Employee Health Questionnaire

Personal Information

Dear Employee,

We are committed to creating a healthy and safe workplace for all our employees. As part of this commitment, we are conducting a confidential health questionnaire to gather information about your current health status. This information will help us identify potential health and safety risks, and take appropriate measures to mitigate them.

We kindly request that you take the time to complete this questionnaire truthfully and to the best of your knowledge. Your answers will be kept confidential and used for internal purposes only.

Thank you for your cooperation.

1. Name:


2. Department:


3. Date of Birth:


4. Gender: