Caregiver medical forms

Download, print, and bring any required medical form directly
for your doctor's office. All forms are available here. You can also visit one of our Pod Health clinics.

How to use this page

Find your column

New employee or current employee — click the form you need.

Download & bring to your doctor

Print it or show the page — your provider can print directly from here.

Return completed forms

Fax: (347) 573-9062  |  Email: HRFAX@truecareny.com

Want to do your tests in one place?

Schedule at a Pod Health clinic.

You can complete your required medical tests at our office — no outside appointment needed.

New employee

Complete all of the following before your first day

Physical exam

Must be done within the past year. Take to your primary care provider, urgent care, or a Pod Health clinic.

TB test

Two-step TST/PPD or IGRA (QuantiFERON Gold or T- Spot). Must not be older than 1 year. TB risk assessment questionnaire also required at hire.

Drug screening

Drug screen per agency policy. All results must be negative. See form for details.

Flu Shot / Declaration

Submit each flu season (Oct – Mar) if you are not receiving the influenza vaccine. Must be returned to HR.

Measles & rubella vaccines (MMR)

Provide proof of 2 MMR doses, or a blood test showing you are immune.

Current employee

Complete all of the following each year to stay active

Annual physical exam

Must be done within the past year. Schedule in advance to avoid a lapse.

Annual TB risk assessment

Questionnaire only for current employees — no repeat skin test or blood draw unless clinically indicated.

Flu Shot / Declaration

Submit each flu season (Oct – Mar) if you are not receiving the influenza vaccine. Must be returned to HR.

Questions about your forms?

Our Compliance Team is available to help. Reach out before your appointment if you're unsure which form to use.

📱 Text only — this line does not accept phone calls.

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