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JGEmployHealth(E)0705 6/28/2005 12:06 PM Page 1 Firm # E M P L O Y E E S T A T E M E N T O Certificate # F H E A L T H EMPLOYEE INFORMATION (PLEASE ANSWER ALL QUESTIONS IN INK) Employees Name Date
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What is employee statement of health?
Employee statement of health is a form filled out by employees to report their current health status.
Who is required to file employee statement of health?
All employees are required to file employee statement of health.
How to fill out employee statement of health?
Employees can fill out employee statement of health form either online or on paper by providing accurate health information.
What is the purpose of employee statement of health?
The purpose of employee statement of health is to assess the health status of employees and provide a basis for health-related decisions.
What information must be reported on employee statement of health?
Employees must report information such as current health conditions, medications, allergies, and recent medical history on employee statement of health.
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