ACCS Statement of Health
My signature on this form attests that I am free from communicable disease, generally in good health, and free from any weight lifting restrictions that would inhibit my ability to work and perform duties consistent with my job description at American Critical Care Services (ACCS).

I agree and understand that it is the policy of American Critical Care Services that I will employ safe work practices at all times when lifting or turning any patient assigned to me by ACCS.

Sign in to Google to save your progress. Learn more
Email *
Please Type your Full Name in Lieu of your Signature: *
Today's Date *
Clear form
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service - Privacy Policy