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Peace Officer and Public Safety Dispatcher Medical Screening Forms
The POST Medical History Statement – Peace Officer Form 2-252 (doc) and Medical Examination Report – Peace Officer Form 2-253(doc) have been updated. Additionally, POST has created comparable forms for use in the medical evaluation of public safety dispatchers: Medical History Statement – Public Safety Dispatcher Form 2-264 (doc) and Medical Examination Report – Public Safety Dispatcher Form 2-265 (doc). The forms are intended to assist agencies with the pre-employment medical screening of peace officers and public safety dispatchers, as stipulated in Procedure C-2 (doc) for peace officers and Regulation 1018 (pdf) for public safety dispatchers.
The peace officer medical forms have been updated based on input from screening physicians, and are intended to be easier to complete. In addition, the format of POST 2-253 has been revised to ensure that necessary information is conveyed to the employer while maintaining candidate’s medical information as confidential as required by state and federal law.
Commission Regulation 1018 mandates the conduct of a pre-employment public safety dispatcher medical examination; however, until now no POST forms existed to support that requirement. The new dispatcher medical forms are modeled after the revised peace officer medical forms, but focus on questions and issues relevant for the dispatcher position.
Agencies may request “unprotected” versions of these forms that can be revised to meet the needs of their specific operations. Requests for unprotected versions of the forms, as well as administrative questions about the forms, should be directed to the POST Forms Manager at publications.manager@post.ca.gov. Substantive questions about the forms should be directed to Dr. Shelley Spilberg of the Standards and Evaluation Services Bureau at shelley.spilberg@post.ca.gov or 916.227.4824.