Occupational Health Assessment Employee Consent form template

Occupational Health Assessment Employee Consent form template cover image
Occupational Health Assessment Employee Consent
Template
Occupational Health Assessment Employee Consent form template cover image
£14

Our Occupational Health Assessment Employee Consent form template streamlines the process, ensuring employee compliance and facilitating efficient health evaluations.

  • 2 pages / 330 words.
  • Last updated 05/02/2025.
  • Designed for United Kingdom use.
  • Suitable for use in other territories; check local laws first.
  • Instantly download as Word / PDF / plain text, or send by email.
  • Includes 12 months’ access, with all updates to this page provided free of charge and notified to you.
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Occupational Health Assessment Employee Consent form

I, [Employee's Name], hereby provide my consent to [Company Name] to refer me to Occupational Health for an assessment of my health status and any potential work-related issues. I understand and agree to the following terms and conditions:

  1. Purpose of Referral: I understand that the purpose of this referral is to assess my health status and any potential work-related issues that may impact my ability to perform my job safely and effectively.

  2. Confidentiality: I understand that all information gathered during the occupational health assessment will be kept confidential and will only be shared with relevant

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The Occupational Health Assessment Employee Consent form serves as formal authorization from an employee to undergo occupational health assessments. It outlines the employee's agreement to participate in the assessment process, including medical examinations, tests, and consultations, to evaluate their fitness for work or specific job-related tasks.

Additionally, the form seeks the employee's consent to disclose relevant medical information to the occupational health provider for assessment purposes.

The form ensures compliance with data protection regulations by obtaining explicit consent from the employee for the collection, processing, and sharing of their health information for occupational health purposes only. By obtaining informed consent, the employer demonstrates respect for the employee's autonomy and privacy while facilitating access to necessary health assessments to support their well-being and safety in the workplace.

It is usually delivered to the Employer / HR by the Employee.

It should be actioned prior to referring the employee to an occupational health service.

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