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Innovate Healthcare
Innovate Healthcare
  • Home Page
  • Workplace Health
  • Personal Injury
  • Life Claims
  • About us
  • Careers
  • Contact Us

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  • The purpose of the questionnaire is to determine whether there may be any relevant health problems that could affect your ability to undertake the duties of the post you have been offered or place you at any risk in the workplace.

    You will have received the name of your HR representative, Referrer cost centre, reference number and referrer email address, in your email inviting you to complete the questionnaire. You will need these details once you start the questionnaire.

    The questionnaire will take approximately 5 to 10 minutes to complete. A response to all questions is required. You will be prompted to revisit any questions that require a response prior to moving to subsequent questions. Your progress will be saved should you start the questionnaire and need to return to it at a later date.

    Your answers to this questionnaire will be CONFIDENTIAL to Innovate Healthcare and will not be provided to anyone else without your permission. However, we may recommend adjustments or assistance to your HR representative, when it is Innovate Healthcare’s opinion that adjustments are required. Our aim is to promote and maintain the health of all people at work. Before health clearance is given for employment you may be contacted by the Innovate Healthcare team and may need to be seen by an Occupational Health advisor or physician.
  • Please input the email address of the person who asked you to complete this form. Please note this is where your outcome certificate will be issued.

  • Based on the information provided this employee has :



  • - Exposure to Asbestos or other hazardous materials / chemicals

    - Exposure to Lead

    - Exposure to Biological Waste

    - Exposure to Clinical Waste








































































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