Muscle And Nerve Test Submission Form
PDF template
Comprehensive form for submitting veterinary muscle and nerve diagnostic tests with detailed pricing and payment options.
See template
See template
Supervision Of Normal Pregnancy And Delivery Form
PDF template
A healthcare form for documenting pregnancy details, medical information, and patient consent for medical services related to pregnancy and delivery.
See template
See template
Lifetime Limited Warranty HV Battery
PDF template
A lifetime limited warranty document for a high-voltage battery, covering replacement and repair under specific conditions.
See template
See template
Parental Consent To Attend Setsucon
PDF template
Legal consent form for parents or guardians to allow minors under 18 to attend Setsucon convention with specified terms and responsibilities.
See template
See template
Severe Incident Response And Notification TIMELINE
PDF template
A comprehensive guideline for responding to and managing severe incidents with prioritized notification and action steps.
See template
See template
Santa Fe Conservation Trust Medical Form
PDF template
A comprehensive medical form for participants of Santa Fe Conservation Trust trips, collecting health history and emergency contact details.
See template
See template
Registration Of Written Advance Health Care Directive
PDF template
Official state form for registering, amending, or revoking an advance health care directive with the California Secretary of State.
See template
See template
Medical Reimbursement Account Claim Form
PDF template
Comprehensive instructions for submitting medical expense reimbursement claims through a Medical Reimbursement Account (MRA)
See template
See template
SFSU Incident Report Form
PDF template
A form for reporting information security incidents at San Francisco State University that potentially compromise IT asset confidentiality, integrity, or availability.
See template
See template
Application For Approval Of Research Proposal
PDF template
A comprehensive form for submitting and obtaining approval for a research proposal at Shahid Gangalal National Heart Centre.
See template
See template
Shannon Center Membership Form
PDF template
Membership registration and liability waiver for the Shannon Center at Saint Xavier University fitness facility
See template
See template
DA 325 Shared Leave Request Form
PDF template
A form for state employees to request shared leave benefits for serious medical conditions affecting themselves or family members.
See template
See template
Shared Leave Request Form
PDF template
A form for City of Tacoma employees to request shared leave due to severe illness, injury, or medical condition that has exhausted their accrued leave.
See template
See template
UF Student Health Care Center (SHCC) Exposure Ordering Form
PDF template
Medical form for ordering laboratory tests following potential blood-borne pathogen exposure for UF employees and students
See template
See template
PARK AND REC FACILITY RENTAL REQUEST FORM 2022
PDF template
Rental form for reserving park and recreation facilities in La Pointe, Wisconsin with fee and deposit details.
See template
See template
Park And Rec Facility Rental Request Form 2024
PDF template
A rental request form for the Big Bay Town Park Pavilion in La Pointe, Wisconsin, with details about fees, deposits, and rental requirements.
See template
See template
MIT Student Health Insurance Plan Enrollment Form
PDF template
Comprehensive health insurance enrollment form for MIT students covering individual and family coverage options
See template
See template
INTERNATIONAL HEALTH SERVICE SHIPPING FORM
PDF template
A form for documenting and shipping medical and personal supplies for International Health Service logistics
See template
See template
Instructions For Shipping Samples For Porphyria Testing
PDF template
Comprehensive instructions for collecting, processing, and shipping blood and urine samples for porphyria laboratory testing at the University of Texas Medical Branch.
See template
See template
SHOE MODIFICATION ORDER FORM
PDF template
A detailed form for ordering customized shoe modifications for patients with specific medical needs or conditions.
See template
See template
4 H Shooting Sports Competition Entry Form
PDF template
Official entry form for 4-H youth to register for various shooting sports competition disciplines and classes.
See template
See template
In Case Of Emergency Contact Form
PDF template
A form to be placed on a child's car seat with emergency contact and medical information for first responders.
See template
See template
Patient Intake Form
PDF template
Comprehensive medical intake form for chiropractic patients, collecting personal, employment, medical, and lifestyle information.
See template
See template
Granite School District Short Term Disability Claim Form
PDF template
A form for Granite School District employees to file a claim for short-term disability benefits, documenting medical condition and work absence details.
See template
See template
Granite School District Short Term Disability Claim Form
PDF template
A form for employees of Granite School District to file a claim for short-term disability benefits, detailing medical condition and leave requirements.
See template
See template
Short Term Disability Claim Form
PDF template
A policy document detailing short-term disability benefits for employees, including eligibility, compensation, and leave requirements.
See template
See template
Disability Claim For Accident Sickness (AS)Short Term Disability (STD)Salary Continuance
PDF template
A comprehensive form for filing a disability claim, including employer and employee information for accident, sickness, or short-term disability
See template
See template
Short Term Disability Income Claim Form
PDF template
A document used to file a claim for short-term disability benefits, requiring details from the employee, employer, and attending physician.
See template
See template
Short Term Disability Benefits Claim Form
PDF template
A claim form for supplemental short-term disability benefits for hospital staff, providing coverage for up to 26 weeks at 70% of basic weekly salary.
See template
See template
SHORT TERM DISABILITY BENEFITS CLAIM FORM
PDF template
Claim form for supplemental short-term disability benefits for hospital staff, providing up to 70% of weekly salary for up to 26 weeks.
See template
See template
Short Term Disability Leave Request Form
PDF template
A form for employees to request short-term disability leave, including tracking PTO and leave details.
See template
See template
School Based Supplemental Health Services Consent Form
PDF template
A comprehensive health information and consent form for students at Saint Martin de Porres High School, collecting medical history and insurance details.
See template
See template
School Based Supplemental Health Services Consent Form
PDF template
A comprehensive health information and consent form for students at Saint Martin de Porres High School, collecting medical history and insurance details.
See template
See template
Preparticipation Physical Evaluation Physical Examination Form
PDF template
Comprehensive medical evaluation form for athletes to assess physical fitness and health status prior to participation in sports activities.
See template
See template
Self Insurance Fund Rules And Regulations
PDF template
Comprehensive document outlining rules, regulations, and definitions for the Anne Arundel County Self-Insurance Fund.
See template
See template
Signatures On A Consent Form
PDF template
Document explaining signature procedures for consent forms in RSS, detailing changes effective February 2024.
See template
See template
Significant Change Proposal Form
PDF template
A form used to propose significant changes to graduate degree or graduate certificate program requirements at the University of Washington.
See template
See template
Specialist International Medical Graduate (SIMG) 2024 Application For Fellowship
PDF template
Application form for international medical graduates seeking fellowship with the Royal Australian and New Zealand College of Psychiatrists (RANZCP)
See template
See template
Catastrophic Leave Request Form
PDF template
Form for employees to request catastrophic leave of absence for personal or family medical reasons, in accordance with West Virginia state regulations.
See template
See template
District Employee Benefits Enrollment Form
PDF template
A comprehensive form for employees to enroll in medical, dental, vision, and life insurance benefits with detailed personal and dependent information.
See template
See template
SELF INSURED SERVICES COMPANY REIMBURSEMENT FORM
PDF template
A form for employees to submit medical expense claims for reimbursement through a self-insured employer benefit program.
See template
See template
Client Application Form
PDF template
Confidential client intake form for medical and contact information at a recovery center specializing in brain and spinal cord injury rehabilitation.
See template
See template
Personal Health History Form
PDF template
A comprehensive health form required for students participating in SIT Study Abroad programs, consisting of multiple parts to be completed by students and medical providers.
See template
See template
Supplementary Statement By Employer
PDF template
A form for employers to report outstanding death or disability claims related to workplace accidents.
See template
See template
Confidential Medical History
PDF template
Comprehensive medical form capturing patient's personal and family health history, with a specific focus on eye-related conditions and general health status.
See template
See template
Skate Park Acknowledgement, Waiver And Release Of Liability
PDF template
Legal document releasing the Town of River Bend from liability for risks associated with skateboarding at their skate park.
See template
See template
Conference Registration, Personal And Liability Release Form
PDF template
A comprehensive registration form for SkillsUSA conference participants, including personal details, emergency contact information, and liability release.
See template
See template
CONFERENCE REGISTRATION, PERSONAL AND LIABILITY RELEASE FORM
PDF template
Registration form for SkillsUSA conference participants, including personal information, division selection, and liability release.
See template
See template
SkillZone DIY Workshop Release And Liability Waiver Form
PDF template
A liability release form for participants in a DIY workshop, covering consent, safety acknowledgment, and media usage rights.
See template
See template
NFHS Medical Release Form For Wrestler To Participate With Skin Lesion(S)
PDF template
A medical release form for wrestlers with skin lesions, developed by the NFHS Sports Medicine Advisory Committee to provide guidelines for participation with skin conditions.
See template
See template
NFHS Medical Release Form For Wrestler To Participate With Skin Lesion(S)
PDF template
A standardized medical form developed by the National Federation of State High School Associations to manage skin lesions and communicable skin disorders in wrestling.
See template
See template
DIAANFHS Medical Release Form For Wrestler To Participate With Skin Lesion(S)
PDF template
A standardized medical release form for wrestlers with skin lesions, developed by the National Federation of State High School Associations to protect athletes and manage communicable skin disorders.
See template
See template
Skip Gorman Memorial Scholarship Application
PDF template
A scholarship program by the South Shore Soccer League for high school seniors who have been involved in soccer from age 12 through high school.
See template
See template
Perreard Professional Billing Insurance Form
PDF template
A medical billing form for collecting patient and insurance information for professional healthcare services.
See template
See template
Utah Surplus Line Submission Form
PDF template
Official form for filing insurance policies written by non-admitted insurers in Utah, including premium tax and regulatory compliance documentation.
See template
See template
MEDICAL HISTORY FORM
PDF template
Comprehensive medical form for collecting patient personal information, medical history, vaccination status, and surgical history.
See template
See template
Fluorochromes Slide Digitization Submission Form
PDF template
A form for submitting slides for digital scanning and imaging with details about project, contact information, and scanning specifications.
See template
See template
Emergency Contact And Medical Release
PDF template
A medical release and emergency contact form for participants in a service-learning program, allowing medical treatment authorization.
See template
See template
MISSISSIPPI DEPARTMENT OF INSURANCE ELIGIBLE NONADMITTED INSURANCE FORM
PDF template
A form for Mississippi licensed surplus lines insurance producers to document placement of insurance coverage with nonadmitted insurers and certify diligent effort.
See template
See template
Salt Lake Regional Medical Center Student Orientation Module
PDF template
Comprehensive orientation guide for healthcare students preparing for clinical placement at Salt Lake Regional Medical Center.
See template
See template
SLTD Premium Waiver Form
PDF template
Form to terminate a Supplemental Long Term Disability premium waiver when an employee returns to work.
See template
See template
Trapeze Experience Registration Agreement Form
PDF template
Registration and medical consent form for a flying trapeze course with participant medical information and liability release
See template
See template
Trapeze Experience Registration Agreement Form
PDF template
Registration and medical consent form for a flying trapeze course, including participant details, medical information, and image release
See template
See template
Form 2E Smallpox Case Household And Primary Contact Surveillance Form
PDF template
A CDC form for tracking and documenting household or primary contacts of a smallpox case, including daily temperature monitoring and contact information.
See template
See template
Surrey Minor Hockey Association Request For Refund
PDF template
Detailed policy outlining refund conditions and process for Surrey Minor Hockey Association registration fees.
See template
See template
DoctorS Examination Form
PDF template
Medical examination form to assess child's fitness for participating in a Soap Box Derby race.
See template
See template
Management Benefits Fund Superimposed Major Medical Plan (SMMP) Claim Form
PDF template
A comprehensive medical claim form for submitting healthcare expenses and patient information to the Management Benefits Fund insurance plan.
See template
See template
Umpire Feedback Form
PDF template
A form for collecting feedback about umpire performance, welcoming both positive and negative comments.
See template
See template
Request For Reinstatement Of Policy Contract
PDF template
A form used by insurance policyholders to request reinstatement of a previously lapsed insurance policy by providing updated health information.
See template
See template
Sierra Nevada Swimming Proposal For Hosting A Meet
PDF template
A proposal form for organizing a swimming competition under Sierra Nevada Swimming with various meet format options and guidelines.
See template
See template
Snow Fun YOUTH Informed Consent And Parental Consent Form
PDF template
A consent form for youth participation in Snow College's SnowFun courses and programs, requiring parent/guardian and participant signatures.
See template
See template
Vision Group Insurance Form
PDF template
A comprehensive form for submitting vision insurance claims, to be completed by employees and vision care providers.
See template
See template
REFERRAL FORM BARIATRIC SURGERY
PDF template
A comprehensive medical referral form for patients seeking bariatric surgery evaluation, detailing patient requirements and documentation needs.
See template
See template
Medical Form For US Programs
PDF template
Comprehensive medical form for Special Olympics athletes to document health information, conditions, and assistive needs.
See template
See template
Special Olympics Incident Report Form
PDF template
Comprehensive form for documenting accidents and injuries during Special Olympics events, capturing details about the injured person, incident, and witnesses.
See template
See template
Provider Nomination Form
PDF template
A form for members to recommend new dental or eye care providers to be added to Solstice Benefits' network.
See template
See template
Special Olympics MA Class A Volunteer Form
PDF template
A comprehensive volunteer application form for individuals 18 years or older seeking to volunteer with Special Olympics Massachusetts.
See template
See template
SOM Family Campaign Payroll Deduction Form
PDF template
Payroll deduction form for making charitable contributions to the School of Medicine Scholarship Campaign
See template
See template
Medical Authorization Request Form
PDF template
A comprehensive form for healthcare service authorization by insurance members, used for various medical service requests and approvals.
See template
See template
SoonerCare Health Risk Assessment
PDF template
A comprehensive medical assessment form collecting patient demographics, health status, family information, and medical conditions for SoonerCare patients.
See template
See template
Sleep Out Saturday 2018 Waiver
PDF template
Legal release and assumption of risk form for Sts. Joachim and Ann Care Service's Sleep Out Saturday event
See template
See template
VISION CLAIM FORM
PDF template
Insurance claim form for submitting vision-related medical service claims and patient information.
See template
See template
VISION CLAIM FORM
PDF template
A standard form for submitting vision insurance claims with patient and insurance details.
See template
See template
SPARK Waiver And Media Release Form (Required)
PDF template
A legal release form for participants in the University of Iowa's Space Physics and Astronomy Kamp, covering liability, risks, and media usage rights.
See template
See template
Sacroiliac Joint Injection Consent Form
PDF template
Medical consent form for sacroiliac joint injection procedure detailing treatment, risks, and patient acknowledgment.
See template
See template
DIVING MEDICAL HISTORY FORM
PDF template
A comprehensive medical history questionnaire designed to assess an individual's fitness for scuba diving and training programs.
See template
See template
Special Category Volunteer Medical Packet
PDF template
A comprehensive medical packet for volunteers detailing health screening and immunization requirements for special category volunteers at a healthcare facility.
See template
See template
Guarantee Trust Life Insurance Company Accident Insurance Enrollment
PDF template
Insurance enrollment form for accident coverage for special events, offering standard and deluxe policy options with varied rates and benefits.
See template
See template
Special Event Permit Insurance Requirements
PDF template
Guidelines for insurance documentation required for special event permits in Palm Beach County, detailing insurance certificate requirements and compliance standards.
See template
See template
PLATELET TEST REQUISITION FORM
PDF template
A comprehensive form for collecting patient information and requesting platelet-related laboratory testing at Cincinnati Children's Hospital Medical Center.
See template
See template
SPECIAL PROGRAM INCOME SUBMISSION FORM
PDF template
A form for tracking and reporting income from book sales for a special program.
See template
See template
Specialty Referral Form
PDF template
A medical referral form for patients being referred to a specialist within the Holston Medical Group network.
See template
See template
Specialty Care Referral Form
PDF template
A medical referral form for patients seeking specialized dental care at Creighton Dental Clinic.
See template
See template
Specialty Referral Form
PDF template
A medical referral form for specialty healthcare services, including periodontics and endodontics referrals.
See template
See template
Retiree Special EnrollmentWaiver Form
PDF template
A special enrollment form for NYC retirees to modify health benefits, Medicare plan, or prescription drug coverage for September 1, 2023.
See template
See template
Supply Order Form For Diagnostic Immunology Collection Kits
PDF template
Form for ordering diagnostic testing supply kits for blood, urine, and multi-test swab specimens from the West Virginia Department of Health Office of Laboratory Services.
See template
See template
PIN Specimen Inventory Form
PDF template
Laboratory documentation form for tracking and recording specimen details, storage locations, and collection information for research study specimens.
See template
See template
Exhibitor Appointed Contractor Form
PDF template
Form for exhibitors to designate a company other than the official contractor, requiring a certificate of insurance with specified coverage limits.
See template
See template
SPLASH ZONE BIRTHDAY PARTY RENTAL APPLICATION AND AGREEMENT
PDF template
Application and agreement for renting the Splash Zone facility for birthday party events with two package options.
See template
See template
Out Of State Tuition Waiver Application
PDF template
Application form for students seeking waiver of out-of-state tuition fees, typically for sport club members.
See template
See template
CLUB SPORTS EMERGENCY CONTACT FORM
PDF template
A comprehensive form for collecting personal, contact, and medical information for club sport participants at Kent State University.
See template
See template
Sports Hall Of Fame Nomination Form
PDF template
A form for nominating individuals to the Sports Hall of Fame at Northeast Mississippi Community College
See template
See template
SLU Sports Medicine Medical History Form
PDF template
Comprehensive medical history form for sports medicine patients documenting personal health details, injuries, and medical background.
See template
See template
Preparticipation Physical Evaluation (Interim Guidance) Physical Examination Form
PDF template
A comprehensive medical examination form for athletes or participants to assess physical fitness and health status before participating in sports or activities.
See template
See template
Sports Physical Examination Form
PDF template
Medical form required for student-athletes to participate in team sports, documenting medical history and fitness for athletic participation.
See template
See template
Sports Physical Health Examination Form
PDF template
A comprehensive medical history questionnaire for student athletes to assess health status and potential medical concerns prior to participating in sports.
