Pre-Employment Health Questionnaire Template

Although it is not very common, these days more and more companies have become conscious and have started to use a pre-employment health questionnaire, as it helps them ask the employee about his health during the recruitment process. The selection of an employee does not depend on the information provided by this form. However, it gives plenty of information to the company about the person it is going to hire.

Why is it used?

The basic objective of using the pre-employment form is to collect information about the candidate who is likely to get hired by the company. The collected information is then used to determine the health history of the employee.

This helps a company determine whether an employee is the right fit for the position for which he is being recruited. If the form shows that the employee is physically and mentally fit, the company will get an idea that the applicant is the right fit and able to perform the job responsibilities that will be assigned to him. Usually, security-providing companies use this form.

Every country has a disability law, according to which some specific rights are especially governed by disabled people. The pre-employment health form is used to determine if the candidate has any disabilities. This way, a company makes sure that it is showing compliance with the rules of the state and also takes care of the disabled employee in a better way.

Pre-Employment Health Questionnaire Template

The Form File: 92 KB

What is a template for a health questionnaire before the job?

Many companies use the questionnaire template because it saves them from having to create one from scratch. The template is a pre-designed form that is ready to use. It has a lot of information to share with its users. Those who want to create a form of their own can get inspiration from this form template and use it as many times as they want. However, those who don’t want to use it can simply download the template and customize it.

What does a template for a health form include?

The main details added to this form are:

Information about the applicant:

The applicant whom the employee is about to hire needs to provide his personal information, such as his full name, the position for which he has applied, the registration number of the application sent to the company, his phone number and address, and much more.

Health history of the employee:

The health history of the employee is gathered by asking some questions regarding the health of the employee in the past. These questions are regarding the disability of any kind that the employee has gotten in any accident or mishap, information about the medication the employee is taking currently, names of the medicines provided by the employee, and then the company checks about the side effects and potential of the employee to be able to work.

There are also a few questions regarding the diseases that the employee was diagnosed with and to what extent the candidate can work for the specified position.

There are a few questions about physician limitations, too. There are usually open-ended questions that require the employee to answer in detail.

Information about lifestyle:

A few questions are asked about the lifestyle of the employee to determine how healthy he is. These questions are regarding whether or not the candidate uses tobacco products, how much alcohol he consumes, etc.

Emergency contact numbers:

The candidate should provide the name and contact number of the person whom a company can reach in case the employee has a medical emergency at the workplace. 


The prospective employee is required to write down his signature at the end of the form to confirm that he is the authentic person who has filled out the form and provided the information. An employee needs to provide accurate information because this information is for the safety and inconvenience of the employee.

The company should tell the candidate that this information will be kept in the records of the company as long as the employee is going to work for it. In addition, the company also makes it clear that it will not disclose this information to any external entity without the consent of the employee.

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