PLEASE READ THE GUIDANCE NOTES BEFORE COMPLETING THE DECLARATION
Your answers to this questionnaire will be CONFIDENTIAL to the Occupational Health Unit and will not be given to anyone else without your written permission. The purpose of the questionnaire is to see whether you have any health problems that could affect your ability to undertake the duties of the post you have been offered or place you at any risk in the workplace. We may recommend adjustments or assistance as a result of this assessment to enable you to do the job. Our aim is to promote and maintain the health of all people at work. Before health clearance is given for employment you may be contacted by an Occupational Health Advisor. An appointment with the Occupational Health Physician may also be necessary. Please help us to help you by completing the questionnaire as fully as possible.
Please detail the number of days you have been absent from work (or school) in the last two years. Outline the reasons for absence, please state if these absent dates where due to a disability.
We are particularly renowned for using a highly personal approach that tailors a solution for each client that is individual as them.
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