See template
See template
Sports Registration Form
PDF template
Registration form for youth sports programs at North Weddington Recreation Center in Los Angeles
See template
See template
REGISTRATION FORM
PDF template
Registration and parental consent form for minors participating in a sports event at Lincoln Memorial University.
See template
See template
2022 2023 SportsWare Online Sign Up Instructions
PDF template
Step-by-step instructions for athletes to register and complete required forms in the SportsWare online system.
See template
See template
SportsWare Online Login Instructions
PDF template
Step-by-step instructions for accessing and setting up a login for the SportsWare Online Athlete Portal for WSU athletes.
See template
See template
Youth Individual Waiver Form
PDF template
Legal waiver form for youth participants in recreational sports leagues, covering liability and participation rules.
See template
See template
Spouse Disability Benefit Application Form
PDF template
Insurance claim form for spouse disability benefits, requiring comprehensive personal and medical information for claim assessment.
See template
See template
A Guide To Your Benefits From The Seafarers Pension Plan
PDF template
Comprehensive guide detailing pension benefits, eligibility, calculation, and application process for Seafarers Pension Plan participants.
See template
See template
Studio Art Class Income Based Scholarship Form
PDF template
Scholarship application for income-based financial aid for studio art classes at the Armory Center for the Arts.
See template
See template
SPRING 2019 Studio Fellowship Application Form
PDF template
Application form for artists seeking a studio fellowship at Spudnik Press Cooperative, requiring multiple document submissions and project details.
See template
See template
Harn Museum Of Art Internship Application Form
PDF template
Application form for students seeking internship opportunities at the University of Florida's Harn Museum of Art
See template
See template
SPRINGFIELD TOWNSHIP ATHLETIC FIELD PERMIT REQUEST
PDF template
A permit request form for athletic field usage in Springfield Township, detailing application process, eligibility, and priority scheduling.
See template
See template
Holmen Park Recreation Registration Form
PDF template
Registration form for Holmen Park & Recreation programs and aquatic center memberships for residents and non-residents
See template
See template
Georgia Structural Pest Control Insurance Certification Form
PDF template
Guidance and form for structural pest control companies in Georgia to submit their insurance certification and liability coverage details.
See template
See template
Substantive Policy Statement 15
PDF template
Policy guidelines by the Arizona Medical Board for establishing residency when applying for professional licensing under A.R.S. 32-4302.
See template
See template
Swampscott Public Schools EmergencyMedical Form
PDF template
A comprehensive form collecting student medical, contact, and emergency information for the school year 2018/2019.
See template
See template
Special Placement Volunteer Process
PDF template
Detailed process for recruiting, screening, and onboarding volunteer personnel at Upstate Medical University
See template
See template
Arkansas Motor Vehicle Accident Report (SR 1)
PDF template
Official form for reporting motor vehicle accidents involving property damage over $1,000 or bodily injury/death.
See template
See template
Strawberry Recreation District Rental Agreement, Waiver And Release
PDF template
A comprehensive form for renting facilities at Strawberry Recreation District, covering event details, facilities, and liability considerations.
See template
See template
Catastrophic Withdrawal Request Medical
PDF template
A form for students requesting withdrawal from classes due to serious medical circumstances that prevent course continuation.
See template
See template
Student Recreation And Wellness RU Outdoors Medical Screening Form
PDF template
Confidential medical screening form for students participating in outdoor recreational activities to ensure safety and assess participant health conditions.
See template
See template
Student Recreation And Wellness Center (SRWC) Membership Form
PDF template
A membership form for Washburn University's Student Recreation and Wellness Center, detailing membership options, rates, and participation release.
See template
See template
MEETINGCONVENTION ATTENDANCE FORM FOR STUDENTS
PDF template
A form for Pasco-Hernando State College students to document travel for meetings, conventions, or college-affiliated events with liability acknowledgment.
See template
See template
SSC 001C SUPP STATEMENT OF CLAIM FORM
PDF template
A comprehensive form for filing a group disability insurance claim, to be completed by the employee, employer, and healthcare provider.
See template
See template
AUCTION PROCUREMENT FORM
PDF template
Form for collecting donation details for the Seattle Sports Commission's annual auction event
See template
See template
List Of Additional Student Participants Form
PDF template
A form for documenting student participants, their details, and emergency contact information for university-sponsored travel activities.
See template
See template
Waiver Of Liability, Indemnification, And Medical Release FORM ST 2
PDF template
Legal document releasing Hennepin Technical College from liability for potential risks during sponsored activities or field trips.
See template
See template
ST. ALOYSIUS ACADEMY ATHLETICS PHYSICAL EXAMINATION FORM
PDF template
Confidential medical form for student-athletes to document health history and physical condition for participation in school sports.
See template
See template
STAFF VEHICLE REGISTRATION FORM
PDF template
A form for staff to register their personal vehicles with an employer's security office, capturing vehicle and insurance details.
See template
See template
Dental EnrollmentChangeWaiver Group Insurance Form
PDF template
A form for employees to enroll, change, or waive dental group insurance coverage with details about employee and dependent information.
See template
See template
Standard Equipment Request Form
PDF template
A form for requesting computer equipment and accessories for staff, faculty, and labs at an educational institution.
See template
See template
Standardized Application For Pathology Fellowships
PDF template
A comprehensive application form for medical professionals seeking specialized pathology fellowship training in various subspecialties.
See template
See template
Standardized Application For Pathology Fellowships
PDF template
Comprehensive application form for medical professionals seeking specialized pathology fellowship training in various subspecialties.
See template
See template
ORTHOPAEDIC SPINE INSTITUTE NEW PATIENT INTAKE FORM
PDF template
Comprehensive medical intake form for new patients experiencing spine-related pain or conditions, capturing detailed pain assessment and medical history.
See template
See template
Standardized Application For Pathology Fellowships
PDF template
Comprehensive application form for medical professionals seeking specialized pathology fellowship training
See template
See template
Standardized Application For Pediatric Pathology Fellowship
PDF template
Comprehensive application form for individuals seeking a pediatric pathology fellowship position, collecting personal, educational, and professional details.
See template
See template
Standardized Application For Pathology Fellowships
PDF template
Comprehensive application form for medical professionals seeking specialized pathology fellowship training across various subspecialties.
See template
See template
Standardized Application For Pathology Fellowships
PDF template
Comprehensive application form for physicians seeking specialized pathology fellowship training across multiple subspecialties.
See template
See template
Standard Notice And Consent Documents Under The No Surprises Act
PDF template
Official documents for providing notice and consent requirements for nonparticipating healthcare providers and facilities under the No Surprises Act.
See template
See template
Texas Standard Prior Authorization Request Form For Health Care Services
PDF template
Standard form for requesting healthcare service authorization in Texas, used by various healthcare plans and issuers.
See template
See template
Arizona Prior Authorization Form
PDF template
A comprehensive form for requesting healthcare service authorization from an insurance provider in Arizona.
See template
See template
USA Health Referral Form
PDF template
A comprehensive referral form for patient transfer and medical consultation between healthcare providers at USA Health University of South Alabama.
See template
See template
Release Of Claims
PDF template
A legal document releasing a party from liability related to a specific claim or incident, typically used to settle a disputed legal matter.
See template
See template
Volunteer Agreement, Release And Waiver Of Liability
PDF template
Legal document outlining volunteer responsibilities, risks, and liability release for Habitat for Humanity volunteers.
See template
See template
Standing Order Request Form
PDF template
A form for requesting specialized medical transportation services with scheduling and patient details for healthcare-related appointments.
See template
See template
Virginia Standing Order Request Form
PDF template
A form for requesting medical transportation services with detailed patient and trip information for Medicaid recipients.
See template
See template
Physician Referral Form
PDF template
Confidential form for referring children and adolescents for behavioral and developmental health services.
See template
See template
Statement Of Rights Disability Benefits Law
PDF template
Official document outlining employee rights for non-occupational disability benefits in New York State.
See template
See template
State Of Maryland Employee And Retiree Health And Welfare Benefits Program Health Assessment
PDF template
A comprehensive health survey for Maryland state employees and retirees to assess their current physical and mental health status.
See template
See template
Procedure And Filing Guidance For Approval Of Variable Text
PDF template
Guidelines for insurers on filing policy forms with variable material for approval by the Montana Department of Insurance.
See template
See template
Skills Competition Registration Form
PDF template
Registration form for a basketball skills competition involving team and individual shooting contests
See template
See template
STD 101C GROUP SHORT TERM DISABILITY (STD) CLAIM FORM
PDF template
A comprehensive form for employees to file a short-term disability claim, requiring detailed information about their medical condition and work status.
See template
See template
STD CASE REPORT FORM
PDF template
Official medical reporting form for documenting sexually transmitted disease cases and patient information in New Jersey.
See template
See template
Short Term Disability Claim Form Report Of Continued Disability
PDF template
A form for participants to report ongoing short-term disability and provide medical update information for continued claim processing.
See template
See template
Disability Claims Accident Sickness (AS)Short Term Disability (STD)Salary Continuance
PDF template
A comprehensive form for filing disability claims, including sections for employer, employee, and physician/provider information.
See template
See template
Guardian Life Short Term Disability (STD) Claim Form
PDF template
A comprehensive form for employees to file a short-term disability insurance claim with detailed personal and medical information.
See template
See template
Your Disability Benefit Claim
PDF template
Comprehensive guide and forms for applying for disability insurance benefits through Standard Insurance Company.
See template
See template
Short Term Disability Claim Form Statement Of Employee
PDF template
A comprehensive form for employees to file a short-term disability claim, providing personal, employment, and medical information.
See template
See template
Granite School District Short Term Disability Claim Form
PDF template
A form for employees of Granite School District to file a claim for short-term disability benefits, detailing the nature of disability and employment information.
See template
See template
Disability Claim For Accident SicknessShort Term DisabilitySalary Continuance
PDF template
An employer-completed form for filing a disability insurance claim covering accident, sickness, and short-term disability benefits.
See template
See template
Short Term Disability Claim Form Statement Of Employer
PDF template
A form for employers to submit details about an employee's short-term disability claim, including employment information and income details.
See template
See template
Short Term Disability Claim Form Physician Statement
PDF template
A medical form for physicians to document a patient's disability claim details for Anthem Life Insurance Company.
See template
See template
Short Term Disability Claim Process
PDF template
Comprehensive guide for filing a short-term disability claim with USAble Life, detailing submission steps, claim phases, and contact information.
See template
See template
Camp Liability And Medical Release Form
PDF template
A comprehensive liability and medical release form for camp participants, covering medical treatment, property damage, and media usage consent.
See template
See template
Sterilization Consent Form Notice
PDF template
Notice to physician providers about updated sterilization consent form requirements and availability.
See template
See template
St Gabriel CYO Refund Policy
PDF template
Policy detailing circumstances under which refunds are granted for Catholic Youth Organization sports registration.
See template
See template
PATIENT INFORMATION AND MEDICAL RELEASE FORM (FORM I)
PDF template
A comprehensive form for collecting patient insurance details, medical authorization, and payment responsibility for Bioness Inc.
See template
See template
St. Jude Affiliate Clinic Referral Form
PDF template
A referral form for patients seeking medical consultation at St. Jude Affiliate Clinic at Huntsville Hospital for Women and Children
See template
See template
HCO Grant Application Form
PDF template
A form for healthcare organizations to request educational support grants from Astellas for healthcare professionals to attend scientific congresses.
See template
See template
Consent To Treat Form
PDF template
A legal document allowing healthcare providers to treat a patient and use their protected health information for treatment and operational purposes.
See template
See template
St. PaulS Episcopal School Medical Examination Form
PDF template
A comprehensive medical examination form for students at St. Paul's Episcopal School, requiring physician documentation of student's health status and immunization records.
See template
See template
Stryker Benefits Summary
PDF template
Comprehensive benefits summary for Stryker employees, including location-specific healthcare provisions and insurance options.
See template
See template
HistologyImmunohistochemistry Laboratory Requisition
PDF template
A medical laboratory form for submitting tissue specimens for histological and immunohistochemical analysis.
See template
See template
DAMAGE REPORT FORM
PDF template
A form used to document and assess property damage, including structural and utility damage details.
See template
See template
STUDENT ACCIDENT REPORT FORM
PDF template
A comprehensive form documenting details of a student accident, including location, injury specifics, and immediate actions taken.
See template
See template
Student Activity Liability Waiver Form
PDF template
A legal document that releases Whitworth University from liability for student activities, projects, and travel, requiring voluntary participant acknowledgment of risks.
See template
See template
Risk Assessment Guide And Information Manual For Student Activities And Clubs
PDF template
A comprehensive manual for identifying and managing risks associated with student organizations and activities at Chapman University.
See template
See template
Student Activity Or Club Release And Waiver Of Liability, Assumption Of Risk And Indemnity Agreement
PDF template
A legal document allowing students to participate in university activities by acknowledging and accepting potential risks and liability terms.
See template
See template
STUDENTVISITOR WAIVER FORM
PDF template
A waiver form for students and visitors at Pennsylvania State University and Penn State Milton S. Hershey Medical Center, detailing liability and workers' compensation terms.
See template
See template
Virtual Student Art Exhibition Entry Form
PDF template
Entry form for students to submit artwork for the 39th Annual Robert T. Wright Community Gallery of Art Virtual Student Art Exhibition.
See template
See template
Student Art Competition Entry Form
PDF template
Entry form for student art competition at Polk State College with submission guidelines and exhibition details.
See template
See template
Student Art Inventory Form Storage And Transport For Exhibits
PDF template
A form for documenting and tracking student artwork details for storage and transportation prior to exhibit.
See template
See template
Preparticipation Evaluation History Form
PDF template
Comprehensive medical history and health screening form for athletes prior to sports participation.
See template
See template
Change Of Attendance Form
PDF template
Form for students to request changes to their program attendance or cancellation with specific policy requirements.
See template
See template
Student Device Program
PDF template
Guidelines for student device issuance and management of Microsoft Surface Pro devices provided to students for educational purposes.
See template
See template
Student Waiver For Educational Cultural Trips
PDF template
Waiver form for students participating in university-sponsored off-campus events, acknowledging personal liability and trip details.
See template
See template
Student Field Trip Insurance
PDF template
Insurance coverage form for students participating in university-sponsored field trips with details about insurance benefits and trip information.
See template
See template
Student Medical Information And Emergency Notification Form
PDF template
A medical information and emergency contact form for student participants in regional science competitions.
See template
See template
STUDENT HEALTH EXAMINATION FORM
PDF template
A comprehensive health form for students entering kindergarten, fifth, and ninth grades requiring physical and dental examination documentation.
See template
See template
Confidential Student Health HistoryExamination Form
PDF template
Comprehensive medical and health background documentation for school-aged children, completed by parents/guardians and medical practitioners.
See template
See template
Student Incident Report Form
PDF template
A form to document student incidents, exposures, and potential infectious disease or environmental hazards in clinical settings.
See template
See template
Disability VerificationMedical Release Form
PDF template
Medical form for students with disabilities enrolling in Adapted Physical Education and Aquatics courses at Citrus College.
See template
See template
PENNSYLVANIA MUSIC EDUCATORS ASSOCIATION STUDENT MEDICAL INFORMATION FORM
PDF template
Comprehensive medical form for students participating in music education events, collecting critical health and emergency contact information.
See template
See template
Student Health Information Form
PDF template
Comprehensive form collecting student health details, medical needs, allergies, and contact information for school or event purposes.
See template
See template
Student Medical Form
PDF template
Confidential medical form for students in nursing and allied health programs, requiring personal health history, immunization records, and physical exam documentation.
See template
See template
Student Medical Form
PDF template
Annual medical form for students to document health history, screenings, and physician certification for school participation.
See template
See template
Marymount University Student Medical Form
PDF template
Comprehensive medical form outlining immunization requirements and health insurance mandates for Marymount University students
See template
See template
Student Medical Form For Programs That Require Health Forms
PDF template
Medical form required for students in health science programs to participate in clinical experiences, detailing health status and immunization requirements.
See template
See template
Student Medical Form For Programs That Require Health Forms
PDF template
Required medical form for students in health science programs to verify physical and emotional capability for clinical experiences.
See template
See template
Student Medical History Form
PDF template
A comprehensive medical form for collecting student health information, medical history, and parental consent for medical treatment.
See template
See template
Eagle Bluff Student Medical Information And Permission Form
PDF template
A comprehensive medical form for student participation in Eagle Bluff activities, collecting health details and medication information.
See template
See template
Health Form Requirement Checklist
PDF template
Comprehensive health form checklist for students at Packer, detailing required documentation and submission process for medical records.
See template
See template
LAREDO COLLEGE STUDENT ORGANIZATION TRAVEL FORM
PDF template
A form for documenting student group travel details, participants, and emergency contact information.
See template
See template
Release And Waiver Of Liability, Assumption Of Risk And Indemnity Agreement
PDF template
Legal document releasing La Crosse Area Builders Association from liability during a construction career showcase and interactive event.
See template
See template
STUDENT PETITION MEDICAL SUPPORT FORM
PDF template
A form for students to request grade or course removal based on medical conditions affecting academic performance.
See template
See template
Physical Examination Form
PDF template
Medical examination form for students to document health status and medical clearance for participation in health career or athletic programs.
See template
See template
PREVENTATIVE HEALTH CARE EXAMINATION FORM
PDF template
Comprehensive health examination form for students entering Kentucky public schools, documenting medical history, immunizations, and screening results.
See template
See template
Student Profile Vehicle Registration Parking Waiver
PDF template
A comprehensive form for students to register their vehicle, provide medical information, and potentially waive parking fees at their educational institution.
See template
See template
Description Of Student Duties And Medical Release Form
PDF template
Medical release form for Hennepin Technical College emergency service course students detailing physical requirements and health clearance.
See template
See template
StudentS Medical History
PDF template
A comprehensive medical history form required for new students at the University of Montevallo, collecting personal and health information.
See template
See template
STUDENT TRANSPORTATION FORM
PDF template
A form authorizing and documenting driver eligibility and vehicle details for student transportation by employees, parents, or volunteers.
See template
See template
Student Group Travel Insurance Form
PDF template
Form for documenting and calculating insurance charges for student group travel at the University of Arkansas.
