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Free Employee Health Survey HR Template

Free Employee Health Survey HR

Employee Health Survey

Survey Date: January 1, 2050

Employee Name (optional): [Your Name]

HEALTH ASSESSMENT

Have you experienced any recent health issues or symptoms that may affect your ability to work safely?

Yes
No
Prefer not to answer

Are you currently taking any medication or undergoing any medical treatment that may impact your work performance or safety?

Yes
No
Prefer not to answer

Have you been in contact with anyone diagnosed with a contagious illness in the past 14 days?

Yes
No
Not sure

Are you experiencing any chronic health conditions that may require accommodations at work?

Yes
No
Prefer not to answer

Have you had any recent injuries or accidents that may affect your work duties?

Yes
No
Prefer not to answer

Are there any specific health concerns or accommodations you would like to discuss with the company?

Yes
No
Prefer not to answer

ADDITIONAL COMMENTS

Please provide any additional comments or information related to your health or any specific concerns:

The information provided in this Employee Health Survey will be kept confidential and used solely for assessing and ensuring the health and safety of our workforce. Your cooperation in providing accurate information is essential for maintaining a safe workplace.

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Prioritize employee well-being with the Employee Health Survey HR Template from Template.net. This editable and customizable resource empowers HR professionals to assess and enhance employee health seamlessly. Utilize our Ai Editor Tool for effortless customization, ensuring the template aligns perfectly with your organization's needs. Streamline health assessments and promote a healthier workplace with this user-friendly and adaptable document.

Free Employee Health Survey HR

HEALTH ASSESSMENT

ADDITIONAL COMMENTS

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