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Health Declaration

Health Declaration

As a Sub-Contractor, I declare that I have had no health issues which could affect my ability to work In particular;

  • An Epileptic event (seizure or fit)
  • Sudden attacks of disabling giddiness, fainting or blackouts
  • Severe mental handicap
  • A pacemaker, defibrillator or anti-ventricular tachycardia device fitted.
  • Diabetes controlled by insulin or tablets
  • Angina (heart pain) while driving
  • Parkinson’s disease
  • Any other chronic neurological condition
  • A serious problem with memory
  • A Major or minor stroke
  • Any type of brain surgery or tumour
  • Severe head injury involving in-patient treatment at hospital
  • Any severe psychiatric illness or mental disorder
  • Continuing/permanent difficulty in the use of arms or legs
  • Dependence on a misuse of alcohol, illicit drugs or chemical substances in the past three years (do not include drink/driving offences)
  • Any visual disability that affects both eyes (do not declare short/long sight or colour blindness)
  • Any heart condition or heart operation
  • Any visual problem affecting either eye.

If any of the above affects me after I have commenced work; I will inform the company as soon as possible

Sub-Contractor declaration:  I have read the above and fully understand my obligation to inform the company

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