SEMC ANIMAL WORK RISK ASSESSMENT FORM Logo
  • Health and Safety Declaration Form

    Health and Safety Declaration Form

    Singhealth Experimental Medicine Centre
  • This questionnaire will only be used for purpose of assessing fitness to work with animals in the lab or field setting. The questionnaire is secured and meets the US HIPAA (Health Insurance Portability & Accountability Act) requirements for medical information. Upon review by SEMC OH&S Physician, the Certificate of Fitness will be sent to yourself and SEMC. Password will be sent in separate email. Please check with SEMC (Zheng.Lin@singhealth.com.sg) if you have any queries. Thank you. 

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  • Note:

    The personal data collected in this form is used solely for the purpose of assessing your risks for access to SEMC's animal research facilities and/or use of SEMC's facilities for work involving animals, and for contacting you, if necessary.

    It is recognised by and provided for under the Personal Data Protection Act (PDPA), that you are entitled under applicable law to withhold or withdraw consent to the collection, use or disclosure of personal data. However, this withholding or withdrawal of consent may impact our ability to allow your access to and/or use of SEMC's animal research facilities and/or SEMC animals and/or samples. SEMC will take the approach that best safeguards us, you and others from risks, and we may have no choice but to decline your request to access to and/or use SEMC's facilities and/or SEMC animals and/or samples to avoid causing harm or exposing us, you or others to risk.

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  • TO BE FILLED BY CLINIC ONLY

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  • CERTIFICATE OF FITNESS

    The Occupational and Diving Medicine Centre. 20 Lower Kent Ridge Road Singapore
  • If you DO NOT wish to take the above compulsory vaccinations/investigations, please complete and sign the waiver form Annex 1 and return together with a scanned copy of this certificate to SEMC.

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