[MCOH-EH] In Office Lift Test

[David Stoklosa]

Ken,
Here you go.  This is the consent our clinic uses with our agility tests.  Our physician and nurses also do some more simple functional and lift testing which we do not require this form to be signed if it's part of a physical or RTW.  If you need any other guidance, please reach out to me directly and I'd be happy to help.
Thank you,
Dave



Dave Stoklosa MS,ATC,CSCS,CEAS

Assistant Director McLeod Occupational Health - Health and Safety

Email: dstoklosa at mcleodhealth.org

Office: (843) 777-5156

Cell: (843) 409- 5339​


________________________________
From: MCOH-EH <mcoh-eh-bounces+dstoklosa=mcleodhealth.org at mylist.net> on behalf of Subin, Kenneth, MD <ksubin at cayugamedicalassociates.org>
Sent: Thursday, January 5, 2023 12:37 PM
To: mcoh-eh at mylist.net <mcoh-eh at mylist.net>
Subject: [MCOH-EH] In Office Lift Test

**External Email**


All, if anyone does lift testing in their offices, do you have the post-offer employee sign a release of liability in the event of an injury while testing?  If so, would you be willing to share such document?



This is a new service for our office.  Any other issues I should consider before implementing?



Thank you in advance for your feedback.



Ken





Kenneth Subin, MD, MPH, DipABLM

Chief Medical Officer, Cayuga Medical Associates, PC

Occupational Medicine, Cayuga Medical Associates, PC

16 Brentwood Drive

Ithaca, NY 14850

P (607) 339 - 0680

F (607) 319 - 5532



NOTICE: This e-mail message and all attachments transmitted with it may contain legally PRIVILEGED and CONFIDENTIAL information intended solely for the use of the addressee. If the reader of this message is not the intended recipient, you are hereby notified that any reading, dissemination, distribution, copying, or other use of this message or its attachments is strictly prohibited. If you have received this message in error, please notify the sender immediately and delete this message and all copies and backups thereof. Thank You.
-------------- next part --------------
An HTML attachment was scrubbed...
URL: <https://mylist.net/archives/mcoh-eh/attachments/20230106/fef91102/attachment-0001.htm>
-------------- next part --------------
A non-text attachment was scrubbed...
Name: Consent.pdf
Type: application/pdf
Size: 24018 bytes
Desc: Consent.pdf
URL: <https://mylist.net/archives/mcoh-eh/attachments/20230106/fef91102/attachment-0001.pdf>