See template
See template
Participation And Self Transportation Agreement Release And Waiver Of Liability Assumption Of Risk A
PDF template
Legal document for participants to acknowledge risks, waive liability, and provide consent for university-related activities and transportation.
See template
See template
Seton Hall University Off Campus Activity Student Voluntary Participation Waiver And Release And Eme
PDF template
A legal waiver for students participating in off-campus university activities, outlining risks, responsibilities, and release of liability.
See template
See template
Student Volunteer Application Form
PDF template
A comprehensive application form for students interested in volunteering for a research team, particularly in medical or healthcare-related fields.
See template
See template
Studio88 Artist Residency Application Form
PDF template
Application form for artists seeking residency at Studio'88, with options for one to three month stays.
See template
See template
Studio 88 Artist Residency Application Form
PDF template
Application form for artists seeking a residency opportunity at Studio 88 in Chiangmai, Thailand.
See template
See template
Country Home Learning Art Center Birthday Party
PDF template
Details and guidelines for hosting birthday parties at Country Home Learning & Art Center with art, clay, and glass projects.
See template
See template
Parental Consent For Medical Treatment
PDF template
A comprehensive form for parents to provide medical information and consent for their child's medical treatment when parents are not immediately available.
See template
See template
MEDICAL RELEASE FORM
PDF template
A medical consent form allowing treatment of a minor child in the absence of a parent or guardian, with space for medical and contact information.
See template
See template
Diversity Art Exhibit Submission Form
PDF template
Form for artists to submit artwork details for a diversity-themed art exhibit, including personal contact information and artwork details.
See template
See template
CITY OF LOS ANGELES INSTRUCTIONS AND INFORMATION ON COMPLYING WITH CITY INSURANCE REQUIREMENTS
PDF template
Instructions for contractors on submitting insurance documentation to the City of Los Angeles and meeting insurance requirements for city contracts.
See template
See template
Suburban Municipal Joint Insurance Fund Policies Procedures Manual
PDF template
Comprehensive policy manual for a municipal joint insurance fund detailing operational guidelines and regulatory compliance in New Jersey.
See template
See template
Subscriber Claim Form
PDF template
Insurance claim form for submitting medical service bills to Blue Cross Blue Shield of Massachusetts for reimbursement.
See template
See template
Subscriber Claim Form
PDF template
A comprehensive form for submitting medical insurance claims to Blue Cross Blue Shield of Massachusetts for reimbursement of healthcare services.
See template
See template
Success Center Enrollment Form
PDF template
Form for students to enroll in Credit Recovery/Accrual Program at Tulsa Tech for the 2024-25 school year.
See template
See template
Pediatric Sudden Cardiac Death Risk Assessment Form
PDF template
A comprehensive screening form to assess potential cardiac risks in children by examining patient and family medical history related to heart conditions.
See template
See template
Studio Fellowship Application Form
PDF template
Application form for artists seeking a studio fellowship program at Spudnik Press, requiring multiple submission materials and project details.
See template
See template
SUGGESTED REFILL REQUEST FORM
PDF template
Form for requesting refills of medical equipment with patient and supplier information verification.
See template
See template
Summer 2022 Youth Arts Technology Program Medical Release Form
PDF template
Medical release form for children participating in summer arts technology program at Westchester Community College
See template
See template
Summary Of Benefits And Coverage
PDF template
A comprehensive healthcare plan offering flexible enrollment and holistic health coverage options with traditional and alternative treatment approaches.
See template
See template
Summer 2024 Field Trip Waivers
PDF template
Legal waiver for parents/guardians consenting to children's field trips to Chicago Dogs Baseball Game and Wheeling Aquatic Center.
See template
See template
2020 Lorado Taft Day Camp Parental Consent Form And Waiver Of Liability Agreement
PDF template
Parental consent form for children participating in the Lorado Taft Day Camp, including medical authorization and camp guidelines.
See template
See template
Summer CampConferences Policies And Procedures 2020
PDF template
Comprehensive guidelines for summer camps and conferences hosted at Clark Atlanta University, covering legal compliance, conduct, and administrative requirements.
See template
See template
Medical Release Form
PDF template
Medical authorization form for minors participating in county recreation programs, allowing emergency medical treatment and releasing liability.
See template
See template
Summer In The Son 2024 Camp Registration
PDF template
Summer camp registration form for students entering Kindergarten through 6th grade, hosted by Christian Academy of Laurel.
See template
See template
Taylor University Summer Camp Participation Waiver, Release Of Liability And Medical Authorization A
PDF template
Legal document waiving liability and authorizing medical treatment for participants in Taylor University Summer Camp.
See template
See template
Waiver, Indemnification, And Media Release Form
PDF template
Legal document releasing Houston Christian University from liability for potential injuries during event participation.
See template
See template
Child Physical Examination Form
PDF template
Medical form documenting a child's physical health, immunization history, and medical examination details for academic summer school programs.
See template
See template
MEDICAL FORM 2018 SUMMER PROGRAMS
PDF template
A comprehensive medical form for participants registering for summer youth programs, collecting personal, emergency contact, and health information.
See template
See template
2019 Summer Recreation Program
PDF template
Summer day program for children in Trumansburg, offering daycare, playschool, swim bus, and various activities for school-aged children.
See template
See template
SFK OSC Registration Chappelle SUMMER 2021
PDF template
Registration form for children's summer program with medical and emergency contact information
See template
See template
Y Summer Sports Parent Handbook
PDF template
A comprehensive guide for parents about the YMCA's summer sports program for children in grades 1-6, covering program details, policies, and expectations.
See template
See template
Sound To Sea Day Camp Medical Form
PDF template
Comprehensive medical form for children attending day camp, collecting health history, emergency contacts, and medical information.
See template
See template
Champaign Park District 2023 Summer Youth Programs Parent And Participant Handbook
PDF template
A comprehensive guide to summer youth programs offered by the Champaign Park District, covering policies, procedures, and program details.
See template
See template
Summit Orthopaedics Patient Intake Form
PDF template
Comprehensive medical intake form for patients seeking orthopaedic care, collecting personal, medical, and injury-related information.
See template
See template
Patient Information And Insurance Form
PDF template
A comprehensive form for collecting patient personal information, contact preferences, and insurance details for the Advancing Access program.
See template
See template
Sun Life Financial Underwriting Evidence Guide
PDF template
A comprehensive reference for field underwriting and case submission for insurance producers, providing guidelines for submitting insurance cases to Sun Life Financial.
See template
See template
APPLICATION FOR NEUROLOGY SUBSPECIALTY FELLOWSHIP
PDF template
A comprehensive application form for medical professionals seeking subspecialty fellowship training in neurology tracks such as Clinical Neurophysiology and Vascular Neurology.
See template
See template
PROVIDER NOMINATION FORM
PDF template
Form for recommending healthcare providers to be considered for the Superior Vision Plan Preferred Provider Panel.
See template
See template
SupervisorS Incident Report Instructions
PDF template
Comprehensive instructions for supervisors on documenting and reporting workplace incidents across various categories of liability.
See template
See template
Stand Up Paddleboard And Kayak Rental Agreement Form
PDF template
Rental agreement for stand up paddleboards and kayaks, outlining rental terms, equipment responsibility, and safety requirements.
See template
See template
ILWU PMA Welfare Plan Supplemental CSDI Disability Claim Form
PDF template
A comprehensive disability claim form for ILWU-PMA Welfare Plan members to report disability details and seek benefits.
See template
See template
WPHL Supply Order Form
PDF template
Order form for laboratory requisition forms, collection kits, individual components, mailers, and outbreak supplies from Wyoming Public Health Laboratory.
See template
See template
Dependent Care Reimbursements
PDF template
A guide explaining IRS requirements and reimbursement methods for dependent care expenses through Surency Flex.
See template
See template
SURGE Detroit River Agreement For Release Of Liability, Assumption Of Risk, And Indemnification
PDF template
A comprehensive liability release form for participants in SURGE event activities involving boat and maritime-related experiences.
See template
See template
Surgery Scheduling Cancellation Request
PDF template
A medical form used to request cancellation of a previously scheduled surgical procedure at a healthcare facility.
See template
See template
Pathology Requisition (Surgical And Non GYN)
PDF template
A comprehensive medical form for submitting surgical and non-gynecological pathology specimens for laboratory analysis and diagnostic evaluation.
See template
See template
Veterinary Diagnostic Center Surgical Pathology Submission Form
PDF template
A detailed submission form for veterinary surgical pathology specimens and diagnostic testing.
See template
See template
SURF SIMULATOR RELEASE OF LIABILITY, WAIVER OF CLAIMS, EXPRESS ASSUMPTION OF RISK AND INDEMNITY AGRE
PDF template
A legal document releasing liability for participants using a surf simulator, outlining potential risks and participant acknowledgment.
See template
See template
Request For Proposal IT Staff Enrichment Solutions
PDF template
A request for proposal for IT staff enrichment solutions issued by SURS, seeking vendor proposals for staffing and training services.
See template
See template
HEALTH HISTORY MEDICAL FORM
PDF template
Comprehensive medical history and fitness form for assessing participant health and potential medical concerns for outdoor activities.
See template
See template
University Of South Carolina School Of Visual Art And Design (SVAD) Scholarship Application
PDF template
Scholarship application for undergraduate students in Studio Art, Media Arts, Art Education, and Art History at the University of South Carolina.
See template
See template
Member Reimbursement Claim Form
PDF template
A form for submitting claims for vision services from out-of-network providers or in-store promotions through Superior Vision.
See template
See template
McCrackenS Gymnastics Sweetheart Meet Competition Entry Form
PDF template
Entry form for gymnasts to register for McCracken's Gymnastics Sweetheart Invitational competition with team and individual competitor details.
See template
See template
Swimmer Registration Form
PDF template
Registration form for Mississippi State University's Adapted Swim Camp for swimmers with disabilities, designed for participants aged 3 and above.
See template
See template
Swimming Pool Waiver And Release Of Liability Form
PDF template
A legal document that releases property owners from liability for risks associated with swimming pool usage during a vacation stay.
See template
See template
SWIM Access To Care Print Booking Form Quick Reference Guide
PDF template
A step-by-step guide for printing a booking form from the Provider's Office module in the SWIM healthcare system.
See template
See template
Self Declaration Form
PDF template
A form for volunteers to declare any criminal history and acknowledge liability waivers for Kamehameha Schools.
See template
See template
PRLS 191 002 SNOWBOARDING
PDF template
A university course teaching basic snowboarding skills, techniques, and safety through lecture and field experience.
See template
See template
SYMPTOM SURVEY FORM
PDF template
A comprehensive form for patients to self-report medical symptoms across multiple health categories with severity levels.
See template
See template
Symptom Survey
PDF template
A detailed medical form tracking patient symptoms across multiple body regions including neurological, musculoskeletal, and pain indicators.
See template
See template
SYNAGIS CONNECT Patient And Prescriber Information Form
PDF template
Medical form for patient and prescriber information to support prescription and reimbursement for SYNAGIS (palivizumab) medication
See template
See template
Universal Referral Form
PDF template
A comprehensive medical referral form for specialty pharmacy services, collecting patient, insurance, and medical criteria information.
See template
See template
SRC Summer Youth Recreation Program REGISTRATION FORM
PDF template
Comprehensive registration form for children's summer recreation program, collecting personal, health, and interest information.
See template
See template
Risk Assessment Form
PDF template
A comprehensive form for documenting and assessing potential risks across various operational areas of the Texas A&M University System.
See template
See template
Texas AM University System Risk Management And Insurance Matrix
PDF template
A comprehensive tool for identifying, assessing, and managing potential risks associated with university activities and events.
See template
See template
Texas AM University System Risk Management And Insurance Matrix
PDF template
A comprehensive matrix for identifying, evaluating, and managing potential risks associated with university activities and events.
See template
See template
SYSTEMS SURVEY FORM
PDF template
A comprehensive medical survey form documenting patient symptoms, physiological responses, and health indicators across multiple body systems.
See template
See template
SYSTEMS SURVEY FORM
PDF template
Comprehensive medical symptoms survey covering multiple physiological systems and health indicators
See template
See template
Travel Release Form
PDF template
A legal document releasing Texas State University from liability for potential injuries or damages during university-sponsored travel.
See template
See template
Incident And Accident Report Form
PDF template
A comprehensive form for documenting accidents or incidents during sports activities, including details of the injury and actions taken.
See template
See template
TELLURIDE ACADEMY ACKNOWLEDGMENT AND ASSUMPTION OF RISKS RELEASE AND INDEMNITY AGREEMENT
PDF template
Comprehensive risk acknowledgment and liability release document for adult and minor participants in Telluride Academy activities
See template
See template
2017 ParentS Guide To Health Services At Taft
PDF template
A comprehensive guide for parents outlining health services and medical resources available at Taft School's Martin Health Center.
See template
See template
Team America Insurance Form
PDF template
Insurance coverage form for Team America rocket team participants to provide evidence of insurance for launch site owners and sponsors.
See template
See template
Take Charge Attendance Form
PDF template
A form for tracking participant attendance and details for health-related workshops with multiple program options.
See template
See template
The Adolescent Leadership Council Contact Form
PDF template
A form for collecting contact information and medical details for adolescent participants in a leadership program
See template
See template
Art Program Talent Grant Application Form
PDF template
Application form for students seeking talent grants in the University of Louisiana Monroe's Art Program, offering up to $500 per semester.
See template
See template
WAIVER, INDEMNIFICATION, AND MEDICAL TREATMENT AUTHORIZATION FORM
PDF template
Legal document releasing TAMIU Rec Sports Department from liability during recreational activities and authorizing potential medical treatment.
See template
See template
WAIVER, INDEMNIFICATION, AND MEDICAL TREATMENT AUTHORIZATION FORM
PDF template
Legal document releasing liability for participation in recreational activities at Texas A&M International University.
See template
See template
PREPARTICIPATION PHYSICAL EVALUATION MEDICAL HISTORY
PDF template
Annual medical history form for students participating in TAPPS athletic activities to assess potential health risks.
See template
See template
PREPARTICIPATION PHYSICAL EVALUATION MEDICAL HISTORY
PDF template
Annual medical history form for students to participate in athletic activities, designed to identify potential health risks.
See template
See template
Preparticipation Physical Evaluation
PDF template
Medical examination form required for high school athletic participation in Texas private and parochial schools
See template
See template
TARC3 Medical Form (Cognitive Limitations Or Psychological Conditions)
PDF template
A medical form used to evaluate an applicant's cognitive abilities and capacity to safely use public transportation services.
See template
See template
TARC3 Medical Form (General Medical Or Physical Disability)
PDF template
Medical form for assessing an individual's ability to safely use public transportation, completed by a healthcare professional.
See template
See template
United States Fire Insurance Company Notice
PDF template
Insurance claim form for reporting accidents or injuries involving sports officials, with fraud warning and reporting requirements.
See template
See template
Hospital Discharge Approval Request Form
PDF template
A medical form used by the New York City Department of Health and Mental Hygiene to process and approve hospital discharges for tuberculosis patients.
See template
See template
Current Report TRANSILVANIA BROKER DE ASIGURARE S.A.
PDF template
Official report documenting an Extraordinary General Meeting of Shareholders for TRANSILVANIA BROKER DE ASIGURARE S.A. on October 23, 2024.
See template
See template
Tuberculosis Risk Assessment Form (Required)
PDF template
Medical form for screening tuberculosis risk through history, symptoms, and exposure assessment
See template
See template
TUBERCULOSIS RISK ASSESSMENT FORM
PDF template
A comprehensive screening form to assess an individual's risk of tuberculosis based on contact history and travel to high-incidence countries.
See template
See template
Tuberculosis (TB) Screening Questionnaire
PDF template
A screening questionnaire for students to assess tuberculosis risk factors, required by Barton Community College for enrollment.
See template
See template
Tuberculosis Screening Form
PDF template
Medical screening form for tuberculosis risk assessment for students or employees requiring TB testing or chest x-ray.
See template
See template
Tournament Income And Expense Form
PDF template
A detailed Excel workbook for tracking tournament financial information, including budget projection and final financial statement.
See template
See template
Tournament Safety Plan Form
PDF template
A comprehensive form for tournament safety directors to document safety and risk management plans for an AYSO tournament.
See template
See template
Accident Waiver And Release Of Liability Form
PDF template
A legal document releasing liability for participants in an outdoor service event, acknowledging risks and waiving potential claims.
See template
See template
Accident Report Form
PDF template
Comprehensive form for documenting details of a vehicle accident, including driver, vehicle, and incident information.
See template
See template
Form TDI 22
PDF template
Instructions for filing annual reports for temporary disability insurance plans in Hawaii, detailing reporting responsibilities for different types of employers and insurance carriers.
See template
See template
TechNET IT Timesheet Portal Guide
PDF template
A comprehensive guide for using TechNET's online timesheet submission and tracking portal for employees.
See template
See template
Young Technology Scholar Award Application
PDF template
Scholarship award for high school seniors in Utah demonstrating technology skills and leadership in computer information technology courses.
See template
See template
Liability Release, Waiver, And Indemnity Agreement For Personal Computer Support Services
PDF template
A legal agreement outlining terms and conditions for computer support services provided by American University's Office of Information Technology.
See template
See template
Teen Center Membership Registration Form
PDF template
Registration form for teens to join the Santee Teen Center recreational program with parental consent and payment details.
See template
See template
TEEX Firefighter Recruit Academy Medical Release Form
PDF template
A comprehensive medical form for firefighter recruits to document health history and current medical status prior to academy enrollment.
See template
See template
Travel Form
PDF template
Medical form for patients seeking travel health advice and vaccination recommendations before international travel.
See template
See template
Liability Release, Waiver, Indemnity, And Service Level Agreement For Personal Computer Support Serv
PDF template
A legal document outlining the terms and conditions for Southern Oregon University's IT support services for personal computers
See template
See template
Registration Form
PDF template
Comprehensive form for collecting patient and guardian information, emergency contacts, and insurance details for pediatric patients
See template
See template
Telephone Change Request Form
PDF template
Form for modifying existing telephone settings or requesting changes to phone services at Bergen Community College.
