Free Medical Checklist for Employees Template
Medical Checklist for Employees
|
Employee Name |
Company |
Address |
|---|---|---|
|
[your name] |
[your company name] |
[your company address] |
This comprehensive checklist provides a systematic approach to collecting crucial employee health and safety information. The included explanations ensure clarity for medical professionals, helping them make informed assessments.
Medical History
|
YES |
NO |
|
|
Previous Illnesses |
|
|
|
Surgical History |
|
|
Current Health Status
|
YES |
NO |
|
|
Current Medication |
|
|
|
Allergies |
|
|
Workplace Safety
|
YES |
NO |
|
|
Personal protective equipment (PPE) training |
|
|
|
Fire safety training |
|
|
Occupational Health
|
YES |
NO |
|
|
Assessment of work-related stress |
|
|
|
Exposure to hazardous substances |
|
|
