Forms
Please see the information and policy sections of the site for instructions on how these forms should be used.
- Access to Occupational Health Records Application Form *
- Baseline Health Surveillance Questionnaire [.doc]
- Case Conference Form (CC1) *
- Consent Form - Report from Employee's Own Doctor *
- Consent to Release Report to Trustees *
- DSE Eyetest Application [.doc]
- Food Hygiene Declaration Form *
- Employee Feedback Form [.doc]
- Honorary Contract Pre Employment Health Screening Questionnaire [.doc]
- Night Worker Baseline Working Time Directive Assessment Form [.doc]
- Occupational Health Referral Form
- Pre Counselling Form [.doc]
- Pregnancy Risk Assessment [.doc]
- Request for Access to Medical Records *
* The marked forms cannot be submitted electronically as they must be signed by hand. Other forms may be 'signed' electronically by writing your name in the signature field.
Preplacement Forms
Forms relating to preplacements are available in a separate section.