See template
See template
Short Term Temporary Disability Benefits
PDF template
Policy describing temporary disability benefits for non-union employees of the Diocese of Camden, outlining eligibility requirements and benefit calculations.
See template
See template
Consent Form Template For Field Trip (If Participant Is Under 18 Years Old)
PDF template
A comprehensive consent and liability waiver form for minors participating in a field trip, covering medical consent, liability release, and promotional rights.
See template
See template
YOUTH JUNIOR VOLLEYBALL PLAYER MEDICAL RELEASE FORM
PDF template
A medical release form for youth and junior volleyball players, collecting essential medical information and emergency contact details.
See template
See template
Inbuilt Temporary Incapacity Benefits For Defined Benefit Division Members
PDF template
Detailed guide explaining temporary incapacity benefits for Defined Benefit Division members, including eligibility requirements and claim process.
See template
See template
Temporary Permanent Disability Claim Form
PDF template
A comprehensive insurance claim form for temporary and permanent disability claims, to be completed by the policyholder and employer.
See template
See template
Tenant Welcome Package
PDF template
A comprehensive welcome document for new tenants with contact information, emergency instructions, and insurance requirements.
See template
See template
TENANT WELCOME PACKAGE
PDF template
Comprehensive guide for new tenants with property management contact information, emergency procedures, and insurance requirements.
See template
See template
Tennis Purchase Form
PDF template
Application form for purchasing tennis permits and additional play options at Central Park and Prospect Park tennis facilities.
See template
See template
Term Owner And Policy Change Form
PDF template
A form used to change policy ownership, address, or legal name for insurance policies issued by Fidelity Investments Life Insurance Company.
See template
See template
Standard Term And Conditions Of Rental
PDF template
Comprehensive legal document outlining definitions, conditions, and responsibilities for vehicle rental agreements.
See template
See template
Psychological Testing Referral Form
PDF template
A comprehensive form for requesting psychological testing and evaluations for patients of all ages, including patient and insurance information.
See template
See template
Outreach Services Test Requisition
PDF template
Medical test requisition form for pathology and laboratory testing at MD Anderson Cancer Center with multiple diagnostic testing options.
See template
See template
Sample Discharge Form
PDF template
A comprehensive form for tracking a shelter guest's health status, medical needs, and transportation requirements during evacuation or return.
See template
See template
Tick Submission Form
PDF template
Official form for submitting ticks found on human hosts for medical testing and investigation by the Texas Department of State Health Services.
See template
See template
Tick Submission Form
PDF template
Official form for submitting human-extracted ticks for medical testing and investigation by state health services.
See template
See template
NEW PATIENT INTAKE FORM
PDF template
Comprehensive medical intake form for new patients, collecting personal health information, symptoms, and medical history for Dr. William S. Crawford.
See template
See template
DentalOptical Benefit Application Form
PDF template
Application form for claiming dental and optical benefits through the Transport Friendly Society, requiring detailed expense and payment information.
See template
See template
Osteopathic Benefit Application Form
PDF template
Application form for claiming osteopathic treatment benefits, specifically for members of the Transport Friendly Society who joined prior to 1996.
See template
See template
Student Handbook
PDF template
Comprehensive guide outlining policies, processes, roles, and resources for students participating in a specific program.
See template
See template
The 44th Othello Meijin Sen Registration Agreement Form
PDF template
Registration form and consent agreement for participants in the 44th Othello Meijin-sen tournament, covering personal information usage and media rights.
See template
See template
Student Medical Form
PDF template
A medical form for collecting student health information, emergency contacts, and medical permissions for Ocala Civic Theatre
See template
See template
Determination The Appellants V Gymnastics Australia
PDF template
A legal determination regarding the non-selection of gymnasts for the World Age Group Competition & Junior World Championships.
See template
See template
Determination The Appellants V Gymnastics Australia
PDF template
A legal determination regarding the non-selection of gymnasts for the World Age Group Competition & Junior World Championships.
See template
See template
Partnership Inquiry Form
PDF template
A form for faculty, staff, students, and community members to propose collaborative programs and request co-sponsor funding from the Forum for Scholars and Publics.
See template
See template
ENROLLMENT FORM
PDF template
Comprehensive enrollment form for employees to select insurance and benefits options through The Hartford.
See template
See template
The Meadows Sports Complex Rental Policy
PDF template
Policy detailing rules and procedures for renting athletic fields at The Meadows Sports Complex in the Town of Abingdon.
See template
See template
The Meadows Sports Complex Rental Policy
PDF template
Policy detailing rules and procedures for renting athletic fields at The Meadows Sports Complex in the Town of Abingdon.
See template
See template
Theme Housing Program Attendance Form
PDF template
A form used to track attendance for Theme Housing programs by residents in a housing facility.
See template
See template
PRESCRIPTION REFERRAL FORM
PDF template
A comprehensive medical form for referring patients to various physical, occupational, and speech therapy services with multiple treatment options.
See template
See template
RINJ Peer Review Chart Audit Form
PDF template
A comprehensive medical chart review form used by the RINJ Foundation for documenting and validating patient medical records and procedures.
See template
See template
The Role Of A Surety In The Context Of A Construction Project
PDF template
A webinar discussing surety bonds, their role in construction projects, and differences from traditional insurance.
See template
See template
Wellness Center Health Information Form
PDF template
A confidential medical form for collecting student health and family medical history for Sage Colleges
See template
See template
Incident Report Form
PDF template
A form for reporting misconduct or poor behavior during soccer games by coaches, referees, players, or spectators.
See template
See template
Heartburn And Reflux Center Intake Form
PDF template
Medical intake form for patients experiencing heartburn, reflux, and related gastrointestinal symptoms at Texas Health Heartburn and Reflux Center.
See template
See template
PRE AUTHORIZATION FORM FOR PROMETHEUS Thiopurine Metabolites
PDF template
Medical pre-authorization form for requesting laboratory services related to thiopurine metabolite testing from Prometheus Laboratories.
See template
See template
Pre Authorization Form For Bundled ART Services For Thiqa
PDF template
Insurance pre-authorization form for assisted reproductive technology (ART) services for Thiqa members.
See template
See template
Third Party Vendor Agreement Form
PDF template
A form for documenting third-party vendor details and agreements for university events, including liability and contact information.
See template
See template
Downtown Manhattan Third Thursday ArtistExhibitor Agreement
PDF template
A participation agreement for artists and exhibitors in the Downtown Manhattan monthly art event, outlining responsibilities and guidelines.
See template
See template
McKenzie Institute International Thoracic Spine Assessment
PDF template
Comprehensive medical assessment form for thoracic spine condition, capturing patient history, symptoms, and clinical observations.
See template
See template
Public Plans Provider Manual Claim Requirements, Coordination Of Benefits And Dispute Guidelines
PDF template
Comprehensive manual detailing claim submission methods, coordination of benefits, and dispute resolution processes for healthcare providers.
See template
See template
Senior Products Provider Manual
PDF template
A manual detailing claim submission guidelines, processing procedures, and coordination of benefits for healthcare providers working with Tufts Health Plan Senior Products.
See template
See template
Insurance Form Thrive
PDF template
Form authorizing Personal Touch Medical Claims to submit medical insurance claims on behalf of a patient and outlining payment terms for claim processing.
See template
See template
Tick Submission Form
PDF template
A form for submitting tick specimens for identification and testing, primarily for ticks that have fed on humans.
See template
See template
Tiny Art Show Submission Form
PDF template
Form for artists to submit artwork for the Tiny Art Show at Wilmington Memorial Library
See template
See template
Tissue Share Request Form
PDF template
A form for requesting post mortem tissue collection from deceased animals for research purposes.
See template
See template
Non Emergency Medical Travel Reimbursement
PDF template
A guide for Medicaid recipients explaining how to claim reimbursement for non-emergency medical travel expenses including mileage, lodging, and meals.
See template
See template
MRS Title 24 A, Chapter 27. THE INSURANCE CONTRACT
PDF template
Legal document defining scope, policies, premiums, and insurable interest in insurance contracts.
See template
See template
Order Request Form
PDF template
A comprehensive form for requesting title services and property-related documentation for real estate transactions.
See template
See template
Trail Life USA ADULT Weekend Health And Medical Record
PDF template
Comprehensive medical and health information form for adult participants in Trail Life USA weekend activities
See template
See template
Accident Waiver And Release Of Liability Form
PDF template
A legal document releasing Trail Design Specialists, LLC from liability for potential risks and injuries during a crew leader training event.
See template
See template
Proof Of Delivery Of Temporomandibular Joint Disorder (TMD) Oral Appliance
PDF template
Document acknowledging patient receipt and understanding of a custom oral appliance for temporomandibular joint disorder treatment.
See template
See template
Train Mountain Railroad Museum Participant Release
PDF template
Legal release form for participants entering Train Mountain railroad property, waiving liability for potential injuries or damages.
See template
See template
Transcranial Magnetic Stimulation (TMS) Pre Authorization Form
PDF template
Medical pre-authorization form for requesting Transcranial Magnetic Stimulation (TMS) treatment, requiring patient and medical coding details.
See template
See template
Customer Service Representative Awards Competition Entry Form
PDF template
A nomination form for customer service representatives in the insurance industry to compete for state and national awards by submitting an essay and professional references.
See template
See template
Authorization For Treatment Form
PDF template
Form for medical examinations, physical tests, drug screening, and workplace health services
See template
See template
TOOTH REMOVAL CONSENT FORM
PDF template
Medical consent form detailing risks and patient understanding of tooth removal procedure and potential complications.
See template
See template
Assumption Of Risk And Indemnity Agreement (Tour Of District Facilities)
PDF template
Legal document outlining risk assumption and indemnification for participants in Santa Clara Valley Water District facility tours.
See template
See template
NERVA Tournament Audit Form
PDF template
Comprehensive evaluation form for assessing volleyball tournament venue safety, facilities, and compliance with standards.
See template
See template
Tournament Liability, Photo Release And Emergency Medical Form
PDF template
Legal release form for student participation in South Carolina Department of Natural Resources program, covering liability, medical consent, and photo permissions.
See template
See template
Property Damage Report Form
PDF template
Comprehensive insurance claim form for documenting property damage incidents, including details about the insured, incident, witnesses, and claim specifics.
See template
See template
Town And Country Animal Clinic Medical History Form
PDF template
Comprehensive veterinary intake form documenting a pet's current health status, symptoms, and medical history.
See template
See template
Facility Rental Agreement Form
PDF template
A rental agreement form for using the Asphodel-Norwood Town Hall facility, detailing rental terms, conditions, and insurance requirements.
See template
See template
Annual Report Third Party Administrators
PDF template
Mandatory annual reporting form for third-party administrators operating in Nevada, requiring financial statements and contract details.
See template
See template
Third Party Administrator Annual Report Filing Information
PDF template
Instructions for Nevada third-party administrators to submit annual reports to the Division of Insurance within 90 days of fiscal year end.
See template
See template
Third Party Administrators Licensing, Renewal And Annual Report Instructions
PDF template
Comprehensive instructions for obtaining and renewing third party administrator licenses in Kansas for non-resident administrators.
See template
See template
TissueBloodNucleic Acid Request Form
PDF template
A form for researchers to request tissue, blood, and nucleic acid samples from the University of North Carolina Tissue Procurement Facility.
See template
See template
TRINITY PROFESSIONAL GROUP REGISTRATIONCONSENT TO TREAT FORM AND HIPAA
PDF template
A comprehensive medical registration form for patient intake, consent to treatment, and insurance information collection.
See template
See template
TPH204 Medical Declaration Form Part 1
PDF template
Medical fitness declaration form for London taxi and private hire vehicle drivers, requiring medical assessment based on DVLA Group 2 standards.
See template
See template
PRE AUTHORIZATION FORM FOR PROMETHEUS TPMT Enzyme
PDF template
A medical pre-authorization form for requesting laboratory services related to TPMT enzyme testing at Prometheus Laboratories Inc.
See template
See template
Declaration Of Tobacco Use Or Non Tobacco Use Form
PDF template
A form for University of Texas System medical plan members to declare their tobacco use status and understand potential premium surcharges.
See template
See template
Declaration Of Tobacco Use Or Non Tobacco Use Form
PDF template
Form documenting tobacco use status for University of Texas System medical plan members with potential premium surcharges based on tobacco usage.
See template
See template
Graduate Track Subplan (Program Track) Proposal Form
PDF template
A comprehensive form for proposing and documenting a new graduate program track or subplan within an academic institution.
See template
See template
Trade And Food Vender Booking Form
PDF template
Application form for trade and food vendors to participate in the Wentworth Show, including booking requirements and regulations.
See template
See template
Trading Partner Agreement
PDF template
A legal agreement establishing terms for trading partners in the energy services industry, specifically for Electronic Data Interchange (EDI) compliance.
See template
See template
TRAFFIC ACCIDENT REPORT FORM
PDF template
A comprehensive form for documenting details of a traffic accident for insurance and police purposes.
See template
See template
Waiver, Release Of All Claims And Hold Harmless Agreement
PDF template
Legal document releasing Barrington Park District from liability for potential injuries during park district programs and activities
See template
See template
Wildwood Park District TransferRefund Request Form
PDF template
A form for requesting program transfers or refunds from the Wildwood Park District for recreational activities.
See template
See template
Activity Transfer Request Form
PDF template
Form for requesting transfer between park district activities with guidelines for submission and processing.
See template
See template
BONENT Exam Transfer Request
PDF template
Form for transferring between different BONENT examination formats and locations with associated processing fees.
See template
See template
DHS Early Intervention Transportation Billing Form
PDF template
A billing form for transportation services provided to children in early intervention programs in Illinois.
See template
See template
Louisiana Office Of Risk Management Client Instructions For The Transportation Unit
PDF template
Detailed instructions for third-party administrators handling transportation-related claims for the Louisiana Office of Risk Management.
See template
See template
Application Form Trauma, Emergency Services And Surgical Critical Care Research Fellowship
PDF template
Application form for medical professionals seeking a research fellowship in trauma, emergency services, and surgical critical care.
See template
See template
What To Do After An Accident
PDF template
A comprehensive guide outlining nine critical steps to take immediately following a car or bus accident, focusing on safety, documentation, and legal protection.
See template
See template
Travel AcknowledgementWaiver Form For Stetson Field Trip, Event, Function Or Course Related Travel
PDF template
A waiver form for students participating in university-sponsored field trips, events, or course-related travel, acknowledging risks and liability.
See template
See template
Access2Care Travel Assessment Form
PDF template
Medical form to determine appropriate transportation services for individuals with disabilities or medical conditions
See template
See template
Request For Authorization To Travel Form
PDF template
A form for requesting and documenting authorization for travel, including a liability release section for university-related activities.
See template
See template
Travel Authorization Reimbursement
PDF template
Comprehensive guide for SUU employees and students on travel authorization, reimbursement procedures, and best practices for travel documentation.
See template
See template
Travel Booking Form
PDF template
Comprehensive form for patients seeking travel health advice and vaccination consultation prior to international travel.
See template
See template
Travel Consent Form
PDF template
A consent form for minor athletes to travel with the rowing club, including medical authorization and transportation details.
See template
See template
Travel Form
PDF template
Form for documenting and approving travel details for club sports activities and competitions.
See template
See template
Pre Travel Assessment Form
PDF template
Comprehensive medical form for travelers to assess health status, medical history, and vaccination record before travel.
See template
See template
Travel Form For Out Of State Practice
PDF template
A form required by the Michigan High School Athletic Association for schools planning interstate travel for team practice activities.
See template
See template
Travel Medical History Questionnaire
PDF template
Comprehensive questionnaire for documenting medical and travel details for international travelers from Saint Xavier University Health Center.
See template
See template
Travel Medical Release Form
PDF template
Medical information release form for cancer patients seeking air travel support through the Cassie Hines Shoes Cancer Foundation (CHSCF)
See template
See template
UAF Vehicle Accident Reporting Procedure
PDF template
Comprehensive guidelines for reporting and handling vehicle accidents involving University of Alaska Fairbanks (UAF) vehicles and personnel.
See template
See template
Beckman Laser Travel Pre Authorization Form
PDF template
A form for documenting and pre-authorizing travel details for reimbursement purposes, including traveler information and trip specifics.
See template
See template
Travel Form Auto
PDF template
Form for patients to request reimbursement for medical transportation expenses related to medical appointments.
See template
See template
Release Of Liability And Assumption Of Risks
PDF template
Legal document waiving liability for a student's voluntary international trip participation, acknowledging potential risks and dangers.
See template
See template
Registered Student Organization (RSO) Travel Form
PDF template
A form for Lansing Community College student organizations to request and document travel arrangements and obtain necessary approvals.
See template
See template
Travel Risk Assessment Form
PDF template
Comprehensive form for collecting traveler medical history and trip details prior to travel
See template
See template
Travel Risk Assessment Form
PDF template
A comprehensive form for evaluating health risks and medical history for travelers before an international trip.
See template
See template
Travel Service Agreement
PDF template
A legal agreement defining terms and conditions for a participant's enrollment in a travel program, including responsibilities, reservation process, and participation requirements.
See template
See template
Certificate Of Cancellation And Application For Withdrawal Trust Funded Prepaid Funeral Contract
PDF template
A document allowing the cancellation and withdrawal of funds from a prepaid funeral contract with specific refund terms and conditions.
See template
See template
Short Term Disability Claim Form
PDF template
Insurance claim form for documenting a short-term disability, including personal information, medical details, and potential compensation sources.
See template
See template
Trinity Lutheran Church Youth Group Permission, Liability, Travel Form
PDF template
A comprehensive form for parental consent, medical authorization, and liability release for youth group events and activities.
See template
See template
Trip Transit Insurance Form (Sponsored Owned)
PDF template
Insurance form for covering shipments of sponsored-owned property during commercial transit by Georgia Tech.
See template
See template
Trip Transit Insurance Form
PDF template
A form for documenting and insuring property shipments by Georgia Institute of Technology via commercial carriers.
See template
See template
Referral Form
PDF template
A comprehensive medical form for documenting patient wound details, diagnosis, and referral information for healthcare professionals.
See template
See template
Student Athletic Eligibility Form
PDF template
Form for determining student athletic participation eligibility and consent for school sports involvement.
