12 NCAC 09C .0202         MEDICAL HISTORY STATEMENT

The Medical History Statement is a questionnaire to be completed by an applicant. The form seeks to facilitate the applicant's medical examination by listing information pertinent to the applicant's present and past physical condition, injuries, diseases, or operations.

History Note:        Authority G.S. 17C‑6; 150B‑11;

Eff. January 1, 1981;

Pursuant to G.S. 150B-21.3A, rule is necessary without substantive public interest Eff. May 25, 2019.