Pre-Employment Physical Form: ICE Form 30-042, Medical Examination and History Report

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Which Form Is on This Page?

The PDF on this page is ICE Form 30-042, Medical Examination and History Report (12/23), a form of U.S. Immigration and Customs Enforcement (ICE), Department of Homeland Security. It is not a general employer physical-examination template.

What Is ICE Form 30-042 Used For?

The Privacy Act statement on page 1 says that the information is collected to perform a pre-employment medical examination and that the form is used as part of the pre-employment hiring process.

How Is the Form Organized?

The instructions on page 1 tell selectees to complete pages 1 through 8 before reporting for the medical examination and not to write in the areas marked "Examining Facility Use Only". The packet has pages numbered 1 to 15 and an additional comment page 6a.

  • What to Expect at Pre Employment Medical Examination?

    A pre-employment medical examination typically includes a physical exam, vision and hearing tests. Depending on the job requirements, the medical examination may also include tests to evaluate your physical and mental abilities, such as dexterity, agility, and strength.

  • What Is the Pre Employment Medical Examination?

    A pre-employment medical examination is a health examination that is conducted as part of the application process for a job. The exam is usually requested by employers to ensure that the applicant is physically and mentally capable of performing the job safely and effectively. The type of medical examination required will depend on the job role and the industry.

Fillable online Pre-Employment Physical Form
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