New Jersey police and fire employers use this one-page report for the physical examination of a new officer or firefighter enrolling in the Police and Firemen's Retirement System. A physician representing the employing agency records history and exam findings, then certifies whether the applicant is physically capable of sustaining the labors and exposures of the job. It is an enrollment record, not a disability form.
A physician representing the employing agency completes the entire report and signs it; there is no section for the applicant to complete.
Download the current version from the source each time; forms change without notice.
Report of Examining Physician for the Police and Firemen's Retirement System (PFRS)
If your copy of the form is a fillable PDF, upload it once and Vero Documents fills it from the visit note and the chart, ready for you to review and sign. Download, print, or email the finished form, with the patient’s consent.
A form is listed only after its name and number were confirmed on the issuing agency’s or insurer’s own website, or in the form itself. Each entry links to that source. The list was last checked in October 2026. Forms and their requirements change without notice, so check the official page for the current version before you complete one.
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The report must be completed within one year of the submission of the PFRS Enrollment Application, by a physician representing the employing agency. The employer then keeps it on file for auditing review rather than sending it to the Division of Pensions and Benefits.
No. PF-1061 documents the pre-enrollment physical of a new police officer or firefighter. Disability retirement uses different forms, such as BD-1177, the Medical Examination by Personal or Treating Physician for PFRSNJ disability retirements.