See template
See template
University Of Arkansas Athletic Tryout Medical Documentation
PDF template
Required medical documentation for students attempting to join University of Arkansas intercollegiate athletic teams.
See template
See template
TS Alliance Clinic Ambassador New Patient Contact Form
PDF template
A contact form for individuals and families connected to Tuberous Sclerosis Complex (TSC) to receive information and support services.
See template
See template
TERRA SUMMER RESIDENCY IN GIVERNY 2017 Application For Predoctoral Scholar Fellowship
PDF template
Application form for predoctoral scholars seeking a summer research residency in Giverny, France, with detailed submission requirements.
See template
See template
Comparative Medicine Technical Service Request Form
PDF template
Form for requesting technical services and supplies from the University of Maryland Baltimore's Comparative Medicine department
See template
See template
Tuberculosis (TB) Risk Assessment Form
PDF template
Medical form to assess patient's risk and history of tuberculosis exposure and infection.
See template
See template
TUBERCULOSIS RISK ASSESSMENT FORM
PDF template
A comprehensive medical form for screening and assessing individual risk factors and history related to tuberculosis infection and exposure.
See template
See template
Accident Information Form
PDF template
A comprehensive form for documenting details of a vehicle accident, including member, vehicle, and incident information.
See template
See template
Twinbrook Swimming Pool Membership Application 2022
PDF template
Membership application for Twinbrook Swimming Pool with various membership options and rates for individuals and families.
See template
See template
Snowmobile Rental Agreement
PDF template
Rental agreement and liability waiver for snowmobile equipment, outlining terms, conditions, and renter responsibilities.
See template
See template
Temescal Wellness Of New Hampshire Patient Intake Form
PDF template
Intake form for qualifying medical cannabis patients in New Hampshire, collecting patient and caregiver information and legal acknowledgments.
See template
See template
Request To Cancel Workers Compensation Coverage
PDF template
Official form for requesting cancellation of workers' compensation insurance policy in Ohio.
See template
See template
Incident Report Form
PDF template
A comprehensive form for documenting incidents involving U3A members, including injury or property damage details.
See template
See template
UB 04 Claim Form Instructions
PDF template
Comprehensive instructions for completing the UB-04 healthcare claim form with detailed guidance on form locator entries and billing specifications.
See template
See template
UB 04 CMS 1450
PDF template
Official standardized form used by healthcare facilities for medical billing and insurance claims processing.
See template
See template
UB92 Claim Form
PDF template
A standardized medical billing form used by healthcare facilities to submit patient treatment and billing information.
See template
See template
UC Medicare PPOHigh Option Supplement Enrollment Form
PDF template
Enrollment form for UC retirees and family members to assign and coordinate Medicare prescription drug plan coverage.
See template
See template
U CAN Pre Project Form
PDF template
A form for potential U-CAN users to submit project proposals and collaboration details in the biomedical research domain.
See template
See template
Sample Submission Form
PDF template
Form for submitting veterinary medical samples to UC Davis Veterinary Medical Teaching Hospital's Clinical Diagnostic Laboratory for testing.
See template
See template
Standardized Application For Pathology Fellowships
PDF template
Comprehensive application form for medical professionals seeking specialized pathology fellowship training in various subspecialties.
See template
See template
Vehicle Accident Report
PDF template
Document used to record details of a vehicle accident involving a University of California vehicle and personnel.
See template
See template
Authorization For Use Or Disclosure Of Health Information
PDF template
A medical authorization form allowing patient to authorize disclosure of personal health information to specified recipients
See template
See template
Waiver Of Liability, Assumption Of Risk, And Indemnity Agreement
PDF template
Legal document releasing University of California San Diego from liability for potential risks during an activity or program participation.
See template
See template
Standardized Application For Pathology Fellowships
PDF template
A comprehensive application form for medical professionals seeking specialized pathology fellowship training in various subspecialties.
See template
See template
Participant Consent, Release And Waiver Of Liability
PDF template
Legal document releasing University of Florida from liability for participation in youth events or activities
See template
See template
Change Of Address Form
PDF template
A form for UFCW members to update their contact information with the National Health and Welfare Fund.
See template
See template
MAE International Travel Checklist Form
PDF template
A checklist and registration form for University of Florida employees traveling internationally for business purposes.
See template
See template
Waiver Of Liability And Hold Harmless Agreement
PDF template
Legal document releasing University of Florida from liability for potential injuries while using exercise equipment in the UFIT space.
See template
See template
Volunteer Agreement Insuring Volunteers At UGA
PDF template
Comprehensive guidelines for volunteer participation and liability coverage at the University of Georgia, detailing insurance provisions and volunteer program requirements.
See template
See template
PrescriPtion Reimbursement Request Form
PDF template
Form for requesting reimbursement for covered medications purchased at retail cost by insurance members.
See template
See template
UnitedHealthcare Medical Claim Form
PDF template
A form used to request payment for eligible healthcare services that have already been received from an out-of-network provider.
See template
See template
Employee Enrollment Form
PDF template
A comprehensive enrollment form for employees to sign up for medical, dental, and related insurance benefits.
See template
See template
Medical Claim Form
PDF template
A form for submitting medical expense claims to UnitedHealthcare for reimbursement of eligible healthcare services.
See template
See template
Waiver Of Premium
PDF template
Instructions for employers and employees on how to process a Waiver of Premium for life insurance during total disability.
See template
See template
Medical Claim Form
PDF template
A form for submitting out-of-network medical claims and requesting payment for eligible healthcare services
See template
See template
Pre Participation Health Examination Form
PDF template
A comprehensive health form required for students participating in athletic activities, including medical history and physical examination documentation.
See template
See template
Pharmacy Student Enrollment Form
PDF template
Enrollment form for first-time pharmacy customers at University Health Services for students and their families.
See template
See template
Yandisa Benefit Application Form
PDF template
Application form for patients seeking medical benefits through Umvuzo Health Medical Scheme's Yandisa program, requiring comprehensive personal and medical information.
See template
See template
Form 47 Official Survey Form
PDF template
Official survey form for collecting athletic program information by the Utah Interscholastic Athletic Administrators Association
See template
See template
UIHC Student Checklist Form
PDF template
Comprehensive checklist for students completing clinical rotations at University of Iowa Hospitals & Clinics, covering health screenings, requirements, and training
See template
See template
UIMUI Report Form
PDF template
A comprehensive form for reporting unusual incidents or major unusual incidents involving individuals in care settings.
See template
See template
UIMUI Report Form
PDF template
A comprehensive form for documenting unusual incidents and major unusual incidents involving individuals in a care or support setting.
See template
See template
Diagnostic Imaging Department Ultrasound Requisition
PDF template
Medical form for documenting and requesting ultrasound diagnostic imaging across various body regions and systems.
See template
See template
Outside Group Facilities Use Indemnity Agreement
PDF template
Agreement outlining terms and conditions for outside groups using church facilities or vehicles, including risk acknowledgment and indemnification.
See template
See template
Member Medical Claim Submission Form
PDF template
A form for submitting medical insurance claims for reimbursement of eligible medical expenses when providers do not file claims directly.
See template
See template
UMKC Safety Prescription Eyewear Order Form
PDF template
A form for UMKC employees to order prescription safety eyewear with various lens and frame options.
See template
See template
Medical Claim Form
PDF template
A form for submitting medical reimbursement requests for services from non-network providers under Uniform Medical Plans.
See template
See template
Member Claim Submission Form
PDF template
A form for submitting medical and vision-related insurance claims for reimbursement with required patient and service details.
See template
See template
Member Claim Submission Form
PDF template
A form for submitting medical and vision service claims to UMR for reimbursement by members.
See template
See template
VIM Mission Team Form Instructions
PDF template
Comprehensive instructions for mission team leaders detailing required documentation, forms, and submission guidelines for mission trips.
See template
See template
VIM Mission Team Form Instructions
PDF template
Comprehensive guide for mission team leaders to collect and submit required documentation for mission trips, including registration, medical releases, and consent forms.
See template
See template
Athletic Exit Interview
PDF template
Comprehensive survey for athletes departing their collegiate sports program to gather feedback on their athletic experience.
See template
See template
UNCG Exposure To BloodInfectious Material Incident Investigation Form
PDF template
A detailed form used to document and investigate workplace exposure to blood or infectious materials, tracking incident details, routes of exposure, and recommended preventive actions.
See template
See template
UNC Health Endocrinology Physician Referral Form
PDF template
Medical referral form for patients requiring endocrinology consultation, specifying patient information and diagnostic requirements.
See template
See template
NEW PATIENT MEDICAL HISTORY FORM
PDF template
Comprehensive medical history form for new patients to document personal health, screening, vaccination, and family history.
See template
See template
Skagway Recreation Center Weight Room Cardio Room Equipment Use Waiver
PDF template
A waiver for children and teenagers to use the weight and cardio room at the Skagway Recreation Center, outlining usage rules and parental consent.
See template
See template
UNIVERSITY OF THE INCARNATE WORD FINANCIAL ASSISTANCE CHECKLIST
PDF template
A comprehensive checklist for students outlining financial assistance requirements and steps for the academic term prior to Fall 2020.
See template
See template
Certificate Of Liability Insurance (COI) Instructions
PDF template
Guidelines for vendors providing insurance documentation when working with public school facilities projects in New Mexico.
See template
See template
Artist ApplicationAgreement
PDF template
A document for artists to apply and agree to liability terms when participating in Buttonwood Art Space activities.
See template
See template
Undiscovered Frontiers Booking Form
PDF template
Comprehensive travel registration form for collecting traveler details, emergency contacts, and trip preferences for adventure travel.
See template
See template
ParentS Or GuardianS Agreement Of Waiver Of Liability, Indemnification, And Medical Release
PDF template
A legal document for parents or guardians to acknowledge risks and release liability for a minor's participation in an activity.
See template
See template
Record Of Employment
PDF template
A form for documenting employment status for unemployment insurance claims in New York State.
See template
See template
Initial Unemployment Insurance Benefits Claim
PDF template
Comprehensive guide for filing an initial unemployment insurance claim in New Jersey, detailing required documentation and application process.
See template
See template
University Of New Hampshire Technology Incident Investigation Form
PDF template
A comprehensive form for documenting and investigating technology security incidents at the University of New Hampshire.
See template
See template
2023 24 PermissionWaiver Emergency Information Form Minor
PDF template
A comprehensive permission and emergency contact form for minors participating in church activities, including liability waiver and medical information.
See template
See template
Special Olympics Unified Sports Participation Form
PDF template
Registration and liability waiver form for minor participants in Special Olympics Unified Sports programs
See template
See template
Maryland Uniform Consultation Referral Form
PDF template
A standardized form for healthcare providers to request medical consultations, referrals, and services between healthcare providers and facilities.
See template
See template
Uniform Consultation Referral Form
PDF template
A standardized form for healthcare providers to submit patient referrals and consultation requests through CareFirst insurance plans.
See template
See template
Unique Services Reimbursement Program Claim Form
PDF template
A claim form for submitting reimbursement requests for unique healthcare services through Presbyterian Health Plan for the City of Albuquerque.
See template
See template
DENTAL ENROLLMENT FORM
PDF template
Form for enrolling in dental insurance coverage, collecting employee and dependent information for group dental insurance.
See template
See template
Claim Information Form UnitedHealthcare StudentResources
PDF template
Insurance claim form for students to submit medical claims and accident information to UnitedHealthcare StudentResources
See template
See template
National Youth Leadership Training Unit Leader Approval Form
PDF template
A form for scout unit leaders to approve a scout's participation in the National Youth Leadership Training program.
See template
See template
Universal Enrollment Form
PDF template
Comprehensive enrollment form for medical, dental, and vision insurance covering active employees, retirees, COBRA, and surviving spouse participants.
See template
See template
UNIVERSAL MEDICAL ASSESSMENT FORM FOR ALL TREATMENT CENTRES
PDF template
Comprehensive medical history form for documenting patient health conditions and personal information for adults and children.
See template
See template
University Agency Agreement For Placement Of Students (UAAPS)
PDF template
A formal agreement between California State University Monterey Bay and local agencies for student service-learning, internships, and community engagement placements.
See template
See template
University Of Oregon Camps Accident Insurance Program
PDF template
Insurance policy providing primary accident medical benefits for University of Oregon camp participants with up to $25,000 coverage per injury.
See template
See template
Unum Disability Claim Form
PDF template
A comprehensive claim form for submitting disability insurance claims with Unum Group subsidiaries, covering multiple types of disability benefits.
See template
See template
How To File A Voluntary Benefits Claim
PDF template
A comprehensive guide for employees on how to file claims for voluntary benefits, including wellness and health screening benefits.
See template
See template
Unusual Incident Reporting (UIR) Form
PDF template
A comprehensive form for reporting critical incidents involving children, including details about the child, incident type, and notifications.
See template
See template
Wayne State University Club Sports Travel Form
PDF template
A comprehensive travel form for university club sports teams to document event, transportation, and emergency contact details.
See template
See template
On The Road Booking Form
PDF template
A form for schools and groups to request environmental and heritage education programs from the Lower Thames Valley Conservation Authority.
See template
See template
Medical Summary Report Of Ministerial Candidate
PDF template
A confidential medical authorization form for ministerial candidates to release medical information to the Board of Ordained Ministry.
See template
See template
Booking Form
PDF template
A form for booking school or club travel with group details, contact information, and travel preferences
See template
See template
Medical Release Form Accuracy Checklist
PDF template
A checklist to help verify the completeness and legal adequacy of a medical release form by reviewing seven key requirements.
See template
See template
MEDICAL HISTORY FORM
PDF template
Comprehensive medical form for collecting patient health information, medical history, and emergency contact details.
See template
See template
Eligibility Determination For Sliding Fee Discounts
PDF template
A form for patients to apply for healthcare service discounts based on income and family size at Long Island Select Healthcare, Inc.
See template
See template
Referral Form
PDF template
A form for referring patients to ophthalmology services with multiple evaluation options and contact details.
See template
See template
TMJ Patient Referral Form
PDF template
A medical referral form for patients seeking consultation at the IU School of Dentistry TMJ Institute for temporomandibular joint (TMJ) issues.
See template
See template
Flu Shot Reimbursement Form
PDF template
Form for members to request reimbursement for out-of-pocket flu shot expenses through UPMC Health Plan.
See template
See template
Release From Responsibility, Assumption Of Risk, And Waiver
PDF template
Legal document releasing University of Portland from liability for participant activities and risks associated with university-sponsored events
See template
See template
Participation, Waiver, And Release Of Liability Form
PDF template
A legal document that participants must sign to acknowledge risks and release the university from liability during an activity or event.
See template
See template
SHEPHERD UNIVERSITY UPWARD BOUND PROGRAM EMERGENCY MEDICAL CONSENT CONTACT FORM
PDF template
Emergency medical consent and contact form for students participating in the Shepherd University Upward Bound Program, including medical history and medication information.
See template
See template
First Baptist Church Ocala ChildrenS Ministry Scholarship Form
PDF template
A scholarship application form for children's ministry sports program participation at First Baptist Church Ocala
See template
See template
Parental Authorization To Treat Minor Child When Not Accompanied By Parent Or Guardian
PDF template
Form allowing parents to authorize medical care for their child when the child is not accompanied by a parent or guardian
See template
See template
TEST REQUEST
PDF template
Comprehensive medical test request form for various microbiological, viral, bacterial, and other diagnostic examinations.
See template
See template
UAB Urology New Patient Referral Form
PDF template
Medical referral form for new patients seeking urology services at UAB Department of Urology in Birmingham, Alabama.
See template
See template
CASE REPORT AND ACCIDENT INSURANCE CLAIM FORM
PDF template
A form for submitting accident insurance claims and reporting case details for medical expenses.
See template
See template
IZERVAY My WaySM Enrollment Form
PDF template
Comprehensive enrollment form for patient support services related to IZERVAY medication, including insurance and financial assistance screening.
See template
See template
IZERVAY My WaySM Enrollment Form
PDF template
Enrollment form for patient support services related to IZERVAY medication, including insurance and financial assistance screening.
See template
See template
USAV Youth Junior Volleyball Player Medical Release Form
PDF template
Medical release form for youth and junior volleyball players documenting health information and emergency contacts.
See template
See template
YOUTH JUNIOR VOLLEYBALL PLAYER MEDICAL RELEASE FORM
PDF template
A comprehensive medical release and consent form for youth and junior volleyball players to capture health information, emergency contacts, and participation permissions.
See template
See template
IT Purchase Request Form
PDF template
A form for requesting and approving IT equipment purchases within an organization, including details about the item, purpose, and funding.
See template
See template
US Club Soccer Medical Waiver Form Printing
PDF template
Guide for US Club Soccer teams to print medical waiver forms through their GotSoccer team account.
See template
See template
US Club Soccer Registration Form
PDF template
A consent form for registering a player with US Club Soccer, including personal and medical information.
See template
See template
Isaacs V. Metropolitan Life Insurance Company Court Opinion
PDF template
Judicial opinion regarding a long-term disability benefits claim against Metropolitan Life Insurance Company under ERISA regulations.
See template
See template
Order Granting In Part And Denying In Part Motion For Summary Judgment
PDF template
Judicial order addressing a dispute over insurance contract coverage related to contaminated feed causing cattle mortality
See template
See template
Order Granting DefendantS Motion To Compel Arbitration
PDF template
Court order addressing Aetna Life Insurance Company's motion to compel arbitration in a case filed by Lori Stover-Davis.
See template
See template
Memorandum And Order For Judgment Malcolm Et Al. V. Franklin Drywall, Inc. Et Al.
PDF template
Judicial document regarding personal liability of Philip J. Franklin in a union fringe benefits fund case involving Franklin Drywall and Master Drywall.
See template
See template
ExecutionGarnishmentSequestration Application And Order
PDF template
Legal document detailing a garnishment proceeding against State Farm to satisfy a judgment debt from Eugene Roedder to Greg and E'Wana Monroe.
