Pre-employment Health Questionnaire

Are you aware of any circumstances regarding your health or capacity to work that would interfere with your ability to perform the duties of the position you are applying for? (In answering this question Yes or No you are also covering factors such as: existing or exposure to infectious diseases, taking of medication/treatment on a regular basis (daily, weekly, monthly)) *

Yes

If yes, please provide additional information

Do you have an existing injury or condition or pre-existing injury or condition which may be exacerbated or aggravated by, or deteriorate as a result of performing the duties outlined in the job advertisement? (Existing is a condition for which treatment is still being received. Pre-Existing is where an injury or condition/s is present, but treatment is not required.) *

Yes

If yes, please provide additional information

Have you ever suffered, or do you have any pre-existing physical or psychological injuries or conditions that may prevent you from carrying out the inherent requirements of the job, as informed and/or understood from the job advertisement? *

Yes

If yes, please provide additional information

I consent to any reference checks that may be necessary to support this application *

I understand that any false or misleading information given in this application may render my contract of employment, if I am appointed, liable to termination. I declare that to the best of my knowledge the above information, and that submitted in any accompany document(s), is correct. *

I understand that CMTP undertake mandatory pre-employment drug and alcohol testing. *

Employee
Registration Form

Contact Information

Work qualifications

Pre-employment Health Questionnaire

Employee Registration Form

Contact Information

Work qualifications

Pre-employment Health Questionnaire

Employee
Registration Form