Medical Fitness Declaration Form Template for Saudi Arabia

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Key Requirements PROMPT example:

Medical Fitness Declaration Form

"I need a Medical Fitness Declaration Form for our construction company in Saudi Arabia, compliant with both Ministry of Health and Ministry of Labor requirements, to be used for screening new employees starting from January 2025 who will be working at heights above 30 meters."

Document background

The Medical Fitness Declaration Form is a crucial document required under Saudi Arabian regulations for various official purposes, primarily employment and visa processing. This document is mandated by Saudi Labor Law (Royal Decree No. M/51) and regulated by the Ministry of Health guidelines. It serves as an official certification of an individual's health status and fitness for specific purposes, such as employment, education, or residency requirements. The form includes comprehensive medical information, professional assessment, and formal declarations, ensuring compliance with local healthcare standards and labor regulations. Medical Fitness Declaration Forms must be completed by authorized medical practitioners at approved healthcare facilities and typically require official authentication for use within Saudi Arabia.

Suggested Sections

1. Personal Information: Individual's details including full name (in Arabic and English), nationality, ID/Iqama number, date of birth, and contact information

2. Purpose of Declaration: Specific purpose for which the medical fitness declaration is being made (e.g., employment, visa requirement, educational institution)

3. Medical History: Self-declared history of medical conditions, surgeries, and ongoing treatments

4. Current Health Status: Declaration of current medical conditions, medications, and any existing disabilities or impairments

5. Physical Examination Results: Basic results of physical examination including vital signs, height, weight, and general health indicators

6. Medical Practitioner's Assessment: Professional evaluation and fitness determination by the examining healthcare provider

7. Declaration Statements: Formal statements confirming the truth of provided information and understanding of implications

8. Authentication: Signatures of the individual, examining medical practitioner, and official stamps/seals

Optional Sections

1. Occupational Requirements: Specific health requirements related to particular job roles or industries, used when the declaration is for employment purposes

2. Vaccination Record: Details of relevant vaccinations, included when required for specific purposes such as healthcare workers or educational institutions

3. Mental Health Assessment: Evaluation of mental health status, included when required for specific positions or purposes

4. Substance Testing Declaration: Results and declarations regarding substance testing, included when required by employer or regulatory bodies

5. Previous Workplace Injuries: Declaration of any previous workplace injuries or occupational illnesses, included for employment-related declarations

6. Female Employee Special Conditions: Additional declarations specific to female employees as per Saudi labor law requirements

Suggested Schedules

1. Schedule A - Detailed Medical Examination Results: Complete results of all medical tests conducted, including laboratory tests, x-rays, and other diagnostic procedures

2. Schedule B - Specialist Evaluations: Reports from any specialist consultations or specific medical evaluations

3. Schedule C - Medical Testing Laboratory Certificates: Original or certified copies of laboratory test results and medical certificates

4. Appendix 1 - Required Medical Standards: Specific medical standards and criteria for the relevant industry or purpose

5. Appendix 2 - Declaration Forms in Multiple Languages: Translations of key declarations in Arabic and English

6. Appendix 3 - Privacy Notice and Consent Forms: Detailed information about how medical data will be used and stored, with relevant consent forms

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 & Gas

Education

Hospitality

Transportation

Mining

Retail

Aviation

Maritime

Public Sector

Food Services

Pharmaceutical

Security Services

Relevant Teams

Human Resources

Legal

Compliance

Health & Safety

Operations

Risk Management

Employee Relations

Immigration

Medical Services

Training & Development

Relevant Roles

Human Resources Manager

Recruitment Specialist

Compliance Officer

Health and Safety Manager

Occupational Health Nurse

Medical Director

HR Administrator

Legal Counsel

Risk Manager

Operations Manager

Training Coordinator

Employee Relations Manager

Immigration Specialist

Workplace Health Coordinator

Benefits Administrator

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