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Medical Questionaire Form
Do you have any current or previous upper body, back, joint or muscular problems that may affect your ability to work?
Do you have any previous injuries that may affect your ability to carry out Manual Handling tasks safely?
Male – Are you able to lift 25kg safely?
Female – Are you able to lift 16kg safely?
Have you ever had or suffered from dizziness, fainting attacks or blackouts?
Have you ever had or suffered from high blood pressure?
Have you ever had or suffered from Chest pains or angina?
Do you have or ever suffered from Diabetes?
Do you have or ever suffered from Epilepsy?
Have you recently had a head injury or been knocked unconscious?
Do you have or ever suffered from depression, anxiety or stress?
Do you have or ever suffered from Eye disease or past eye injuries?
Do you need to wear prescription contact lenses or glasses?
Have you ever had an ear injury, frequent ear infections or hearing loss?
Are you taking any regular prescribed medication?
Do you drink alcohol regularly?
Do you take part in regular exercise?
Do you have a full clean driving licence?
Commercial Application Form
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Industrial Application Form
Maximum upload size: 50MB

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