Exhibit 1 Phys Exam Summary Records Custodian.pdf

PDF 225 KB Posted

Attached to
Ohio Air National Guard Firefighter Medical Evaluations
Solicitation number
SRC0000019823
Issued by
Ohio

About this file

Written by GovTribe AI ·

This document is the Physical Exam Summary Records Custodian for the Ohio Air National Guard Firefighter Medical Evaluations contract opportunity. The contract seeks a professional medical organization to furnish candidate and member firefighter annual medical evaluations for Mansfield, Toledo, and Rickenbacker Air National Guard Bases in accordance with National Fire Protection Association (NFPA) 1582-2022 and the associated U.S. Air Force Technical Implementation Guide (TIG) 1582 2022 edition. The selected contractor will serve as the designated fire department physician and provide post-infectious exposure care and testing in accordance with NFPA 1581, 1582, and associated TIG guidance.

The summary indicates that the medical evaluations will assess the physical fitness of firefighters, including review of physical exams, audiograms, pulmonary function, treadmill stress tests, and EKG. The evaluations will determine if firefighters are able or unable to perform job tasks based on the findings. The contract opportunity does not provide details on pricing, set asides, funding sources, or any other salient commercial terms.

View the file

Other files

File Type Posted
Exhibit 5 NFPA TIG 1582 2022 Edition.pdf PDF
Firefighter Physicals SOW.pdf PDF
Exhibit 6 OSHA Respirator Protection.pdf PDF
Exhibit 2 2018 Records Cust Meets Does Not Meet.pdf PDF
Exhibit 4 Infectious Substance Exposure Form.pdf PDF
Exhibit 8 AFI 48-137.pdf PDF
Exhibit 3 2018 Fire Chief Meets Does No Meet.pdf PDF
Exhibit 7 AFI 32-2001.pdf PDF
Exhibit 9 OSHA Respirator Med Eval Questionaire.pdf PDF
Standard Terms and Conditions 23MAY2024.pdf PDF
Request for Proposals FF Med Exams.pdf PDF
2025 Bid Form.docx DOCX document
Exhibit 10 TIA_1581_22_1 (2).pdf PDF
Show all 13

On GovTribe

Work with this file

  • Download the original file
  • Contacts named in this file
  • Similar government files
  • Ask GovTribe AI about this file
Try for free Login

Text version

The file's text, extracted by GovTribe without its formatting.

Employer:

Employee's Name:

Date of Exam:

Components Performed

□ Physical Exam

□ Audiogram n Pulmonary Function rl Treadmill Stress

D EKG-12 lead

D Chest x-ray

□ Mammogram

0 Pelvic/Pap

0 Laboratory Tests

D Other

State of Ohio - MCA Firefighter

NFPA 1582 Physical Exam Summary AGOH-SHRD Medical Records Custodian's Copy

Position Title:

Examining Physician:

Within Normal Abnormal, Able to Abnormal, Unable

Limits Perform Job Tasks to Perform Job

Tasks

Explanation of Abnormal Results/Significant Changes:

□ Medically cleared to perform job tasks

□ Denied medical clearance for current job tasks

Significant Change Noted from Previous Exam (if applicable)

MCA Physical Exam Summary

Attachment 2

Employer:
Employees Name:
Position Title:
Date of Exam:
Examining Physician:
Within Normal LimitsD Physical Exam:
Abnormal Able to Perform Job TasksD Physical Exam:
Abnormal Unable to Perform Job TasksD Physical Exam:
Significant Change Noted from Previous Exam if applicableD Physical Exam:
Within Normal LimitsD Audiogram:
Abnormal Able to Perform Job TasksD Audiogram:
Abnormal Unable to Perform Job TasksD Audiogram:
Significant Change Noted from Previous Exam if applicableD Audiogram:
Within Normal LimitsD Pulmonary Function:
Abnormal Able to Perform Job TasksD Pulmonary Function:
Abnormal Unable to Perform Job TasksD Pulmonary Function:
Significant Change Noted from Previous Exam if applicableD Pulmonary Function:
Within Normal LimitsD Treadmill Stress:
Abnormal Able to Perform Job TasksD Treadmill Stress:
Abnormal Unable to Perform Job TasksD Treadmill Stress:
Significant Change Noted from Previous Exam if applicableD Treadmill Stress:
Within Normal LimitsD EKG12 lead:
Abnormal Able to Perform Job TasksD EKG12 lead:
Abnormal Unable to Perform Job TasksD EKG12 lead:
Significant Change Noted from Previous Exam if applicableD EKG12 lead:
Within Normal LimitsRow6:
Abnormal Able to Perform Job TasksRow6:
Abnormal Unable to Perform Job TasksRow6:
Significant Change Noted from Previous Exam if applicableRow6:
Within Normal LimitsRow7:
Abnormal Able to Perform Job TasksRow7:
Abnormal Unable to Perform Job TasksRow7:
Significant Change Noted from Previous Exam if applicableRow7:
Within Normal LimitsRow8:
Abnormal Able to Perform Job TasksRow8:
Abnormal Unable to Perform Job TasksRow8:
Significant Change Noted from Previous Exam if applicableRow8:
Abnormal Able to Perform Job TasksRow9:
Abnormal Unable to Perform Job TasksRow9:
Significant Change Noted from Previous Exam if applicableRow9:
Abnormal Able to Perform Job TasksRow10:
Abnormal Unable to Perform Job TasksRow10:
Significant Change Noted from Previous Exam if applicableRow10:
Explanation of Abnormal ResultsSignificant Changes:
Department The purpose of this annual physical is to establish fitness for the continuation of:
is a Firefighter with the:
Exercise:
FH:
voiced the:
Medications:
EKGTMT:
0 Other:
Text2:
Check Box3: Off
Check Box4: Off
Check Box5: Off
Check Box6: Off
Check Box7: Off
Check Box8: Off
Check Box9: Off
Check Box10: Off
Check Box11: Off
Check Box12: Off
TEST3:
TEST4:
TEST5:
TEST6:
TEST7:
TEST8:
TEST9:
Group1: Yes
Other 1:
0 Other 2:
Other 3:
Other 4:
Other 5:
Other 6:
Other 7:
Other 8:
Other 9:
Other 10:
Other 11:
Other 12:
Other 13:
Other 14:
Other 15:
Other 16:
Other 17:
Other 18:
Other 19:
Other 20:
Other 21:
Other 22:
Other 23:
Other 24:
Other 25:
Other 26:
Other 27:
Other 28:
Other 29:
Other 30:
Other 31:
Other 32:
Other 33:
Other 34:
Other 35:
Other 36:
Other 37:
Other 38:
Other 39:
Other 40:
Other 41:
Other 42:
Other 43:
Other 44:
Other 45:
Other 46:
Other 47:
Other 48:

File details come from the government source that posted it. Updated .