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The Medical Examination Form For Employment is a mandatory document in various employment situations under Belgian law, particularly when hiring for positions with specific health and safety requirements. This form is required under the Belgian Well-being at Work Act and must comply with GDPR and Belgian data protection regulations regarding medical data processing. It is used during pre-employment screenings, periodic health assessments, and when employees return to work after extended illness. The document ensures that employees are medically fit for their specific job functions while protecting both employer and employee interests. It includes sections for personal information, medical history, physical examination results, and job-specific health assessments, all structured to meet Belgian legal requirements and occupational health standards.

1. Personal Information: Basic identification details of the candidate/employee including name, date of birth, contact information, and employee ID (if applicable)

2. Position Details: Information about the position being applied for/held, including job title, department, and specific job functions that may have health implications

3. Medical History: General medical history section covering past illnesses, surgeries, and current medical conditions relevant to employment

4. Current Health Status: Assessment of current health conditions, medications, and ongoing treatments that might affect work performance

5. Physical Examination Results: Standard physical examination findings including vital signs, vision test, hearing test, and other relevant physical assessments

6. Occupational Health Risk Assessment: Evaluation of health risks specific to the job role and workplace environment

7. Medical Professional's Declaration: Official statement from the examining physician regarding the candidate's fitness for work

8. Privacy Notice and Consent: GDPR-compliant declaration regarding the processing of medical data and consent form