CM-936 Fillable PDF Form – Download & Complete Online

The CM-936 is a federal form used by the National Institute for Occupational Safety and Health (NIOSH) to authorize the release of medical information for workers’ compensation and occupational health investigations. Historically, the form is only available as a static PDF, which can be cumbersome to complete.

What Is the CM-936 Form?

The CM-936 authorizes physicians, hospitals, and other medical facilities to share a claimant’s health records with NIOSH and related agencies. It is commonly required for:

• Workers’ compensation claims involving occupational illnesses.
• Safety investigations in high‑risk industries.
• Research studies conducted by federal health agencies.

How to Fill Out the CM-936 Form on Formize

Instead of downloading, printing, and scanning, you can complete the form directly in your browser:

1. Click the "Fill out this form" button on this page.
2. Wait a few seconds while the Formize PDF Filler app loads.
3. Enter your information into the fillable fields – the interface highlights required fields in red.
4. Use the built‑in signature tool to sign electronically.
5. When you’re done, click Save & Download to get a completed PDF, or choose Email to Recipient to send it directly.

Common Mistakes to Avoid

• Leaving required fields blank: The Formize filler will prevent you from saving until all mandatory sections are completed.
• Using the wrong date format: Stick to MM/DD/YYYY as required by the form.
• Signing on a scanned copy: Electronic signatures are accepted and faster.

Where to Submit the Completed Form

After you download the filled PDF, submit it according to the instructions on your claim packet. Typically, you will email or fax the form to the NIOSH contact listed on the claim notice.

Why Choose Formize for PDF Forms

Formize provides a secure, browser‑based PDF editor that:

• Works on any device – no installation required.
• Ensures data privacy with SSL encryption.
• Offers auto‑save, so you never lose your progress.
• Generates a perfectly formatted, fillable PDF ready for official use.

Ready to complete your CM-936 form? Click the button above and start filling in seconds.