Employee Health Questionnaire

1
Employee Health Questionnaire

Welcome to our employee health questionnaire. As part of our commitment to ensuring a safe and healthy working environment, we kindly ask you to complete this form with honesty and accuracy.

Your responses will help us comply with relevant health and safety regulations, including the Health and Safety at Work etc. Act 1974 and the Management of Health and Safety at Work Regulations 1999.

It is crucial to provide truthful information so that we can identify any necessary accommodations, prevent workplace injuries, and maintain the well-being of all employees.

Your confidentiality will be respected, and the information provided will be used solely for health and safety purposes.
2
Name
First Name
Last Name
3
1. Do you have any medical conditions that could affect your ability to work in a distillery?
Huge
Large
Normal
Small
Ok
Ok
4
2. Have you had any recent illnesses or injuries that might impact your work?
Huge
Large
Normal
Small
Ok
Ok
5
3. Do you have any allergies or sensitivities that we should be aware of?
Huge
Large
Normal
Small
Ok
Ok
6
4. Are you currently taking any medication that could affect your job performance?
Huge
Large
Normal
Small
Ok
Ok
7
5. Have you had any alcohol-related illnesses or issues in the past 12 months?
Huge
Large
Normal
Small
Ok
Ok
8
6. Do you have any concerns about your health that you would like to discuss with your line manager?
Huge
Large
Normal
Small
Ok
Ok
Should be Empty: