Statement Of Health Form For Employment Template for Philippines

Create a bespoke document in minutes,  or upload and review your own.

4.6 / 5
4.8 / 5

Let's create your Statement Of Health Form For Employment

Thank you! Your submission has been received!
Oops! Something went wrong while submitting the form.

Get your first 2 documents free

Your data doesn't train Genie's AI

You keep IP ownership of your information

Key Requirements PROMPT example:

Statement Of Health Form For Employment

"I need a Statement of Health Form for Employment for our Manila-based manufacturing company that will be implementing new health screening procedures from January 2025, with special focus on occupational hazards in industrial settings and compliance with recent DOLE guidelines."

Document background
The Statement Of Health Form For Employment is a crucial document in the Philippine employment process, required by various organizations to ensure workplace safety and compliance with local regulations. This form is typically used during pre-employment screening or when returning to work after extended leave. It complies with the Data Privacy Act of 2012, Labor Code of the Philippines, and Occupational Safety and Health Standards Act. The document collects essential health information including medical history, current health status, and any conditions that might affect job performance. It's designed to balance the employer's need to ensure workplace safety with employee privacy rights, incorporating necessary consent mechanisms and data protection measures as required by Philippine law. The form serves as a risk management tool while ensuring non-discrimination and confidentiality of sensitive medical information.
Suggested Sections

1. Personal Information: Basic identification details including name, date of birth, address, contact information, and position applied for

2. Health Declaration Statement: Opening statement explaining the purpose of the form and legal basis for collection of health information

3. General Health Status: Current health condition, existing medical conditions, and regular medications

4. Medical History: Past significant illnesses, surgeries, and hospitalizations within a specified timeframe

5. Family Medical History: Relevant hereditary conditions that might affect work performance

6. Physical Fitness Declaration: Statement regarding physical capability to perform job duties

7. Occupational Health History: Previous work-related health issues or injuries

8. COVID-19 Health Declaration: Recent exposure, vaccination status, and related health information

9. Data Privacy Notice: Information about how the health data will be used, stored, and protected as per Data Privacy Act

10. Certification and Authorization: Declaration of truth and consent for verification of provided information

Optional Sections

1. Disability Disclosure: Optional section for voluntary disclosure of disabilities requiring workplace accommodations

2. Mental Health Declaration: Optional section for mental health conditions that may require support or accommodation

3. Pregnancy Status: Optional section for female employees where relevant for workplace safety considerations

4. Vaccination History: Optional section for specific roles requiring certain immunizations

5. Emergency Medical Information: Optional section for emergency contact and critical medical information

Suggested Schedules

1. Medical Examination Results: Attachment for official medical examination results if required

2. Vaccination Records: Copies of relevant vaccination certificates

3. Medical Certificates: Any supporting medical documentation from healthcare providers

4. Privacy Policy Details: Detailed information about data handling and privacy protection measures

5. Job Physical Requirements: Detailed description of physical requirements for the specific position

Authors

Alex Denne

Head of Growth (Open Source Law) @ Genie AI | 3 x UCL-Certified in Contract Law & Drafting | 4+ Years Managing 1M+ Legal Documents | Serial Founder & Legal AI Author