See template
See template
Monarch Life Ins. Co. V. Estate Of Robert Tarone, III
PDF template
Judicial memorandum resolving a dispute over annuity beneficiary rights between an estate and a sister following a settlement from a 1980 motorcycle accident
See template
See template
Memorandum Opinion And Order
PDF template
Legal document addressing an insurance coverage dispute involving policy stacking and liability allocation in a wrongful death lawsuit settlement.
See template
See template
Emergency Medical Release Form
PDF template
A medical release form for riders to provide emergency contact and medical information for horse trials events.
See template
See template
OFFICE OF INFORMATION TECHNOLOGY AUTHORIZATION RELEASE FORM
PDF template
Authorization form for students, faculty, staff, and guests to access SUNY College of Optometry computing resources and facilities.
See template
See template
Life Insurance Claim Form
PDF template
A comprehensive form for filing a life insurance claim with authorization and personal information sections
See template
See template
COB Prescription Co Pay Reimbursement Form
PDF template
A form for members to request reimbursement for prescription co-pay expenses through US Family Health Plan.
See template
See template
Outpatient Referral Form
PDF template
A referral form for patients seeking specialist medical care within the USFHP network, requiring physician completion and details about the referral.
See template
See template
USF Institute For Research In Art Internship Application Form
PDF template
Application form for students seeking internship opportunities at USF's Contemporary Art Museum or Graphicstudio
See template
See template
Notification Of Injury
PDF template
Form for submitting medical accident claims to United States Fire Insurance Company with detailed instructions for claim submission.
See template
See template
Participant Medical History And Examination Form
PDF template
Medical history and examination document required for U.S. Department of State international educational exchange program participants to confirm health status and medical clearance.
See template
See template
United States Importer Declaration Form
PDF template
A form for non-participating manufacturers importing products into the United States to declare importer information and liability assumptions.
See template
See template
Participant Waiver And Release Of Liability, Assumption Of Risk And Indemnity Agreement
PDF template
Legal document outlining liability waiver and risk assumption for United States Masters Swimming participants in swimming events and activities.
See template
See template
PARENTGUARDIAN CONSENT AND PLAYER MEDICAL RELEASE FORM
PDF template
Medical release and consent form for youth soccer players, providing emergency contact and health information.
See template
See template
PARENTGUARDIAN CONSENT AND PLAYER MEDICAL RELEASE FORM
PDF template
A consent and medical release form for youth soccer players, providing emergency contact and medical information for participation in soccer programs.
See template
See template
Sports Camp Application For UT Owned Operated Camps
PDF template
Insurance application form for University of Texas sports camps covering accident and liability risks for campers and staff.
See template
See template
High School Sports Registration Information
PDF template
Registration guide for high school athletes detailing required forms, deadlines, and submission process for sports participation.
See template
See template
Middle School Sports Registration Information
PDF template
Registration guide for middle school sports participation with details on required forms and submission dates for fall, winter, and spring seasons.
See template
See template
Volunteer Agreement Form
PDF template
A document outlining the terms and conditions for volunteers at the University of West Georgia, including liability coverage and volunteer responsibilities.
See template
See template
University Of Washington Diving Medical History Form
PDF template
Confidential health screening form for diving applicants to assess medical fitness for diving activities and potential risks.
See template
See template
Parental Consent Assumption Of Risk And Liability Waiver
PDF template
Legal document for parents to consent to a minor's participation in an activity and assume potential risks and liabilities.
See template
See template
Catastrophic Leave Request Form
PDF template
A form for UW System employees to request extended unpaid leave due to serious illness or family medical needs.
See template
See template
ADA Dental Claim Form Completion Instructions
PDF template
Comprehensive instructions for completing the American Dental Association's dental claim form, detailing recent version changes and field completion guidelines.
See template
See template
Group Short Term Disability Claim Form
PDF template
A comprehensive form for employees to file a short-term disability insurance claim with medical and employment details.
See template
See template
MESA INVITE EXAM 6A6PLUS SHIPPING FORM
PDF template
Shipping form for tracking and documenting MESA (Multi-Ethnic Study of Atherosclerosis) exam samples and shipments.
See template
See template
MESA INVITE BLIND DUPLICATE SHIPPING FORM
PDF template
A shipping document used for tracking and documenting shipments in the MESA research study.
See template
See template
VAAP TEACHER INVENTORY FORM
PDF template
Form for collecting student art submission details for University of Montevallo's art department inventory.
See template
See template
VAAP Teacher Inventory Form
PDF template
Form for documenting student art submissions and details for the University of Montevallo Art Department
See template
See template
Outside School Hours Care Vacation Care Program 2024
PDF template
A two-week summer vacation program for school-aged children featuring daily activities, excursions, and special events during June-July 2024.
See template
See template
Vacation Donation Program Contribution Form
PDF template
A form allowing state employees to donate vacation or personal leave hours to colleagues experiencing medical costs or salary needs.
See template
See template
Vacation Rental Agreement
PDF template
A rental agreement for vacation property rental with details about payment, insurance, and booking terms.
See template
See template
Newport Visual Arts Center (VAC) Exhibition Proposal Form
PDF template
A comprehensive form for artists to submit exhibition proposals to the Newport Visual Arts Center, covering details about their artwork, exhibition concept, and professional background.
See template
See template
Athletes Medical Information Form
PDF template
Medical evaluation form for veterans participating in the National Veterans Golden Age Games, assessing physical fitness and health status for athletic events.
See template
See template
Foreign Medical Program (FMP) Registration Form
PDF template
A government form for registering and processing medical programs for veterans receiving care outside the United States.
See template
See template
2013 2014 Volunteer Application Form
PDF template
Application form for volunteers interested in participating in recreational activities and social events for individuals with disabilities
See template
See template
Vehicle Accident Report
PDF template
Comprehensive guidelines for handling vehicle accidents involving institutions in the Iowa Board of Regents system, including reporting and notification procedures.
See template
See template
Vision Reimbursement Claim Form
PDF template
A form for employees to claim reimbursement for vision-related medical expenses under an employer's vision benefit plan.
See template
See template
Vehicle Accident Reporting Quick Guide
PDF template
Comprehensive guide for reporting vehicle accidents while driving on official state business for Louisiana State University Health Sciences Center.
See template
See template
Varsity Student Athlete Physical Examination Form
PDF template
A comprehensive medical history and physical examination form for MIT intercollegiate varsity student athletes to assess their fitness for sports participation.
See template
See template
Participant Liability Release And Waiver Form
PDF template
Legal release form for participants in cheer and dance events, releasing Varsity Spirit and associated organizations from liability.
See template
See template
Prescription Reimbursement Claim Form
PDF template
A form for submitting prescription medication reimbursement claims, detailing patient, pharmacy, and insurance information.
See template
See template
Valley ChildrenS Referral Form
PDF template
A comprehensive medical referral form for patient consultation and diagnostic services at Valley Children's healthcare facility.
See template
See template
Request For Reimbursement
PDF template
A form for submitting out-of-network vision care reimbursement claims with detailed processing instructions.
See template
See template
Test Requisition Form
PDF template
Medical laboratory test request form for collecting patient specimen information and ordering diagnostic tests
See template
See template
NDSU VETERINARY DIAGNOSTIC LABORATORY GENERAL SUBMISSION FORM
PDF template
A comprehensive form for submitting animal specimens and medical samples to a veterinary diagnostic laboratory.
See template
See template
HILL GROUP DRIVERS AUTO ACCIDENT REPORT FORM
PDF template
A comprehensive form for documenting details of a vehicle accident involving company vehicles and drivers.
See template
See template
Hill Group DriverS Auto Accident Report Form
PDF template
Comprehensive form for documenting details of a vehicle accident involving company vehicles and drivers.
See template
See template
Vehicle Accident Report
PDF template
Official government document for recording details of a vehicle accident involving county-owned or insured vehicles.
See template
See template
Fleet Unit Accident Incident Reporting Procedure
PDF template
Detailed procedure for reporting and handling vehicle accidents involving city fleet units, including required steps and documentation.
See template
See template
Vehicle Accident Reporting Procedure
PDF template
Comprehensive instructions for employees on how to handle and report vehicle accidents involving fleet or rental vehicles.
See template
See template
Vehicle AccidentIncident Procedures
PDF template
Guidelines for employees involved in motor vehicle accidents while conducting official state business, detailing step-by-step responsibilities at the accident scene.
See template
See template
VEHICLE ACCIDENT RELEASE OF LIABILITY FORM
PDF template
A legal document that releases a party from liability for property damage sustained in a vehicle accident.
See template
See template
Stetson Vehicle Accident Report
PDF template
Comprehensive form for documenting details of a vehicle accident involving Stetson employees or vehicles.
See template
See template
SCSU Vehicle Accident Report Form
PDF template
A comprehensive form for documenting details of a vehicle accident involving an SCSU Sport Club driver.
See template
See template
Vehicle Accident Report
PDF template
Comprehensive form for reporting vehicular accidents involving district staff or district vehicles with damage to property or persons.
See template
See template
Vehicle Accident Reporting Form (STD 270)
PDF template
Instructions for reporting vehicle accidents involving state-owned or rental vehicles, including form completion and distribution requirements.
See template
See template
Accident Report Kit
PDF template
A comprehensive guide and form for reporting various types of accidents, including vehicle incidents, property damage, and personal injuries.
See template
See template
Vehicle Accident Report
PDF template
Comprehensive guide for reporting vehicle accidents involving Iowa state university vehicles and personnel, including step-by-step procedures for handling accidents.
See template
See template
Vehicle Accident Report Form
PDF template
A comprehensive form for collecting details and information following a vehicle accident, designed to assist in insurance claims and documentation.
See template
See template
Vehicle Entry Permit Form
PDF template
A permit form for vehicles entering the Chennai Port Trust and PSA Chennai terminal, specifying rules and requirements for entry and movement within the facility.
See template
See template
Vehicle Lock Out Waiver Form
PDF template
Waiver form for Manawa Police Department vehicle lockout service with liability release and fee acknowledgment.
See template
See template
Vehicle Accident Reporting Procedures
PDF template
Policy outlining procedures for reporting and managing vehicle accidents involving university-owned or personal vehicles used for university business.
See template
See template
Physician Referral Fax Form
PDF template
A comprehensive medical referral form for patient information, insurance details, and physician contact for vascular specialist consultation.
See template
See template
Program Enrollment Form
PDF template
A comprehensive form for patient enrollment in a Pfizer healthcare program, collecting personal, insurance, and healthcare professional information.
See template
See template
IRIS Vendor Claim Form
PDF template
Form for providers to submit non-HIPAA claims for IRIS-funded healthcare services.
See template
See template
Vendor Information June 2025
PDF template
Application guidelines and requirements for non-food vendors participating in the Friday the 13th event in Port Dover, Ontario.
See template
See template
Venipuncture Procedure Checklist
PDF template
A comprehensive checklist for evaluating the proper technique and safety protocols for performing venipuncture (blood drawing)
See template
See template
Vermont Advance Directive Form
PDF template
A legal document allowing individuals to specify healthcare preferences and designate a healthcare decision-making agent.
See template
See template
Prescription Prior Authorization Request Form
PDF template
A medical form used to request prior authorization for prescription medications from an insurance provider or healthcare plan.
See template
See template
Venus Legacy Informed Consent Form
PDF template
Informed consent document for Venus Legacy medical cosmetic treatment, outlining potential side effects, treatment protocol, and patient agreements.
See template
See template
Disability Verification Form For Students With Physical AndOr Chronic Medical Disability
PDF template
A form used by physicians to verify a student's disability and functional limitations for requesting academic accommodations at University of Maryland Global Campus.
See template
See template
NJCAA Physical Examination Form
PDF template
Medical evaluation form for student athletes to assess fitness for intercollegiate sports participation.
See template
See template
VESSEL BOOKING FORM
PDF template
A comprehensive form for booking and documenting vessel arrival, departure, and cargo details for maritime logistics operations.
See template
See template
RELEASE FROM LIABILITY FOR DEATH OR INJURY OCCURRING ON VESSELS OF THE UNIVERSITY OF SOUTHERN MISSIS
PDF template
Legal document releasing the University of Southern Mississippi from liability for injuries or damages during vessel activities.
See template
See template
Veterans Of Foreign Wars Of The United States Motorcycle Riders Groups (VFWRG) Membership (Participa
PDF template
Application form for joining the Veterans of Foreign Wars Motorcycle Riders Groups, including personal information and liability release.
See template
See template
VISTA GRANDE SPARTAN ATHLETICS Athletic Participation Requirements
PDF template
Comprehensive guide for high school athletes detailing required registration, medical, and participation forms for sports enrollment.
See template
See template
Student Medical Form
PDF template
A comprehensive medical form for students to provide health history, insurance information, and medical details for college enrollment.
See template
See template
My Benefit Plan Booklet
PDF template
Comprehensive benefit plan booklet for post-doctoral fellows at the University of Toronto, detailing group benefits through Green Shield Canada.
See template
See template
Volunteers In The Parks (V.I.P.) Program Manual
PDF template
A comprehensive manual for volunteers in Rockdale County Recreation and Maintenance Department, detailing volunteer opportunities and benefits.
See template
See template
VIP Marketplace Worldwide Reseller Program Guide
PDF template
A comprehensive guide for Adobe resellers outlining requirements and guidelines for participating in the global VIP Marketplace Reseller Program.
See template
See template
Athletic ParticipationParental ConsentPhysical Examination Form
PDF template
A comprehensive form for student athletes to obtain consent and document eligibility for school sports participation.
See template
See template
2021 IBSA JUDO Grand Prix Warwick GBR VISA APPLICATION FORM
PDF template
Visa application form for participants in the 2021 IBSA Judo Grand Prix event in Warwick, United Kingdom.
See template
See template
Out Of Network Reimbursement Instructions
PDF template
Detailed instructions for submitting out-of-network healthcare reimbursement claims to VBA, including required documentation and submission methods.
See template
See template
Member Reimbursement Claim Form
PDF template
Form for members to request reimbursement for vision services from out-of-network providers or in-store promotions.
See template
See template
Out Of Network Vision Services Claim Form
PDF template
A claim form for submitting out-of-network vision care service expenses for reimbursement by EyeMed Vision Care through First American Administrators.
See template
See template
Delta Dental Of Wisconsin EnrollmentChangeWaiver Form DeltaVision
PDF template
Insurance enrollment form for Delta Dental of Wisconsin's vision benefits, allowing employees to accept, change, or waive coverage.
See template
See template
Enrollment Change Waiver Group Insurance Form
PDF template
Insurance enrollment form for eye care coverage, allowing employees to add or modify group insurance benefits and dependent coverage.
See template
See template
Vision Enrollment
PDF template
Form for ACERA retirees to enroll in or modify vision insurance coverage options.
See template
See template
Supplemental Vision Active Employee Enrollment Form
PDF template
Employee enrollment form for supplemental vision insurance coverage through Delta Dental of Wisconsin.
See template
See template
University Health Center Vision Insurance Form
PDF template
A form for students to submit vision insurance information for processing at the University Health Center
See template
See template
Vision Plan Out Of Network Claim Form
PDF template
Form for employees to submit out-of-network vision care expenses for reimbursement through their employer's vision plan.
See template
See template
Vision Claim Form
PDF template
A form for submitting vision care expenses for reimbursement through a health benefits plan.
See template
See template
Personal Medical Info Form
PDF template
A comprehensive medical information form for students participating in a travel program, collecting health history and current medical details.
See template
See template
U.S. Department Of State Academic Exchanges Participant Medical History And Examination Form
PDF template
Medical history and examination form required for international educational exchange program participants to confirm health status and medical clearance.
See template
See template
PRE ADMISSION BOOKING FORM
PDF template
Comprehensive form for collecting patient and medical aid details prior to hospital admission, used for pre-authorization and patient registration.
See template
See template
Visual Talk Proposal Form
PDF template
A form for artists to propose presentations about their art, experiences, and stories for community events in the Fargo-Moorhead area.
See template
See template
Patient Intake Form
PDF template
Comprehensive clinical intake form for evaluating patient's mental health, medical history, and current psychological functioning.
See template
See template
Rehabilitation Referral Form
PDF template
A comprehensive form for referring veterinary patients to rehabilitation services at the University of Minnesota Veterinary Medical Center.
See template
See template
Leave Request Form
PDF template
Comprehensive form for employees to request various types of leave, including medical, family, and military leaves.
See template
See template
Instructions Online Abstract Submission Form
PDF template
Comprehensive instructions for submitting academic or medical conference abstracts, covering submission requirements and process details.
See template
See template
Nutrition Referral Form
PDF template
A comprehensive form for veterinary professionals to request nutrition consultation and provide detailed patient medical information.
See template
See template
Referral Form
PDF template
A comprehensive referral form for animal patients seeking specialized veterinary services at the University of Tennessee Veterinary Medical Center.
See template
See template
VREP Waiver
PDF template
A legal document for participants in a motorcycle safety training course, releasing liability and acknowledging risks associated with the training.
See template
See template
VNSNY Physician Referral Form
PDF template
Comprehensive medical referral form for home care services, collecting patient information, insurance details, and physician certification.
See template
See template
Form 5 Special Love Medical Form For Volunteer
PDF template
Comprehensive medical and contact information form for camp volunteers, capturing health history, emergency contacts, and immunization details.
See template
See template
City Of Springfield STD Cancellation Form
PDF template
Insurance form for cancelling short-term disability coverage through Hartford Life and Accident Insurance Company
See template
See template
Waiver Of Liability, Assumption Of Risk, And Indemnity Agreement
PDF template
Legal document waiving liability and assuming risks for participation in music activities at Indiana University of Pennsylvania's Community Music School.
See template
See template
Voluntary Audit Form
PDF template
An insurance document requesting payroll records and documentation to finalize workers' compensation insurance premium calculations.
See template
See template
Voluntary Participation Acknowledgement And Assumption Of Risk
PDF template
A legal document for volunteers at Mt. San Jacinto Community College to acknowledge risks and release the institution from liability.
See template
See template
Rules And Requirements, Medical Consent, Release And Waiver Of Liability, Assumption Of Risk And Ind
PDF template
A legal document outlining terms of participation, risks, and liability release for university-related activities
See template
See template
Voluntary Shared Leave Request Form
PDF template
A form for employees to request leave donated by other employees when they have exhausted their own leave credits.
