Gordon, GA · Wilkinson County
Physical Exam Consent Form
This form records an applicant’s consent to a physical examination and drug and alcohol screening for City of Gordon employment.
What this form is
The form records an applicant’s voluntary agreement to a physical examination that includes a drug and alcohol screen. It also states that falsification is 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. The applicant signs and dates the form, and a witness signs it.
Who needs it
An applicant completing this consent for City of Gordon employment needs to sign and date the form, with a witness signature.
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 document is signed without a notary; the applicant and witness sign it, and the applicant dates it.
How to submit this form
- 1
Download The Form
Download the Physical Exam Consent Form PDF.
- 2
Complete The Form
Read the consent statements and provide the requested applicant signature and date.
- 3
Get A Witness Signature
Have a witness sign the form. No attachments are listed on the document.
- 4
Submit To The City
Submit it to the city department named on the form; check the city website for current contact details.
Frequently asked questions
- What does the Physical Exam Consent Form authorize?
- It records an applicant’s agreement to a physical examination that includes a drug and alcohol screen, and authorizes release of medical information to the City.
- Who signs the Physical Exam Consent Form?
- The applicant signs and dates the form, and a witness also signs it. The form states that falsification is grounds for termination of employment.
- Do I need a notary for the Physical Exam Consent Form?
- No. The document has applicant and witness signature lines and a date field, but no notary block; the applicant and witness sign it without a notary.
- How do I submit the Physical Exam Consent Form?
- Submit it to the city department named on the form; check the city website for current contact details.