Attachment 3 - Medical Clearance Determination Form.pdf
PDF 1 MB Posted
- Attached to
- Medical Surveillance Federal contract opportunity
- Solicitation number
- W911WN23Q3005
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Other files for this federal contract opportunity
| File | Type | Posted |
|---|---|---|
| W911WN23Q30005 Amendment 0006.pdf | ||
| Amendment 0006 Summary of Changes.pdf | ||
| W911WN23Q3005 Amendment 0005.pdf | ||
| W911WN23Q3005 0004.pdf | ||
| W911WN23Q30005 0003.pdf | ||
| Price Schedule 0003.xlsx | XLSX spreadsheet | |
| W911WN23Q3005 Amendment 0002.pdf | ||
| Attachment 2- Exam Services.pdf | ||
| W911WN23Q3005 Amendment 0001.pdf | ||
| Appendix I- Quality Control Plan Template.pdf | ||
| Appendix II- PIEE Vendor Registration.pdf | ||
| Attachment 1- USACE LRP Facilities and Contacts.pdf | ||
| Attachment 2- Exam Services.pdf | ||
| W911WN23Q3005.pdf | ||
| Performance Work Statement (PWS).pdf | ||
| Appendix IV - How to Submit an Electronic Invoice.pdf | ||
| Attachment 4 - ENG Form 6227- Diver Medical Instructions and Authorization.pdf | ||
| Attachment 6 - Wage Determinations.pdf | ||
| Price Schedule.xlsx | XLSX spreadsheet | |
| Appendix III- Blank AHA Form.pdf | ||
| Attachment 5 - Performance Requirements Summary.pdf |
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Page of Version 1.0, NOV 2022
MEDICAL CLEARANCE DETERMINATION FORM
U.S. Army Corps of Engineers, Pittsburgh District This form must be completed and signed by a Qualified Occupational Health Physician specifying the employee's clearance for duty. Do not include any employee personal or medical information.
Exam Service(s) Performed:
Upon review of the Exam Service(s) performed, the employee is determined to be: (select one of the following) 6.4.0.20180228.1.932123.929382
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