Employee Physical Examination Questionnaire Template
Streamline Health Evaluations with Our Employee Physical Exam Form
Managing employee health evaluations can feel overwhelming, especially when keeping track of countless forms and requirements. This template is designed for HR professionals and medical staff who need a reliable way to assess an employee's fitness for work. With benefits like easy customization, accurate health data collection, and compliance with health regulations, this employee physical exam form can save you time and enhance your hiring process. Create a more efficient experience for your team-try the live template now.
When to use this form
Use this form during hiring, job transfers, and annual checkups to confirm that a candidate or employee can safely meet the physical demands of the role. It helps HR and supervisors match people to tasks, reduce injury risk, and document baseline health for safety-sensitive work. For general health history, pair it with the Medical questionnaire form. Before placing someone in a safety-critical post or after extended leave, use the Fitness for duty form to confirm readiness. When an employee returns after illness or injury, align this screening with the Return to work form to guide restrictions and a phased schedule. The result is faster onboarding, clearer expectations, and fewer avoidable incidents.
Must Ask Employee Physical Examination Questionnaire Questions
- Which essential job tasks will your role require (e.g., lifting, prolonged standing, driving, PPE use)?
This ties your health information to real job demands, so reviewers assess actual risk instead of guessing. Clear task details help tailor evaluations and reduce unnecessary restrictions.
- Do you have any current symptoms or conditions that could affect these tasks?
Noting active issues (pain, shortness of breath, dizziness) guides immediate precautions and prioritizes follow-up. It also documents a baseline for tracking change over time.
- Are you taking any medications that may cause drowsiness, dizziness, or limit safe equipment use?
Medication effects can impact driving, ladder work, or shift duty. Disclosing them helps set safe work assignments and schedule adjustments if needed.
- Have you had any surgeries, hospitalizations, or major injuries in the past 12 months?
Surgery clearance form can support clearance for recent procedures. Sharing dates and restrictions helps determine if temporary limits or conditioning are needed.
- Do you need any accommodations or ergonomic adjustments to perform essential functions?
Medical review form can coordinate details from your clinician. Early disclosure helps your team arrange tools, pacing, or schedule changes that keep you productive and safe.
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