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Pre-employment medical questionnaire form template

Why is this an essential Job offer document template?

This questionnaire collects specific job-related information about a post, and relevant health information about the new starter. This information can then be assessed by OHS advisers or other qualified personnel, who can: 

  1. Assess the candidate's medical capability to do the job for which they have applied: this will include assessing whether there are any statutory and legal reasons why an individual may not carry out particular work: for example, health and safety regulations would mean that a candidate with epilepsy would not be allowed to undertake a post involving driving; and
  2. Provide advice to departments to ensure that none of the role's duties will adversely affect any pre-existing health conditions the candidate has declared.

£8.00
Preview only. The complete Pre-employment medical questionnaire form template text will be displayed below when you purchase either the individual document or the template pack that the document is contained in.
Pre-employment medical questionnaire form template

Pre-employment medical questionnaire

[Employees starting jobs that involve work with hazards (e.g. sensitising chemicals, allergens etc) or safety-critical activities (e.g. night work, driving a vehicle etc) must complete and return this medical questionnaire before commencing employment.]

An answer must be provided for all questions. The information will be treated in confidence by the Occupation Health Adviser.

PLEASE COMPLETE IN CAPITAL LETTERS

Personal details

Title:  Mr | Mrs | Ms | Mx | Dr | Other
Full Name:  
Address:  
Contact telephone:  
Date of birth:  

GP details

GP name:  
Address:  
Telephone: &nb

Reviewed: 15/03/21
Editing this Pre-employment medical questionnaire form template is simple; if you have purchased it, or if it is FREE, simply copy/email/download and replace any highlighted wording contained in "[ ]", with your details.