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Request for Medical Appt
Complete this form to set-up a 'Fit for Duty' medical exam with a member of UFS Academy Staff
* Indicates required question
Your OFFICIAL UFS NAME (as per your UFS Service Jacket)
*
Your answer
Your RANK
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Your answer
Your EMAIL address
*
Your answer
Repeat your EMAIL
*
Your answer
Availability for Appointment: Please list 1st preference for day and time SLT (allow 30 minutes). For example: Mon between 1pm and 3pm SLT
*
Your answer
Availability for Appointment: Please list 2nd preference for day and time SLT (allow 30 minutes). For example: Tue between 9pm and 10pm SLT
*
Your answer
Availability for Appointment: Please list 3rd preference for day and time SLT (allow 30 minutes). For example: Sat between 10am and 4pm SLT
*
Your answer
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