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