Each applicant shall meet the following requirements relative to the applicant’s physical examination:

1. (a) Each uncertified person employed as a police or corrections officer, after being issued a conditional offer of probationary employment by the hiring authority, shall undergo a physical examination by a New Hampshire licensed physician. For the purposes of this rule, “licensed physician” shall also include a licensed health care provider;
2. (b) The examination shall be conducted in order to provide all of the information specified on the council form "D";

3. (c) The licensed physician shall provide on council form "D" the following:

   1. (1) Name, date of birth, height, and weight of examinee;
   2. (2) Results of a visual acuity test on the examinee;
   3. (3) Lung breath sounds and rales;
   4. (4) Date of chest X-ray, if given;
   5. (5) Blood pressure, pulse rate, and heart sounds and rhythm at rest, after moderate exercise and 3 minutes after exercise;
   6. (6) Results of nervous system tests including Romberg and knee-jerk tests;
   7. (7) Examination of the eyes, ears, nose, throat and teeth, and any abnormalities noted;
   8. (8) Mobility, symmetry and posture of the musculoskeletal system, including spine, upper and lower extremities, with notation of any limited function or missing parts;
   9. (9) Any physical, mental or emotional conditions which in the opinion of the physician suggest further examination;
   10. (10) A certification that the examining physician has no reservations about the examinee's ability to participate without restrictions in a rigorous physical training program or perform the duties of a police or corrections officer, as appropriate;
   11. (11) Name, address and signature of physician; and
   12. (12) Date of examination;
4. (d) Council form "D" shall also contain a report of medical history section which shall be completed by the examinee;

5. (e) The medical history section of the Form "D" shall include information regarding:

   1. (1) Examinee’s name;
   2. (2) History of prior diseases;
   3. (3) Hospitalizations;
   4. (4) Medical treatment;
   5. (5) Allergies, including any allergies that require special attention, such as, but not limited to, food and bee stings;
   6. (6) Medical disabilities;
   7. (7) Illnesses or injuries; and
   8. (8) Suicide attempt;
6. (f) The examinee shall sign a release on the form to allow doctors, hospitals or clinics involved in treatment of the examinee to release the examinee's medical transcript to the council. It shall also contain a section where the examining physician may enter any comments on the reported medical history, and the name, address and signature of the examining physician.

Source. #1534, eff 2-17-80; ss by #1988, eff 3-25-82; ss by #2783, eff 7-27-84; ss by #4437, eff 6-22-88; ss by #5836, eff 6-15-94; ss by #7302, eff 6-8-00; ss by #9168, INTERIM, eff 6-3-08, EXPIRES: 11-30-08; ss by #9224, eff 8-1-08; amd by #9400, eff 2-27-09; ss by #12041, eff 11-16-16; (Form D amd by #12734)