Pre-employment Medical Questionnaire Form

Pre-Employment Medical Questionnaire Long-Form

EMP.RE.JA.08

The Pre-employment Medical Questionnaire should be issued to all successful candidates where the Simply-docs Job Application Form III has been applied. The Medical Questionnaire Guidance Notes and the General Practitioner's Comments form should also be provided to the prospective employee.

This long-form version of the Pre-employment Medical Questionnaire form contains the following sections:
1. Personal Details
2. General Practitioner's Details
3. Disability Discrimination Act
4. Medical Conditions
5. Past Medical History
6. Sickness Absence Record
7. Alcohol History
8. Declaration

The short-form version of the Medical Questionnaire excludes the section listing a range of medical conditions with yes/no answers, and does not ask for details of the prospective candidates' alcohol history.

This Medical Questionnaire template is in fixed field format. Simply press TAB to jump from one field to the next and SHIFT + TAB to go back. Alternatively, use the mouse to click from one field to the next.

The form can be unlocked by clicking on the "Padlock" icon on the tool bar. To display the “Padlock” icon click on “View” and then “Toolbars”. From the “Toolbar” menu enable the “Forms" option.

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