Physician Affidavit Form


Attention ALL Full-time Employees! Complete your physical, have your doctor sign the Physician Affidavit Form, and receive a $50.00 gift card! And if your spouse gets a physical, they are eligible to receive a $50.00 gift card, too!

If you have completed your physical any time between January 1 and December 31 of the current year simply click on the link below, print out the form, and take it to your physician to certify and sign.

Email your completed form to Corporate Human Resources at, or fax it to 480-546-3337 by December 31 for the current year. You’ll receive an email confirmation upon receipt of your form and your $50.00 gift card will be mailed to your address on file within 45 days of your confirmation. Questions? Contact Human Resources at or 800-347-4348.

The deadline to submit the Physician Affidavit Form for the current year is December 31.