Relevant legal definitions
Relevant Industries

Healthcare

Manufacturing

Construction

Food Service

Education

Transportation

Hospitality

Mining

Maritime

Aviation

Retail

Information Technology

Banking and Finance

Pharmaceutical

Chemical Industry

Relevant Teams

Human Resources

Legal

Compliance

Occupational Health and Safety

Risk Management

Medical Services

Operations

Employee Relations

Privacy and Data Protection

Recruitment

Relevant Roles

Human Resources Manager

Occupational Health Nurse

Health and Safety Officer

Compliance Officer

Medical Officer

HR Administrator

Risk Management Officer

Legal Counsel

Privacy Officer

Employee Relations Manager

Recruitment Specialist

Operations Manager

Industries
Data Privacy Act of 2012 (Republic Act No. 10173): Regulates the collection, handling, and protection of personal and sensitive information, including medical data. Requires informed consent and proper safeguards for health information.
Labor Code of the Philippines (Presidential Decree No. 442): Provides the fundamental framework for employment relationships and workers' rights, including provisions on medical examination and health standards in employment.
Magna Carta of Persons with Disability (Republic Act No. 7277): Prohibits discrimination against persons with disabilities in employment and requires reasonable accommodation in the workplace.
AIDS Prevention and Control Act (Republic Act No. 8504): Protects the rights of individuals regarding HIV/AIDS status disclosure and prohibits mandatory HIV testing as a precondition for employment.
Occupational Safety and Health Standards Act (Republic Act No. 11058): Sets requirements for workplace safety and health standards, including provisions for medical examinations and health monitoring.
Mental Health Act (Republic Act No. 11036): Protects rights of persons with mental health conditions and regulates how mental health information should be handled in employment contexts.
Philippine Medical Act (Republic Act No. 2382): Governs medical practice and documentation requirements for health certifications and medical examinations.
Department of Labor and Employment (DOLE) Department Order No. 178-17: Provides guidelines on pre-employment medical examinations and the scope of allowable medical inquiries.
Teams

Employer, Employee, Start Date, Job Title, Department, Location, Probationary Period, Notice Period, Salary, Overtime, Vacation Pay, Statutory Holidays, Benefits, Bonus, Expenses, Working Hours, Rest Breaks,  Leaves of Absence, Confidentiality, Intellectual Property, Non-Solicitation, Non-Competition, Code of Conduct, Termination,  Severance Pay, Governing Law, Entire Agreemen

Find the exact document you need

Witness Statement Affidavit

A legally binding sworn statement document executed before a notary public in the Philippines, containing testimony about facts or events within the affiant's personal knowledge.

find out more

Student Statement Form

A Philippine-compliant document capturing student declarations, personal information, and acknowledgments for educational institution records.

find out more

Affidavit Of Name Discrepancy

A Philippine legal document sworn before a Notary Public that formally declares and explains variations in how a person's name appears in different official documents.

find out more

Statement Of Support Letter

A formal declaration of support commitment under Philippine law, outlining specific support provisions and terms between supporting and receiving parties.

find out more

Financial Statement Letter

A formal attestation document regarding financial statements or information, compliant with Philippine financial reporting standards and regulatory requirements.

find out more

Statement Form

A formal notarized declaration document under Philippine law containing factual assertions or testimonial evidence from a declarant.

find out more

Signature Agreement Statement

A Philippine-compliant agreement establishing the framework and requirements for legally binding electronic signatures under RA 8792.

find out more

Self Employment Statement Letter

A formal declaration document used in the Philippines to confirm an individual's self-employed status and compliance with local regulatory requirements.

find out more

Agreement Statement

A formal declaration of mutual understanding between parties under Philippine law, establishing agreed terms and conditions.

find out more

Retirement Statement Letter

A formal document issued under Philippine law that confirms an employee's retirement and outlines all associated benefits, obligations, and final settlements.

find out more

Privacy Statement And Consent Form

A dual-purpose document under Philippine law that outlines data processing practices and obtains explicit consent for personal data collection and use.

find out more

Non Disclosure Affidavit

A formal sworn statement under Philippine law declaring an individual's obligation to maintain confidentiality of specific information.

find out more

Employee Statement Form

A comprehensive form used in the Philippines for collecting and verifying essential employee information in compliance with local labor laws and regulations.

find out more

Statement Affidavit

A formal written declaration made under oath in the Philippines, containing sworn statements of facts or events, executed before a notary public and governed by Philippine law.

find out more

Privacy Consent Statement

A legal document for obtaining consent for personal data processing under Philippine privacy laws.

find out more

Consent Statement

A Philippine law-compliant consent statement for personal data collection and processing under the Data Privacy Act of 2012.

find out more

Confidentiality Agreement For Business Plan

A Philippine law-governed confidentiality agreement protecting business plan information and related confidential data between disclosing and receiving parties.

find out more

Statement Of Consent For Passport

A Philippine legal document providing formal authorization for passport issuance, typically for minors, compliant with RA 8239 and DFA regulations.

find out more

Police Witness Statement Form

A formal legal document used in the Philippines to record sworn witness testimonies for use in legal proceedings, taken by authorized law enforcement officers.

