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Fork lift truck medical questionnaire

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Thiis questionnaire needs to be completed before you see the Doctor for your Fork lift truck medical.   Your answers will be used to help assess your fitness to used fork lift trucks and manual handling equipment (if applicable). 

 

The outcome will be fed back to your employer which will enable them to ensure that the health, safety and welfare of yourself and other employee’s is safeguarded. 

 

this questionnaire is returned to Rockingham Occupational Health Ltd and is only accessible by medical personnel.  A report will be made following your assessment with the Doctor on whether you are fit for employment, fit with restrictions, further information is required or you are unfit to drive fork lift trucks (brief comments explaining the decision may be made).
 
If there are concerns about your ability to complete your role then you might require a further medical assessment or information may need to be requested from your GP or specialist; this will not be undertaken without your prior consent.

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General Data Protection Regulation  (GDPR) 2018 – You or your authorised representative may apply for access to your own occupational health records under the GDPR 2018 by applying in writing to Rockingham Occupational Health Limited.  For more information on GDPR see the bottom of the page.

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The Access to Medical Reports Act 1988 – This Act does not apply in this situation, as the doctor who examines you is not responsible for your clinical care.  He is acting as an independent medical adviser to your current (or prospective) employer.  For more information on Access to Medical Records see the bottom of the page.

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