Health Risk Assessment Form Template for Saudi Arabia

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Key Requirements PROMPT example:

Health Risk Assessment Form

"I need a comprehensive Health Risk Assessment Form for our new chemical manufacturing facility in Jubail Industrial City, Saudi Arabia, to be implemented by March 2025, that specifically addresses chemical exposure risks and includes both Arabic and English versions."

Document background

The Health Risk Assessment Form is a critical document required under Saudi Arabian law for evaluating and monitoring workplace health risks and employee wellness. It is designed to comply with both the Saudi Public Health Law and Labor Law Royal Decree No. M/51, while adhering to Islamic principles and local cultural considerations. This document is typically used during pre-employment screenings, periodic health checks, or when employees transition to new roles with different health risk profiles. The form covers comprehensive health evaluation criteria including personal medical history, current health status, occupational exposure risks, and specific workplace hazard assessments. It serves as a legal record of health risk evaluation and forms the basis for implementing appropriate preventive measures and health monitoring protocols in the workplace.

Suggested Sections

1. Personal Information: Basic details including name, ID/Iqama number, date of birth, gender, and contact information

2. Employment Details: Current job position, department, work location, and duration of employment

3. Medical History: Past medical conditions, surgeries, chronic illnesses, and family medical history

4. Current Health Status: Present health conditions, medications, allergies, and ongoing treatments

5. Occupational Exposure History: Previous and current exposure to workplace hazards, chemicals, or dangerous materials

6. Physical Assessment: Basic physical measurements including height, weight, blood pressure, and vital signs

7. Lifestyle Factors: Smoking status, exercise habits, sleep patterns, and dietary information

8. Emergency Contact Information: Details of primary and secondary emergency contacts

9. Declaration and Consent: Employee's declaration of truth and consent for health assessment and data processing

Optional Sections

1. Industry-Specific Health Risks: Additional assessment criteria for specific industries (e.g., construction, chemical manufacturing, healthcare)

2. Travel Health Assessment: For employees who travel frequently or work in multiple locations

3. COVID-19 Risk Assessment: Specific section for pandemic-related health risks and vaccination status

4. Psychological Health Assessment: Mental health evaluation section for roles with high stress levels

5. Ergonomic Assessment: For office-based workers or those using specific equipment

6. Heat Stress Assessment: For workers exposed to extreme temperatures in Saudi climate

7. Food Handler's Health Declaration: Additional health declarations for food industry workers

Suggested Schedules

1. Medical Examination Results: Detailed results of physical examinations and laboratory tests

2. Risk Rating Matrix: Standard matrix for evaluating and categorizing health risks

3. Occupational Health Guidelines: Specific guidelines and protocols for different job roles

4. Emergency Response Procedures: Procedures to follow in case of health emergencies

5. Health Monitoring Schedule: Timeline for regular health checks and assessments

6. Workplace Hazard Inventory: List of potential workplace hazards and corresponding preventive measures

7. Medical Fitness Criteria: Standards for determining medical fitness for different job roles

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

alex.den.21@genieai.co

Relevant legal definitions

Clauses

Relevant Industries

Healthcare

Construction

Manufacturing

Oil and Gas

Mining

Chemical Processing

Food and Beverage

Pharmaceuticals

Transportation

Logistics

Education

Retail

Hospitality

Technology

Agriculture

Relevant Teams

Human Resources

Health and Safety

Occupational Health

Risk Management

Compliance

Operations

Quality Assurance

Medical Services

Environmental Health

Employee Relations

Legal

Facility Management

Relevant Roles

Occupational Health Physician

Health and Safety Manager

Risk Assessment Officer

Human Resources Director

Compliance Manager

Environmental Health Officer

Industrial Hygienist

Workplace Safety Coordinator

Medical Director

Operations Manager

Facility Manager

Quality Assurance Manager

Production Supervisor

Site Safety Supervisor

Occupational Health Nurse

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Authors

Alex Denne

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