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	Introduction: Step 1: Personal Information Step 2: Questions 1-10 Step 3: Questions 11-14 Step 4: Questions 15 - 20 Step 5: Questions 21 - 28 Step 6: Questions 29 - 35 Step 7: Questions 36 - 41 Step 8: Declaration Step 9: Medical Reports Act Step 10: Consent Finish Help / FAQ The information given by you on any part of this form will be used as the basis of a medical opinion given by our Company Medical Advisors about your fitness to work to management. Please answer all the questions truthfully and completely. You have 30 minutes to answer all questions, after which your session will time out for security purposes. Please complete this health declaration which will help our Medical Advisor assess your fitness and suitability for the post for which you have applied as part of the overall recruitment process. Please enter your Company and HR reference numbers. These numbers should have been provided to you by your HR advisor. Company Reference:   HR Reference:        Employee Ref (optional):