Medical Questionnaire Template
Medical Questionnaire Short-Form
The Medical Questionnaire Short-Form should be issued to all successful
candidates where the Job Application Form III has been applied.
Employers must be aware that they are prohibited from asking candidates
questions about their health before including them in a shortlist or
offering them a job.
This Medical Questionnaire form contains the following sections:
1. Personal Details
2. General Practitioner's Details
3. Disability Discrimination Act
4. Past Medical History
The employer is required to obtain the candidate’s express consent to seek
a medical report. Information about an individual’s health is one of the
special categories of data under the General Data Protection Regulation
The long-form version of the Medical Questionnaire includes a section
listing a range of medical conditions with yes/no answers.
This Medical Questionnaire form 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 template 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.