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EMPLOYMENT HEALTH QUESTIONNAIRE The Health and Safety 2025

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The Employment Health Questionnaire is a confidential document required by the Taranaki District Health Board (TDHB) to ensure employee safety in compliance with the Health and Safety in Employment Act 1992. It collects detailed health information from job applicants to assess their suitability for employment and potential inclusion in health surveillance programs. The questionnaire covers medical history, previous employment, immunization status, and specific health conditions relevant to the proposed job. Completed forms are securely filed for successful candidates and retained for a minimum of 12 months for unsuccessful candidates before being destroyed.

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Click ‘Get Form’ to open it in the editor.
Begin by filling in your personal details, including your surname, first name, address, and contact phone number. Ensure accuracy as this information is crucial for your health assessment.
Indicate your gender and the proposed job title. This helps the assessing team understand your application context.
Answer the questions regarding previous employment with TDHB, residency status, and any overseas visits in the last two years. Provide detailed responses where applicable.
Proceed to the health history section. Answer questions about past illnesses, injuries, and any disabilities honestly. This information is vital for ensuring workplace safety.
Complete the immunization status section accurately. If you are applying for a clinical position, ensure you answer all MRSA-related questions thoroughly.
Finally, review all entries for completeness and accuracy before signing at the end of the form to confirm that all information provided is true.

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What are the 3 Cs of health and safety?

One effective method is the 3Cs approach- Compliance, Competence and Commitment. This approach forms the cornerstone of a strong safety culture, with each element playing a critical role in safeguarding employees and fostering a secure work environment.

What are the 4 major categories of occupational health and safety hazards?

There are four types of hazards: chemical, biological, ergonomic, and physical hazards. Collect and review information about hazards and potential hazards in the workplace.

What are 10 basic safety rules?

Safety Rule #1 Know Your Name, Number and Address: Safety Rule #2 Do NOT Eat Anything Given By A Stranger: Safety Rule #3 Do NOT Climb the Fence: Safety Rule #4 Do NOT Walk out of the Yard Alone: Safety Rule #5 Playing Or Experimenting with Fire Is NOT Allowed: Safety Rule #6 Never Go Anywhere with A Stranger:

What are good safety questions to ask?

Examples include: What types of hazards do you think this machine / process has? What could you do to make working with this machine safer? What are the symptoms of Heat Illness? What are the types of Fall Protection? Which portable ladder would you choose to do this job and how would you position it?

What is a HSE questionnaire?

Background: The Health and Safety Executive (HSE) indicator tool is one of the most commonly used tools for assessing the risk of work-related stress. Few studies, however, have investigated whether and how its scales are related to psychological distress or other work-related health outcomes.

What are the 3 Cs of work health and safety?

The 3Cs approach Compliance, Competence and Commitment offers a framework to build and maintain a safe working environment. Beyond safeguarding employees and their wellbeing, this supports increased productivity, reduced absenteeism, improved morale, and enhanced organisational reputation, driving business success.

What are the three safety questions?

The three basic process safety questions Do you understand what can go wrong? Answering this question requires you to really understand your risks. Do you know what your systems are to prevent this from happening? Do you have information to assure they are working effectively?

What are the health and safety questions?

12 safety questions to ask What are the steps of your job? What safety measures do you currently take? Do you feel youve received effective safety training? How do you determine what protective gear you need? What are some potential hazards youve identified in our workplace?

EMPLOYMENT HEALTH QUESTIONNAIRE The Health and Safety 2025

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