See template
See template
Voluntary Student Transportation Agreement For Field Trip And Excursions
PDF template
Legal document releasing Barstow Community College District from liability for student-arranged transportation during activities and field trips.
See template
See template
Voluntary Waiver Form
PDF template
Legal document for participants to acknowledge risks and waive liability when engaging in activities at Providence College
See template
See template
Providence College Voluntary Waiver Form
PDF template
A legal document for participants or parents/guardians to acknowledge risks and provide consent for activities at Providence College
See template
See template
Wayfinder Paralympic Games Volunteer Registration Form
PDF template
Registration form for volunteers interested in supporting the Wayfinder Paralympic Games competitions and events
See template
See template
Volunteer Activity Waiver Form
PDF template
A comprehensive waiver form for volunteers to authorize participation and medical treatment in case of emergencies.
See template
See template
Volunteer Activity Waiver Form
PDF template
A comprehensive waiver form for volunteers to release liability and provide emergency contact information for parish or school activities.
See template
See template
GIT Structured Volunteer Form (012021)
PDF template
A document outlining insurance coverage and guidelines for volunteers at Georgia Institute of Technology
See template
See template
Volunteer Agreement Form
PDF template
A volunteer agreement outlining the responsibilities and expectations for volunteers at the Skagit River Bald Eagle Interpretive Center.
See template
See template
VOLUNTEER AGREEMENT FORM
PDF template
A comprehensive agreement outlining volunteer responsibilities, injury waivers, photo consent, and workplace policies for volunteers at North Country Food Bank.
See template
See template
GIT Structured Volunteer Form
PDF template
A document outlining insurance and claims management for volunteers at Georgia Institute of Technology, specifying coverage limitations and volunteer program guidelines.
See template
See template
Adult And College Volunteer Application
PDF template
Comprehensive application for adult and college volunteers seeking to volunteer at various healthcare campuses in Georgia.
See template
See template
Town Of Perinton Volunteer Application Form
PDF template
A comprehensive volunteer application form for individuals interested in various community recreation programs and services.
See template
See template
Volunteer Application And Waiver
PDF template
Application form for volunteers to register and provide personal information for participation in parks and recreation volunteer activities.
See template
See template
Volunteer Application
PDF template
A comprehensive form for individuals interested in volunteering with the Buhler Recreation Commission, collecting personal contact information, availability, and background details.
See template
See template
Volunteer Application Form
PDF template
A comprehensive application form for individuals interested in volunteering at the Watermark Art Center in various capacities.
See template
See template
Creald School Of Art Volunteer Application
PDF template
Application form for individuals interested in volunteering at Creald School of Art, covering personal details, skills, availability, and background check consent.
See template
See template
Volunteer Application Form
PDF template
A comprehensive form for individuals interested in volunteering at various hospitals in the Mackay region of Queensland.
See template
See template
VOLUNTEER APPLICATION FORM
PDF template
A comprehensive form for individuals interested in volunteering with the Village of Pinecrest, covering personal information and volunteer preferences.
See template
See template
Volunteer Consent Form
PDF template
A legal consent and liability release form for volunteers participating in activities at KVC Behavioral HealthCare.
See template
See template
New Milford Health Department Volunteer Contact Form
PDF template
A form for collecting contact and professional information from potential health department volunteers
See template
See template
Volunteer Driver Application Form
PDF template
A comprehensive form for screening and qualifying volunteer drivers for child and family services transportation.
See template
See template
VOLUNTEER EMERGENCY CONTACT FORM
PDF template
Form for collecting emergency contact details and medical transport authorization for volunteers
See template
See template
Cuesta College RN Program Application Volunteer In Healthcare Or Non Profit Organization Verificatio
PDF template
A form for documenting volunteer hours for Cuesta College nursing program application, requiring a minimum of 200 volunteer hours between September 2022 and September 2024.
See template
See template
BOA Volunteer Firefighter Disability Claim Form
PDF template
Official claim form for Alabama volunteer firefighters seeking disability benefits due to service-related injury.
See template
See template
Agreement For Non Reimbursed Volunteer Services
PDF template
A legal document outlining volunteer service terms and conditions for University of Montana Western volunteers.
See template
See template
City Of Roanoke Volunteer Application Form
PDF template
A comprehensive volunteer application form for the City of Roanoke Parks and Recreation Department that collects personal information and includes a liability release.
See template
See template
VOLUNTEER FORM
PDF template
Comprehensive volunteer application form for individuals seeking to volunteer at the San Angelo YMCA, including background check and personal information section.
See template
See template
Volunteer Registration Liability Waiver Form
PDF template
A comprehensive volunteer registration form and liability waiver for individuals interested in volunteering with the Disability Foundation and its affiliated societies.
See template
See template
Volunteer Workers Compensation Form Instructions
PDF template
Guidelines for obtaining workers compensation insurance for volunteers at the University of North Dakota based on task risk and frequency.
See template
See template
VOLUNTEER FORM For NATIONAL CONFERENCE
PDF template
Comprehensive volunteer application form for a national conference, including personal details, availability, references, and code of conduct.
See template
See template
VolunteerS Waiver Of Liability And Release Of Claims
PDF template
Legal document authorizing criminal history records check and releasing liability for volunteers in school district.
See template
See template
Volunteer Form
PDF template
A comprehensive volunteer sign-up form for school community members to help with various activities and events.
See template
See template
Volunteer Medical Form
PDF template
Medical form for collecting health details and emergency contact information for volunteers.
See template
See template
Oberlin College Volunteer Form And Release
PDF template
A comprehensive volunteer agreement outlining responsibilities, risks, and liability waivers for volunteers at Oberlin College.
See template
See template
PARENTAL CONSENT FORM FOR VOLUNTEERS
PDF template
Legal form granting parental permission for minors to volunteer at Towson University and releasing the university from liability.
See template
See template
California State University Volunteer Release Form For Minors
PDF template
Legal form for parent/guardian consent and liability release for minors volunteering at California State University San Marcos.
See template
See template
VOLUNTEER AGREEMENT MEDICAL RELEASE FORM
PDF template
A comprehensive agreement outlining volunteer responsibilities, expectations, and liability release for individuals volunteering with the Westchester Park District.
See template
See template
VOLUNTEER QUICK REGISTRATION FORM
PDF template
A registration form for volunteers to complete prior to starting their volunteer assignment, used by Occupational Health Services for medical clearance.
See template
See template
Volunteer Release And Waiver Of Liability Form
PDF template
Legal document releasing United Food Bank from liability for volunteer activities and potential injuries during service.
See template
See template
Life University Volunteer Service AgreementRelease Parental Consent Form
PDF template
A legal document outlining the terms and conditions for volunteering at Life University, including liability waivers and confidentiality agreements.
See template
See template
Approval For Volunteers Participating In SOM Research Activities
PDF template
Form for authorizing volunteers to participate in research activities under faculty supervision at the UVA School of Medicine.
See template
See template
Volunteer Time For DMS (Diagnostic Medical Sonography)
PDF template
Guidelines for volunteer hours and hospital observation requirements for Diagnostic Medical Sonography program admission
See template
See template
Accident Waiver And Release Of Liability Form
PDF template
Legal document releasing liability for participation in activities, with specific focus on Louisiana SPCA event risks and responsibilities.
See template
See template
Volunteer Waiver And Release Form
PDF template
Legal document for registering volunteers and releasing the city from liability for volunteer activities
See template
See template
Volunteer Waiver Form
PDF template
Legal document outlining volunteer responsibilities, rights, and liability waivers for Genesee County volunteer program.
See template
See template
Volunteer Workers Limited Medical Cost Reimbursement Policy
PDF template
Policy outlining medical cost reimbursement for volunteer workers not covered by workers' compensation, with a maximum reimbursement of $5,000 for work-related injuries.
See template
See template
General Release, Indemnity, And Waiver Of Liability
PDF template
A legal document releasing the Village of Ruidoso from liability for participation in recreational activities and granting permission for media use.
See template
See template
Visitor, Volunteer, Or Other Non Employee Incident Report Form
PDF template
A form for documenting incidents involving visitors, volunteers, or non-employees, including details about the incident, injuries, and witnesses.
See template
See template
Vintage Racers Group Vintage Racing License Medical Form
PDF template
Medical examination form for motorsport competition racing license applicants, focusing on physical fitness and safety capabilities.
See template
See template
ANPACANG Homeowners And Rental Owners Change Form Revision
PDF template
Official communication detailing revisions to the Homeowners/Rental Owners Policy Change Form for ANPAC agency personnel.
See template
See template
Referral Form
PDF template
A specialized referral form for veterinary medical specialty consultations, used to transfer patient information between veterinary practices.
See template
See template
Request For Reimbursement
PDF template
A form for submitting out-of-network vision care reimbursement claims to Vision Service Plan (VSP)
See template
See template
VSP Member Reimbursement Form
PDF template
A form for VSP vision care members to request reimbursement for vision-related services and expenses.
See template
See template
Enrollment Form With Dependent Data
PDF template
A form for employees to enroll in health insurance coverage and provide dependent information.
See template
See template
VSP Member Reimbursement Form
PDF template
A form for VSP vision care members to request reimbursement for vision-related services and expenses.
See template
See template
WAIVER FORM
PDF template
A form to decline participation in the VSP (Vision Service Plan) vision program offered by an employer.
See template
See template
VYSA Medical Release Form
PDF template
A medical release form allowing emergency medical treatment for a youth soccer player by parent or legal guardian.
See template
See template
Mental Health Transport Risk Assessment Form
PDF template
A form used to assess risks associated with mental health patient transportation and determine appropriate transport options.
See template
See template
Vaccine Administration Record (VAR)Informed Consent For Vaccination
PDF template
A legal document providing informed consent for vaccine administration, detailing patient rights, provider responsibilities, and information sharing permissions.
See template
See template
2021 2022 North Shore Academy Of Gymnastics Registration Form And Waiver
PDF template
Registration form and liability waiver for North Shore Academy of Gymnastics programs and activities
See template
See template
Waiver Form And Acknowledgement Of Receipt Of Policies
PDF template
Patient form acknowledging financial responsibility for medical services not covered by insurance and agreeing to office policies.
See template
See template
ACCIDENT WAIVER, RELEASE OF LIABILITY AND INDEMNIFICATION FORM
PDF template
Legal document waiving liability for vendors participating in events at the Canal Street Marketplace Facility.
See template
See template
Waiver And Release Of Liability, Assumption Of Risk, And Indemnity Agreement
PDF template
Legal document releasing liability for participants in glacier diving activities, outlining risks and participant responsibilities.
See template
See template
Waiver And Release Of Liability, Assumption Of Risk, And Indemnity Agreement
PDF template
Legal document waiving liability for diving activities and acknowledging potential risks associated with diving.
See template
See template
Waiver And Rental Agreement Form
PDF template
A comprehensive waiver and rental agreement for clients renting Daybreak Point Bible Camp's island facility, outlining liability, risks, and client responsibilities.
See template
See template
University Of The Incarnate Word Waiver And Consent To Treat
PDF template
Legal document providing parental consent and waiver of liability for a minor's participation in a university or high school camp.
See template
See template
Liability Release Form
PDF template
Legal document releasing Black Hills Paintball from liability for participants in paintball and related activities, including equipment damage and personal injury risks.
See template
See template
Release Of Liability, Waiver Of Claims, Assumption Of Risks And Indemnity Agreement
PDF template
Legal document waiving rights and assuming risks for participation in drop-in pickleball activities at Springbrook Multi-plex.
See template
See template
COVID 19 POOL AREAS USE RELEASE AND WAIVER AGREEMENT
PDF template
Legal document outlining COVID-19 safety terms and conditions for pool area usage by community association members.
See template
See template
ParentGuardian Permission Waiver Form For Minors
PDF template
A waiver form granting permission for minors to participate in volunteer activities at Daily Bread Food Bank, releasing the organization from liability.
See template
See template
Waiver Of Health, Dental AndOr Vision Coverage
PDF template
A form allowing employees to decline health, dental, and vision insurance coverage offered by their employer.
See template
See template
McHenry County College Fitness Evaluation Exercise Waiver Form
PDF template
A legal waiver for participants in McHenry County College's Fitness Education Program, releasing the college from liability for potential injuries or damages.
See template
See template
Release Of Liability, Waiver Of Claims, Assumption Of Risks And Indemnity Agreement
PDF template
Legal document releasing liability for participation in a Round Dance Shuttle Bus event with multiple collection points in Alberta, Canada.
See template
See template
Waiver And Release Of Liability, Assumption Of Risk And Indemnity Agreement
PDF template
Legal document outlining liability release and risk acknowledgment for participants in United States Equestrian Federation events and activities.
See template
See template
WAIVER, INDEMNIFICATION, AND MEDICAL TREATMENT AUTHORIZATION FORM
PDF template
Legal document releasing Prairie View A&M University from liability for participation in university-sponsored activities and acknowledging inherent risks.
See template
See template
PARTICIPANT ACCIDENT WAIVERRELEASE OF LIABILITY FORM
PDF template
A legal document used to waive liability and obtain participant signatures for an event or activity.
See template
See template
For Minors) WAIVER AND RELEASE OF LIABILITY AND ASSUMPTION OF RISK AND PARENTAL CONSENT AND INDEMNIT
PDF template
Legal document waiving liability for minor participation in North American Roller Hockey Championships activities, acknowledging risks and parental consent.
See template
See template
SOUTHWEST TEXAS JUNIOR COLLEGE WAIVER OF LIABILITY MEDIA RELEASE FORM
PDF template
A document requiring parental consent for a STEM summer camp, including liability waiver and media release permissions.
See template
See template
USACC Form COIRWL 1, V. 1.1
PDF template
A liability release form for participants in Army ROTC/JROTC military-style training activities, acknowledging voluntary participation in potentially risky events.
See template
See template
Research And Academic Areas Use Assumption Of Risk And Release Of Liability For Volunteers And Visit
PDF template
A legal document for non-student and non-employee volunteers to assume risks and release the University of Michigan from liability when using university facilities.
See template
See template
Waiver Of Medical Coverage Form
PDF template
Form for employees to waive State Employee Group Insurance Program (SEGIP) medical coverage when having alternative coverage.
See template
See template
Waiver Of Pre Tax Insurance Form
PDF template
A form allowing employees to opt out of pre-tax deductions for employer-sponsored insurance premiums at UND.
See template
See template
Accident Waiver And Release Of Liability
PDF template
Legal document releasing Habitat for Humanity from liability for volunteer activities and potential risks during participation.
See template
See template
Parks And Recreation Department Waiver Release Form
PDF template
Legal document releasing the City of Miami Beach from liability for injuries or damages during recreational activities.
See template
See template
GT Waiver Of Liability, Assumption Of Risk And Indemnity Agreement
PDF template
A comprehensive legal document outlining risks and liability for participants in athletic, recreational, and adventure programs at Georgia Tech.
See template
See template
Waiver Authorizing Disclosure Of Information And Releasing Liability
PDF template
A legal document required by Wisconsin statute for law enforcement job candidates to authorize disclosure of employment files and release employers from liability during hiring process.
See template
See template
Waiver Service Approval Form
PDF template
A form used by care coordinators to request and approve waiver services for members, documenting service details and provider information.
See template
See template
Waiver Service Request Form
PDF template
Comprehensive form for requesting rehabilitation and support services with detailed client and medical information.
See template
See template
Securing Waivers Of Liability From Volunteers Of Nonprofit Organizations
PDF template
A comprehensive guide for nonprofit organizations on obtaining and implementing volunteer liability waivers to protect the organization from potential legal claims.
See template
See template
Assumption Of Risk, Accident Waiver And Release Of Liability
PDF template
Legal document that releases liability for participants in adaptive sports activities, acknowledging potential risks and waiving claims against event organizers and sponsors.
See template
See template
Vaccine Administration Record (VAR)Informed Consent For Vaccination
PDF template
Legal consent form for vaccine administration, detailing patient rights, risks, and information sharing permissions.
See template
See template
St. Clair County Community CollegeYMCA Of The Bluewater Area Activity Waiver Form
PDF template
A comprehensive waiver form for participants in college and YMCA activities, addressing risks, liability, and emergency treatment consent.
See template
See template
Verbal Sign Out Feedback Form
PDF template
Structured evaluation form for assessing the quality of medical trainee verbal patient handoff communication during overnight transitions of care.
See template
See template
Warfarin Care Hospital Discharge Form
PDF template
A specialized hospital discharge form for patients in the Warfarin Care program, tracking medication and health status upon patient release.
See template
See template
WARRANTY CLAIM FORM
PDF template
A comprehensive form for submitting property damage warranty claims, requiring detailed property and damage information.
See template
See template
Claim Payment Appeal Submission Form
PDF template
A form for healthcare providers to submit appeals regarding claim payment decisions made by Amerigroup Washington, Inc.
See template
See template
WASHINGTON YOUTH SOCCER PARENTGUARDIAN CONSENT AND PLAYER MEDICAL RELEASE FORM
PDF template
Medical release and consent form for youth soccer players, including emergency contact and medical history information.
See template
See template
Notice Of Designation As Independent Contractor
PDF template
A form for workers to declare their status as an independent contractor and verify their insurance and business details for workers' compensation purposes
See template
See template
WCC10 Alabama Assessment Form
PDF template
Annual reporting form for documenting workers' compensation claim expenses and settlements in Alabama.
See template
See template
Limited Power Of Attorney For Purpose Of Regulatory Filings
PDF template
A legal document authorizing Minnesota Workers' Compensation Insurers Association to file rating plans with the Department of Commerce on behalf of multiple insurers.
See template
See template
Membership Form
PDF template
Comprehensive membership registration form for participation in Parks and Recreation Department programs, including personal and family details and liability waiver.
See template
See template
WorkerS Compensation Witness Report Form
PDF template
Form for documenting witness details and observations of a workplace incident for workers compensation purposes.
See template
See template
Membership Cancellation Form
PDF template
A form for members to cancel their recreation center membership, documenting payment details and reasons for cancellation.
See template
See template
Creative Competition Entry Form MARDI GRAS
PDF template
A creative competition inviting participants to design the cover for the Ilkley Carnival 2024 programme, with entries encouraged to be colorful and imaginative.
