HOLLAND MEDI CENTER FORMS To shorten wait times, form(s) and questionnaires are available below to be completed prior to your visit. These may be printed or completed electronically and printed. At check-in, staff will ask for the signed copies. Authorize to Treat Form Pre-Employment Pre-Employment Medical History Lift Test Questionnaire Audiogram Questionnaire Respirator Medical History Specialty Services & Physicals HAZMAT Medical History Form Asbestos Questionnaire Lead Medical History Questionnaire Dept. of Transportation – DOT DOT Examination Form (MCSA 5875) Fire Fighters Physicals Fire Fighter History Form