ANNUAL PHYSICAL
PRE-EXAM INSTRUCTIONS
1. Appointment: If you are unable to keep your appointment for any reason, you must notify Work Med at least 24 hours in advance. It is your responsibility to reschedule your appointment. Fire Rescue must also be notified of any changes in the scheduled appointment.
2. Drug Screen/Yearly Urinalysis: Please begin drinking water 2-3 hours prior to your appointment so that you arrive with a full bladder for a urine collection. Also, please bring picture identification, which is required for drug testing.
3. Laboratory Testing: Please do not eat after midnight the night before your appointment if your appointment is in the morning. If your appointment is in the afternoon, you may eat a light meal (toast and juice) in the morning. Be finished eating 6 hours before your appointment. Consuming water is encouraged 2-3 hours prior to blood draw.
4. Immunization Record: Please bring any documentation of all immunizations you have received (in childhood and as an adult). Your complete immunization record – including dates of vaccinations – is required to determine what is needed. If you do not have proof of vaccinations, additional screening/inoculations will be required which will result in added cost to the Department and additional appointments. Please be prepared.
5. Vision Screening: Please bring glasses/contact lenses for distance to your appointment. This will aid in more accurately assessing your vision.
6. Paperwork: Please complete the online Health Questionnaire prior to your appointment.
DAY OF APPOINTMENT
1. Please arrive fifteen (15) minutes prior to your appointment to register.
2. You will first be seen by a nurse who will perform laboratory collection, PPD assessment, audiometry, take vital signs, perform vision testing, pulmonary function testing, CXR, and an EKG. Immunizations will be given as needed. This will take 60-70 minutes.
3. You will see the physician who will review your health history, respiratory questionnaire, pulmonary function test results, vision screening, and perform your physical. This will take approximately 30 minutes. The physician will determine if a cardiac stress test is needed, and if so, the clinic staff will schedule for you.
EXAM COMPONENTS
The exam you will receive is based on part or all of NFPA 1582: Standard on Comprehensive Occupational Medical Program for Fire Departments, 2007 Edition and the IAFF/IAFC Fitness Wellness Initiative, Second Edition.
• Health Questionnaire and OSHA Respiratory Questionnaire
• Drug Screening (pre-employment only)
• Immunizations
- Screening for protection against Hepatitis-A, Hepatitis-B, Hepatitis-C, HIV, measles, mumps, rubella, tuberculosis, tetanus/diphtheria, and chicken pox (Varicella) will be performed for all pre-employment exams.
These screenings and needed boosters/titers will be conducted and administered as needed.
- Influenza vaccinations are provided annually.
• Hands-On Physical
- Vital Signs
- Blood Pressure
- Pulse
- Respiratory Rate
- Temperature
- Height/Weight
- Head, Eyes, Ears, Nose, & Throat
- Vision Screening
- Color Assessment
- Distance Assessment
- Near-Vision Assessment
- Audiology Screening
- Hearing Test (500-1000-2000-4000Hz)
- Neck
- General Evaluation
- Cardiovascular
- Chest X-Ray
- EKG
- Pulmonary
- Pulmonary Function Test (Spirometry)
- Gastrointestinal
- General Evaluation
- Genitourinary
- Men: Testicular & Hernia Evaluation*
- Evaluation & Prostate Specific Antigen (PSA) tests required for at-risk and males over age 40
- Women: Pap Smear, Clinical Breast Exam, Mammography*
- Required for at-risk and females over age 40
- Rectal
- Digital Rectal Exam *
- Fecal Occult Blood Testing*
- Lymph Nodes
- Neurological
- Mental Status Exam
- Cranial & Peripheral Nerves
- Motor
- Sensory
- Reflexes
- Musculoskeletal
- General Range-of-Motion Evaluation
- Skin Exam
- Cancer Screening
- Body Composition**
Laboratory Testing: Urinalysis, Complete Blood Count, Chemistry Metabolic, Lipid Profile (all).
The blood analysis or urinalysis is not intended and will not be used for drug use screening at any time.
- White Blood Cell Count with differential
- Red Blood Cell Count (hematocrit)
- Platelet Count
- Liver Function Test
- Triglycerides
- Glucose
- Blood Urea Nitrogen
- Creatinine
- Sodium
- Potassium
- Carbon Dioxide
- Total Protein
- Albumin
- Calcium
- Cholesterol
- Heavy Metal & Special Exposure Screening
•Aerobic/Cardiopulmonary Testing (Stress Test)
- Required for at-risk individuals & individuals over age 40.
• Follow-Up/Referral
- Annual physical exam results will be forwarded to you and/or your primary care provider (PCP).
- You will complete a HIPAA Release in order to release the results to you and/or your PCP.
- It is extremely important that you meet with your PCP to discuss your annual physical exam results.
• Data Collection
- The HIPAA Release will also authorize the release of some medical component data points for data
collection and reporting. The data will not have any identifiers (name, date of birth, Social Security Number,
etc.); the data will only be raw data used for research and data reporting.
- Date of Exam
- Medical and Family Medical History
- Alcohol Use
- Vital Signs
- Height/Weight
- Body Composition**
- Blood Analysis/Urinalysis Results
- Vision
- Hearing
- Spirometry
- Chest X-Ray
- EKG
- Cancer Screening Results
- Immunizations
*Individual may opt out of this element provided his/her PCP conducts this element as part of an annual exam. The results of the exam must be forwarded to UVA Work Med.
**Optional