find out more

Conflict Of Interest Declaration Form For Employees

A Philippine-compliant declaration form for employees to disclose any actual or potential conflicts of interest in accordance with local regulations.

find out more

Affidavit Written Statement

A formal written declaration made under oath before a notary public in the Philippines, serving as legally binding sworn testimony.

find out more

Affidavit Of Statement Of Facts

A formal sworn statement of facts executed under Philippine law, containing detailed factual declarations authenticated by a notary public.

find out more

Statement Of Consent For Minor To Travel

A notarized legal document under Philippine law authorizing a minor to travel, with parental/guardian consent and essential travel details.

find out more

Affidavit Of Financial Declaration

A sworn statement under Philippine law declaring an individual's or entity's complete financial status, assets, and liabilities, typically used for official or legal purposes.

find out more

Statement Of Health Form For Employment

A Philippine-compliant health declaration form for employment purposes, collecting essential medical information while maintaining legal compliance with local privacy and labor laws.

find out more

Statement Of Financial Support Form

A notarized Philippine legal document declaring an individual's commitment to provide financial support to a beneficiary, typically used for immigration, education, or visa purposes.

find out more

Guarantor Statement Form

A Philippine law-compliant formal declaration where a guarantor commits to assuming responsibility for another party's financial obligations.

find out more

Salary Statement Form

A Philippine-compliant salary statement document detailing employee compensation, benefits, and mandatory deductions in accordance with local labor laws.

find out more

Financial Statement Affidavit

A sworn declaration of financial position compliant with Philippine law, typically used for official financial disclosures to authorities and institutions.

find out more

Declaration Of Confidentiality Form

A legally binding confidentiality agreement under Philippine law that protects sensitive information and establishes confidentiality obligations between parties.

find out more

Billing Statement Form

A Philippine-compliant document that details charges, fees, and payment obligations to customers, adhering to BIR requirements and local regulations.

find out more

Photo Consent Statement

A Philippine law-compliant consent form authorizing the capture and use of photographs, ensuring compliance with local data privacy and intellectual property regulations.

find out more

Account Statement Form

A Philippine-compliant financial document that records and summarizes account transactions and balances, meeting local banking regulations and customer information requirements.

find out more

Form For Parental Consent For Passport

A notarized legal document required under Philippine law where parents/guardians authorize passport issuance for their minor child.

find out more

Short Confidentiality Agreement

A streamlined confidentiality agreement under Philippine law for protecting confidential information in business relationships.

find out more

Employment Statement Letter

A formal document compliant with Philippine labor laws that outlines key employment terms and conditions between employer and employee.

find out more

Training Acknowledgement Statement

A Philippine-compliant document confirming an employee's completion of training programs and associated commitments, governed by local labor laws.

find out more

Acknowledgement Statement For Policy

A Philippine-law governed document confirming an individual's receipt, understanding, and agreement to comply with specific organizational policies.

find out more

Financial Affidavit

A notarized declaration of financial status under Philippine law, detailing assets, liabilities, and income for legal or official purposes.

find out more

Download our whitepaper on the future of AI in Legal

By providing your email address you are consenting to our Privacy Notice.
Thank you for downloading our whitepaper. This should arrive in your inbox shortly. In the meantime, why not jump straight to a section that interests you here: https://www.genieai.co/our-research
Oops! Something went wrong while submitting the form.

Genie’s Security Promise

Genie is the safest place to draft. Here’s how we prioritise your privacy and security.

Your documents are private:

We do not train on your data; Genie’s AI improves independently

All data stored on Genie is private to your organisation

Your documents are protected:

Your documents are protected by ultra-secure 256-bit encryption

Our bank-grade security infrastructure undergoes regular external audits

We are ISO27001 certified, so your data is secure

Organizational security

You retain IP ownership of your documents

You have full control over your data and who gets to see it

Innovation in privacy:

Genie partnered with the Computational Privacy Department at Imperial College London

Together, we ran a £1 million research project on privacy and anonymity in legal contracts

Want to know more?

Visit our Trust Centre for more details and real-time security updates.