Gordon, GA · Wilkinson County
Physical Consent Form
The City of Gordon Physical Consent Form records an applicant’s agreement to a physical examination that includes a drug and alcohol screen.
What this form is
This form records an applicant’s voluntary agreement to a physical examination that includes a drug and alcohol screen. It also states that falsification may be grounds for termination, that the City may require an examination at any time, and that the applicant authorizes release of medical information to the City.
Who needs it
An applicant asked to complete a physical examination for the City of Gordon uses this form to give consent and authorize release of medical information.
How to submit it
Submit it to the city department named on the form; check the city website for current contact details.
About notarization
This form is signed without a notary; the applicant and witness sign, and the applicant dates it.
How to submit this form
- 1
Download The Form
Download the City of Gordon Physical Consent Form.
- 2
Complete And Sign
Read the consent statements, then have the applicant and witness sign; the applicant enters the date.
- 3
Submit To The City
Submit the completed form to the city department named on the form; check the city website for current contact details.
Frequently asked questions
- What does the Physical Consent Form authorize?
- It records the applicant’s agreement to a physical examination that includes a drug and alcohol screen, and authorizes release of medical information to the City.
- Who completes the Physical Consent Form?
- The applicant completes and signs the form. It also includes a signature line for a witness and a date line for the applicant.
- Do I need a notary for the Physical Consent Form?
- No. The form has signature lines for the applicant and a witness, plus a date line; it does not require notarization.
- How do I submit the Physical Consent Form?
- Submit it to the city department named on the form; check the city website for current contact details.