Informed Consent Form for Occupational Health Screening
Personal Information
Full Name:
Date of Birth:
Employee ID / Number:
Department / Position:
Purpose of Screening
Procedures
Risks and Benefits
Confidentiality
Voluntary Participation
Consent
I have read and understood the information above.
I agree to participate in the occupational health screening.
Signature:
Date:
Name of Practitioner (if applicable):
Signature:
Date: