The ESHYFT physical form is a one-page “Physician Clinical Examination” that a doctor fills out to confirm you’re medically fit to pick up nursing shifts through the app. It’s required only if you work in Delaware, Massachusetts, New Jersey, New York, Pennsylvania, or West Virginia, and it must be dated within the past 12 months when ESHYFT reviews it.1ESHYFT Help Center. What Information Do I Need to Create an Account on the ESHYFT Nurse App You can download the PDF from ESHYFT’s website and take it to your own provider, or use ESHYFT’s virtual partner service for $39.
Who Has to Submit One
The physical requirement applies to CNAs, LPNs, and RNs picking up shifts in the six states listed above.1ESHYFT Help Center. What Information Do I Need to Create an Account on the ESHYFT Nurse App If you only work outside those states, you can skip the form, though the rest of the onboarding package (license, ID, TB testing) still applies.
The exam is good for 12 months. If your form is older than a year when you apply or when your renewal comes due, ESHYFT will need a new one before your account stays active.2ESHYFT Help Center. How Do I Update My License
What the Physician Fills Out
The form has three working parts: vitals, a body-system checklist, and a certification.3ESHYFT. ESHYFT Physical Form
Personal Details and Vitals
The top captures your name, date of birth, address, and the date of the exam. The provider then records six vitals: blood pressure, temperature, pulse, respiration rate, weight, and height.3ESHYFT. ESHYFT Physical Form
Sixteen-Point Body System Check
The bulk of the form is a 16-item checklist. For each system, the provider marks normal or writes an explanation for anything abnormal. The systems are general appearance, skin, head, eyes, ears, nose, mouth/throat, neck, thorax/lung, cardiac, abdomen, back, extremities, musculoskeletal, neurological, and psychiatric.3ESHYFT. ESHYFT Physical Form Any abnormality gets noted in the diagnosis section, and the provider can add a limitation or recommendation.
Diagnosis and Certification
After the checklist, the provider selects “No medical problems” or explains any ongoing conditions, and notes any work limitations. At the bottom, the physician signs a certification that you are “free from any health impairment that is of potential risk to patients or which might interfere with the performance of his/her duties,” including freedom from substance dependency and communicable diseases.3ESHYFT. ESHYFT Physical Form That signed certification is what ESHYFT’s compliance team is looking for.
The only provider fields on the form are printed name, signature, phone number, and exam date. There’s no field for a license number or facility address, so don’t have your doctor add information the form doesn’t ask for. Every date on the form must include month, day, and year.3ESHYFT. ESHYFT Physical Form
The TB and Immunization Section
The lower half of the form covers tuberculosis screening and MMR immunity. This is where most submissions run into trouble, because the form isn’t enough on its own; specific documents have to be attached.
Tuberculosis Testing
The form has fields for two PPD (Mantoux) skin tests: date administered, date read, and result in millimeters. Tine tests are not accepted. A prior BCG vaccination doesn’t waive the PPD requirement.3ESHYFT. ESHYFT Physical Form
If your PPD is positive, a chest X-ray is required and a copy of the X-ray report must be attached. As alternatives, ESHYFT accepts a QuantiFERON Gold blood test from within the past 12 months, or a chest X-ray from within the past 5 years. Seven states require a two-step PPD rather than a single test: Delaware, Minnesota, Missouri, New Jersey, Pennsylvania, South Carolina, and Vermont.1ESHYFT Help Center. What Information Do I Need to Create an Account on the ESHYFT Nurse App
MMR
You need to show either documented immunization doses or blood titer results proving immunity to measles, mumps, and rubella. If you’re using titers, dated lab results have to be physically attached. Writing the numbers on the form isn’t enough.3ESHYFT. ESHYFT Physical Form If you don’t have your childhood immunization records, ordering the titer at the same appointment saves a second visit.
Two Ways to Get the Exam Done
Download the form from ESHYFT’s website or through the help center’s onboarding article, print it, and bring it to your appointment.1ESHYFT Help Center. What Information Do I Need to Create an Account on the ESHYFT Nurse App You have two routes:
- Take the printed form to your own doctor or a walk-in clinic and schedule a standard employment physical. Bring your immunization records and any recent TB test results.
- Use ESHYFT’s virtual physical through their partner service for $39. This is the faster route if you don’t have a primary care provider or want to avoid scheduling delays.1ESHYFT Help Center. What Information Do I Need to Create an Account on the ESHYFT Nurse App
Uploading the Form
Once the form is signed, upload it through the ESHYFT mobile app as part of your onboarding documents. Take a high-resolution photo or scan the document so every handwritten entry and the signature are clearly legible. Attach any lab results or X-ray reports in the same submission.
If the app upload gives you trouble, email your documents to Credentials@eshyft.com as a fallback.1ESHYFT Help Center. What Information Do I Need to Create an Account on the ESHYFT Nurse App
What Happens After You Submit
ESHYFT’s team reviews the physical along with your license, certifications, work history, and background check. The full credentialing process takes anywhere from a few days to a couple of weeks, depending on how quickly references respond.4ESHYFT. The Process of Getting Hired with ESHYFT: What to Expect If something on the physical is wrong, illegible, or missing, you’ll be asked to resubmit.
Keep a digital copy of the completed form and every attachment. Save the file somewhere you can find it a year from now.
Why Forms Get Rejected
Most bounced submissions come back for one of these reasons:
- The exam date is more than 12 months old by the time ESHYFT reviews it. If you’re close to the cutoff, book a new exam rather than risk the delay.
- The physician signature, printed name, or exam date at the bottom is missing.
- The TB or MMR fields are blank without an alternative document (titer results or QuantiFERON report) attached.
- Titer lab printouts or chest X-ray reports weren’t attached as separate pages.
- The scan or photo is blurry and the handwriting can’t be read. A scanner app with good lighting fixes this.
Renewal and Getting a Copy Later
You’ll need to submit a fresh physical every 12 months to stay active on the platform. Having the previous version on hand makes the renewal appointment faster because your provider can reference the prior results.2ESHYFT Help Center. How Do I Update My License
If you later need the form for another employer, you have a right under federal recordkeeping rules to request a copy from the employer holding it. Employee medical records must be preserved and made available within 15 working days at no charge.5eCFR. 29 CFR 1910.1020 – Access to Employee Exposure and Medical Records As long as the original is still within its 12-month window, you can reuse it instead of paying for a new exam.