- Completed top section of form
- Step 1: Fill out your information AND include email address.
- Step 2: Ensure YOU have signed your waiver. Without your signature, this form will not be accepted.
- Asked your physician to sign tobacco affidavit and complete the physician section in its entirety
To submit your waiver, complete the fields below. Click Choose File to load your document, then click Upload Files. PLEASE DO NOT UPLOAD PHYSICIAN SCREENING FORMS.
Screening results provided on a waiver will not be accepted. All physician results must be submitted to the health screening site.
For assistance, please contact email@example.com