See template
See template
Prepare Our Island Week 4 Important Documents
PDF template
A comprehensive guide for organizing critical personal documents in preparation for potential disasters like earthquakes.
See template
See template
Weekly Disability Benefit Claim Form
PDF template
A form for filing a weekly disability benefit claim for Teamsters Health and Welfare Fund members seeking disability benefits.
See template
See template
Weekly Disability Benefit
PDF template
A disability insurance program offering partial wage replacement for non-work related injuries or illnesses for eligible employees.
See template
See template
Weekly Disability Claim Form
PDF template
A comprehensive form for reporting employee disability claims, including sections for employee, employer, and physician statements.
See template
See template
Weight Management (Semaglutide) Medical History Form
PDF template
A comprehensive medical history form for patients seeking weight management treatment using Semaglutide medication.
See template
See template
Confidential Medical Form
PDF template
Medical form for Joy Outdoor Education Center's Camp WEKANDU, providing instructions for medication management and health requirements for campers.
See template
See template
Certificate Of Liability Insurance Request Form
PDF template
A form for requesting liability insurance coverage for Synodical Women's Organization events under ELCA's insurance policy.
See template
See template
Certificate Of Liability Insurance Request Form
PDF template
Form for requesting liability insurance coverage for Synodical Women's Organization events under ELCA's insurance policy.
See template
See template
Otolaryngology DIAMOND CONFERENCE Welcome Reception Registration
PDF template
Registration form for welcome reception at the Otolaryngology Diamond Conference with ticket pricing and payment options.
See template
See template
Joint Welfare Fund LU 164 HRA Reimbursement Form
PDF template
Health Reimbursement Account (HRA) claim form for submitting medical expense reimbursement requests for members and dependents.
See template
See template
WELL BEING ACTIVITY PROPOSAL FORM
PDF template
A form for proposing and obtaining approval for a well-being activity within an educational or medical organization.
See template
See template
Well Being Index Academic License Agreement
PDF template
Legal agreement for academic users to utilize the Well-Being Index measurement tool for medical education and research purposes.
See template
See template
Accident Procedures Form
PDF template
Comprehensive guide for handling vehicle accidents, including reporting procedures and documentation requirements.
See template
See template
Student Insurance Claim Form
PDF template
A comprehensive insurance claim form for students to report medical examinations, illnesses, injuries, and insurance coverage details.
See template
See template
WELLNESS BENEFIT CLAIM FORM (Accident Insurance)
PDF template
A form for submitting wellness exam and preventive health screening claims under an accident insurance policy.
See template
See template
Wellness Benefit Claim Form
PDF template
A claim form for submitting wellness-related medical tests and screenings for potential insurance benefits.
See template
See template
RELEASE AND WAIVER OF LIABILITY ASSUMPTION OF RISK AND INDEMNITY AGREEMENT AND DIGITAL, FILM, VIDEO
PDF template
Legal document releasing event organizers from liability and assuming risk for participation in an art event involving pets.
See template
See template
City Of Wilsonville WERK Day Volunteer Form
PDF template
A volunteer liability release form for City of Wilsonville community service activities, outlining participant rights and responsibilities.
See template
See template
Auto LiabilityPersonal Injury Protection Information
PDF template
Form for collecting patient information, insurance details, and liability information related to auto accidents and medical claims.
See template
See template
West Swim Team Procurement Form
PDF template
A form for collecting donations, advertising, and contributions to support a swim team's activities and facilities.
See template
See template
DISINTERESTED THIRD PARTY CONTINUING EDUCATION AFFIDAVIT
PDF template
Instructions for obtaining continuing education credits for insurance agents in West Virginia through proctored examinations.
See template
See template
Claim Form
PDF template
A form used to request reimbursement for eligible out-of-pocket healthcare and dependent care expenses through a flexible spending account.
See template
See template
Dance
PDF template
A document detailing aspects of a dance program or dance-related guidelines and procedures.
See template
See template
Application For Life AndOr Critical Illness Insurance
PDF template
Notice of changes to Equitable Life's insurance application process and form requirements with new version and submission guidelines.
See template
See template
Westlake High School 2020 2021 Application For Student Parking Permit
PDF template
A form for high school students to apply for a parking permit to drive and park at Westlake High School during the academic year.
See template
See template
WIAA Physical Examination Form For Pius XI Catholic High School
PDF template
A mandatory medical examination form for students participating in interscholastic athletics, documenting physical fitness for sports participation.
See template
See template
NEW JERSEY WIC HEALTH CARE REFERRAL
PDF template
A comprehensive health referral form for children under 5 years old, collecting medical and anthropometric data for WIC program enrollment.
See template
See template
WIC Medical Referral Form For Infants And Children
PDF template
A medical referral form for collecting health and demographic information about infants and children for the WIC (Women, Infants, and Children) program.
See template
See template
Hirer Collision Or Damage Report Form
PDF template
A comprehensive form for documenting details of a vehicle rental accident, including driver, witness, vehicle, and incident information.
See template
See template
DOH 799 WIC Medical Referral Form
PDF template
A medical referral form used to refer patients to the WIC Program and communicate patient health information for nutrition care and counseling.
See template
See template
Naropa University Wilderness Therapy Confidential Medical Record
PDF template
Comprehensive medical intake form for Naropa University's Wilderness Therapy program, requiring detailed health information from prospective and current students.
See template
See template
Medical Form
PDF template
Comprehensive medical history form for participants in outdoor adventure activities, including health conditions, emergency contacts, and liability acknowledgment.
See template
See template
Student Health Record
PDF template
Comprehensive medical history form for nursing students, collecting personal health information and health status details.
See template
See template
TOPSFIELD FAIR WINE LABEL COMPETITION ENTRY FORM
PDF template
An entry form for submitting wine labels and artwork to the Topsfield Fair's winemaking exhibit competition.
See template
See template
Withdrawal From Recreation Programs Refund Request
PDF template
A form for participants to request withdrawal and potential refund from recreation and aquatic programs with specific conditions.
See template
See template
Pre Filed Witness Statement Of Michael A. Pedraja
PDF template
A detailed document presenting Allstate Insurance Company's proposed restructuring plan submitted to the Illinois Director of Insurance.
See template
See template
Acord 35 Cancellation Request
PDF template
A document discussing ACORD insurance policy cancellation procedures and related certificate changes.
See template
See template
Consent To Treat Form
PDF template
A form allowing University of Kentucky Medical Center to provide medical treatment and file insurance claims with patient consent.
See template
See template
Imaging Outpatient Order Form
PDF template
Comprehensive medical imaging order form for capturing patient information and procedure details for various radiology examinations.
See template
See template
WMCMetLife Employee Benefit Plan Contact Information
PDF template
Comprehensive contact information for WMC and MetLife employee benefit plan administrators, claims processing, and customer service.
See template
See template
MEDICAL RELEASE FORM
PDF template
A medical authorization form allowing treatment of a minor athlete in case of emergency when parent/guardian is unavailable.
See template
See template
Medical Form
PDF template
A confidential medical form for students attending Westminster Choir College's Summer Arts Programs, collecting health and emergency contact information.
See template
See template
OBSTETRICS AND GYNECOLOGY INTAKE FORM
PDF template
Comprehensive medical intake form for patients seeking obstetric and gynecological care, collecting detailed personal and medical history information.
See template
See template
Liability Waiver Form
PDF template
A legal waiver releasing the Columbus Police Department from liability during a self-defense class participation, covering potential physical injury or property damage.
See template
See template
CP 4866 01 01 WOODCOAL BURNING STOVE SUPPLEMENTAL INSPECTION FORM
PDF template
A detailed inspection form for assessing the safety and installation of wood or coal burning stoves.
See template
See template
Workers Compensation Claim Forms Alphabetical Index
PDF template
Comprehensive reference guide for workers' compensation claim forms, covering various documents used in the claims process.
See template
See template
Workers Compensation Online Interview Form
PDF template
A detailed form for documenting workplace injury, medical treatment, and compensation claims for employees.
See template
See template
WORKERS COMPENSATION PATIENT INTAKE FORM
PDF template
A form for documenting patient information and details related to a work-related injury for insurance and medical processing purposes.
See template
See template
Working Spouse Premium Waiver Form
PDF template
Form for Purdue employees to certify spouse's medical insurance eligibility and waive working spouse premium
See template
See template
Participant Release Of Liability, Waiver Of Claims, Assumption Of Risks And Indemnity Agreement
PDF template
Legal document outlining risks and liability waivers for participants in river rafting activities with World Wide River Expeditions.
See template
See template
Tax Sharing In Insurance Markets A Useful Parameterization
PDF template
An academic research paper examining the economic impacts of taxation on insurance payments and moral hazard using a principal-agent framework.
See template
See template
Membership Form
PDF template
Application form for joining the Woodbridge Pickleball Club, requiring personal information and membership fee payment.
See template
See template
Membership Form
PDF template
Membership form for joining the Woodbridge Pickleball Club, requiring personal information and a $10 fee.
See template
See template
My Benefit Plan Booklet
PDF template
Group benefits booklet for professional firefighters in the City of Windsor, provided through Green Shield Canada.
See template
See template
MY BENEFIT PL AN BOOKLET
PDF template
A benefit plan booklet for retired firefighters and their surviving spouses from the City of Windsor, providing group benefits through Green Shield Canada.
See template
See template
Wayfinder Paralympic Games Volunteer Registration Form
PDF template
Registration form for volunteers interested in supporting the Wayfinder Paralympic Games sporting events
See template
See template
Medical Release Form
PDF template
A legal document granting medical treatment permission for a minor by a parent or guardian, valid for one year.
See template
See template
WUL Wrap Up Liability Insurance Form
PDF template
A certificate of insurance documenting wrap-up liability coverage for a project involving multiple parties and participants.
See template
See template
Wellness And Recreation Center Membership Form
PDF template
Form for faculty, staff, contractors, and affiliates to enroll in or cancel Wellness and Recreation Center memberships with payroll deduction or direct payment options.
See template
See template
Wentzville Rec Center (WREC) Meeting Room Rental Application
PDF template
A form for requesting and reserving meeting rooms at the Wentzville Recreation Center with details about event and facility requirements.
See template
See template
NFHS Medical Release Form For Wrestler To Participate With Skin Lesion(S)
PDF template
A medical release form developed by the National Federation of State High School Associations to guide participation of wrestlers with skin lesions while minimizing disease transmission risks.
See template
See template
Medical Release Form For Wrestler To Participate With Skin Lesion
PDF template
A medical form documenting a wrestler's skin condition and clearance to participate in competitions.
See template
See template
West Side Soccer League Tryout Participation Waiver Medical
PDF template
Registration form for soccer players with medical information, emergency contacts, and parental consent for participation and media usage.
See template
See template
Family Medical Leave Request Form
PDF template
Comprehensive form for employees to request family and medical leave, covering various types of leave and documentation requirements.
See template
See template
Medical History Form
PDF template
Comprehensive medical form for collecting patient's personal, surgical, and family medical history details.
See template
See template
Mountaineer Flexible Benefits Enrollment Form
PDF template
A comprehensive form for employees to enroll, modify, or cancel flexible benefits during open enrollment period.
See template
See template
2020 WWA Decoy Carving Competition Entry Form
PDF template
Official entry form for the World Wildfowl Association (WWA) Decoy Carving Competition, specifying entry requirements and details.
See template
See template
2024 WWA Decoy Carving Competition Entry Form
PDF template
Entry form for participants in the Wisconsin Wildfowl Association (WWA) annual decoy carving competition, with details on entry levels, fees, and submission guidelines.
See template
See template
Walk With Ease Attendance Form
PDF template
A tracking form for recording participant attendance and documentation for a Walk with Ease program session series.
See template
See template
Alabama WISEWOMAN Data Collection Patient Intake Form
PDF template
Medical intake form for collecting patient personal information and health history in Alabama's WISEWOMAN program.
See template
See template
Summer Camp Accident Waiver And Release Of Liability Form
PDF template
A liability waiver for parents allowing their children to participate in Washington Waldorf School's summer camp program, covering potential risks and medical authorization.
See template
See template
Medical Release Form
PDF template
A medical release form allowing emergency medical treatment for a youth soccer player by parent or legal guardian.
See template
See template
Physical Examination Form I
PDF template
Medical examination form for youth admission to Mississippi Department of Human Services youth development center
See template
See template
PATIENT AUTHORIZATION FOR XTANDI SUPPORT SOLUTIONS
PDF template
Comprehensive patient information and authorization form for Xtandi patient assistance program and support services.
See template
See template
YOUTH PROGRAMS XTREMEWEEK REGISTRATION
PDF template
Registration form for high school students to participate in summer art intensive programs at Massachusetts College of Art and Design.
See template
See template
Evaluation Form
PDF template
Form for evaluating the quality and completeness of medical sign-out procedures between healthcare providers.
See template
See template
Yarnfiti 2024 Submission Form
PDF template
Form for submitting artwork to the Yarnfiti Community Art Project hosted by Orange County Library System.
See template
See template
Form DI 4015 United States Youth Conservation Corps Medical History Form
PDF template
Medical history form for applicants to the U.S. Department of Interior's Youth Conservation Corps program to determine eligibility and health status.
See template
See template
Court Referral Program YDAD REGISTRATION
PDF template
Registration form for Court Referral Program's drug and alcohol deterrence program involving personal and case details
See template
See template
Year 12 Work Experience Insurance Form
PDF template
A mandatory form for employers to provide insurance and health & safety details for student work experience placements.
See template
See template
YEARLY UPDATE FORM YEAR 2023
PDF template
Annual form for updating patient and guardian information for established pediatric patients under 18 years old.
See template
See template
Youth Empowerment Summit Application Packet
PDF template
Comprehensive application packet for youth summit participants including medical information, consent forms, and participant details
See template
See template
2024 IFSC Equipment Form
PDF template
A form for paraclimbing athletes to declare specialized equipment used during competition that accommodates their specific impairments.
See template
See template
Guest Waiver Fitness Release
PDF template
Legal document releasing YMCA of the Chesapeake from liability for potential injuries during fitness activities and program participation.
See template
See template
YOGA CLASS WAIVER FORM
PDF template
Legal waiver form for participants in yoga classes, collecting personal and medical information and releasing liability.
See template
See template
Musician Medical Form
PDF template
Medical form for musician participation in the Youth Orchestra of Palm Beach County, requiring health and emergency contact information.
See template
See template
Glucksman Young Light Poster Competition Entry Form
PDF template
Competition entry form for young artists aged 0-18 to submit digital poster artwork for the Glucksman competition.
See template
See template
Your Home Inventory
PDF template
A comprehensive guide for creating and maintaining a detailed inventory of personal property for insurance, tax, and estate planning purposes.
See template
See template
Youth Code Of Conduct Media Medical Release Form
PDF template
A comprehensive conduct and release form for participation in Michigan State University Extension 4-H youth programs, outlining behavioral expectations and program rules.
See template
See template
New Mexico 4 H Youth Medical And Liability Release Code Of Conduct Contract And Media Release Form
PDF template
A comprehensive form for 4-H youth participants covering medical information, liability release, code of conduct, and media release.
See template
See template
Liability Release Form
PDF template
A comprehensive legal document releasing the church from liability and granting medical treatment authorization for participants in church activities or trips.
See template
See template
Acknowledgment And Assumption Of Risks Release And Indemnity Agreement
PDF template
Legal document outlining risks and liability for youth participants in wilderness activities with Women's Wilderness Institute.
See template
See template
Medical Release Form
PDF template
A medical release and emergency contact form for children participating in Parks & Recreation programs, granting medical consent and providing critical health information.
See template
See template
Medical ReleasePermission Form
PDF template
A comprehensive medical form for participant information, emergency contacts, medical details, and liability waiver for activities.
See template
See template
BCYF Member Information Form
PDF template
Comprehensive registration form for youth participation in Boston Centers for Youth & Families community programs, collecting personal, medical, and contact information.
See template
See template
Facility Risk Assessment Form
PDF template
A comprehensive assessment form for identifying facility risks and safety considerations for youth programs.
See template
See template
YouthSERVE Volunteer Registration Form
PDF template
A consent form for youth volunteers to participate in Volunteer Center of Santa Cruz County programs, including liability release and media permissions.
See template
See template
Request For Proposals (RFP) Yellowstone Kelly Heritage Trail
PDF template
Request for professional services to develop a design plan for mountain bike skills park and trail amenities along the Yellowstone Kelly Heritage Trail in Paradise, California.
See template
See template
Clinic Visit Parental Consent Form
PDF template
A consent form for pediatric clinic visits, collecting patient and parent/guardian information and communication preferences.
See template
See template
Client Referral Form
PDF template
A comprehensive form for referring a client for healthcare or therapeutic services, capturing personal, medical, and contact information.
See template
See template
COVID 19 Testing Registration Form
PDF template
A registration form for SARS-CoV-2 nucleic acid testing with patient demographic and insurance information.
See template
See template
Employee Flexible Spending Account (FSA) Enrollment Form
PDF template
A comprehensive form for employees to enroll in and select flexible spending account options for healthcare and dependent care expenses.
See template
See template
LifeVest Medical Order Form
PDF template
A medical order form for prescribing and configuring a LifeVest wearable cardioverter defibrillator for patients at risk of cardiac events.
See template
See template
Group Personal Accident Certificate
PDF template
Insurance certificate providing accident coverage for eligible persons under a group policy issued to the State of Wisconsin Group Insurance Board.
See template
See template
Utah State University Voluntary Accidental Death Dismemberment Insurance
PDF template
Insurance policy providing accidental death and dismemberment coverage for Utah State University employees and their dependents.
See template
See template
Start filling Recreation Insurance Form for free
Why product teams love Anvil
Vouch logo
Travis Hedge
Co-Founder
Anvil plays a really important role for us in being able to translate the unique risks and needs of our client base into the models of how traditional insurance companies operate.
See the full case study
Easy to implement
Pre-built components, clear
documentation
, and AI tools make Anvil a time-saver.
Launch in days
Don't reinvent the wheel building software in-house.
Make it fully yours
Style
components to be on brand, then embed them into your application.