Medical Questionnaire Template

Pre-Employment Medical Questionnaire Short-Form


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 Pre-employment Medical Questionnaire form contains the following sections:
1. Personal Details
2. General Practitioner's Details
3. Disability Discrimination Act
4. Past Medical History
5. Declaration

The long-form version of the Medical Questionnaire includes a section listing a range of medical conditions with yes/no answers, and asks for details of the prospective candidates' alcohol history.

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.