F-HR8 Medical Questionnaire Form
| File Reference : | F-HR8 Medical Questionnaire Form |
A short health questionnaire at the right moment tells you whether someone needs support or an adjustment to do a job safely. This form asks the questions plainly and keeps the answers as the confidential health record they are.
This form template is supplied in fully editable MS Word format and can be easily customised and edited. The document uses pre-defined style formatting throughout, with all text in Calibri font for improved readability.
The following document labelling is included in the footer:
- Form number and title
- Information-classification
- Version
- Page number / total pages
alphaZ documents - beautifully designed, tried and tested form templates. No junk, jargon or unnecessary fields. Simple and usable form templates
developed over 25 years through practical use in the real world. No AI generated nonsense here!
Further guidance on health at work and wellbeing:
Download this form template with your company name and logo already added!
Document Preparation available with all document toolkits.
To get access to this file please click on Add to Cart to purchase for immediate download. If you have an alphaZ Subscription just click on Download Files to view all the files available to download. This form is also included in the ISO 45001 Toolkit and the ISO 9001 Toolkit, and in every alphaZ ISO toolkit that covers managing health and safety, so the toolkit route gives you this file plus everything else you need in one download.
If you'd like hands-on help setting up your occupational health and fitness-for-work records, or your wider health and safety management system, our remote support services provide direct expert input from our team, by the day, by project, or on an ongoing basis.
Medical Questionnaire Form Template
A medical questionnaire for an employee to declare health conditions that could affect their ability to do a job safely. It asks a clear set of yes/no health questions, with space to give details, so you can identify where support, a referral or an adjustment may be needed.
Health information is special-category personal data, so the form is built to be handled carefully under the UK GDPR and held as a confidential health record. Used at the right point, it supports the health and fitness-for-work controls an effective health and safety management system should have.
Built for Health and Fitness for Work
The form captures what you need to spot a health issue that matters at work:
- A clear set of yes/no questions covering common health conditions
- Space to give details on any question answered yes
- Questions relevant to safety-critical work, such as blackouts, fits and diabetes
- A record you can act on with a referral, support or a reasonable adjustment
What's Included in this Medical Questionnaire
The form is set out so the declaration can be completed and reviewed in one place:
- Employee details - name, date and job role or work area
- Health questions - a numbered set of yes / no / not sure questions on health and medical history
- Details - space to expand on any yes answer for review
Who Needs a Medical Questionnaire?
Any employer with roles where health can affect safety - drivers, machine operators, lone or physical workers - benefits from a health declaration at the right point. It suits any business managing occupational health, and supports the health and fitness-for-work controls expected under ISO 45001. Treat the completed form as confidential health data.