The Medical Self Declaration Form is a critical document used in Malta for individuals to formally declare their health status and medical history. This document is required in various contexts, including pre-employment medical screenings, insurance applications, school or university enrollment, sports participation, and general healthcare services. The form must comply with Malta's Health Act (Chapter 528) and Data Protection Act (Chapter 586), as well as EU GDPR requirements for handling sensitive medical data. It typically includes sections covering personal information, current health status, medical history, ongoing treatments, and specific health conditions relevant to the purpose of the declaration. The document serves as a legal basis for health-related decision-making and risk assessment while ensuring proper protection of sensitive personal data under Maltese jurisdiction.
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1. Personal Information: Declarant's full name, ID/passport number, date of birth, contact details, and emergency contact information
2. Data Protection Notice: Statement about how personal data will be processed, stored, and protected in compliance with GDPR and Maltese data protection laws
3. General Health Declaration: Overview section where declarant confirms their general state of health and ability to perform relevant activities
4. Medical History: Detailed section covering past medical conditions, surgeries, hospitalizations, and chronic conditions
5. Current Medical Status: Declaration of current medical conditions, medications, allergies, and ongoing treatments
6. Family Medical History: Relevant hereditary conditions and significant family medical history
7. Certification and Signature: Declaration of truth, consent statement, and signature section with date and place of signing
1. Occupational Health Requirements: Additional section for workplace-specific health declarations, including specific physical or mental requirements for job roles
2. COVID-19 Declaration: Specific section for COVID-19 related health status and vaccination information, particularly relevant during pandemic conditions
3. Mental Health Status: Optional section for declaring mental health conditions when relevant to the purpose of the declaration
4. Pregnancy Status: Section for female declarants when relevant to medical treatment or occupational safety
5. Lifestyle Factors: Additional information about smoking, alcohol consumption, and physical activity when relevant to the medical assessment
1. Schedule A - Medical Conditions Checklist: Detailed checklist of specific medical conditions for the declarant to mark yes/no
2. Schedule B - Medications List: Template for listing current medications, dosages, and duration of use
3. Schedule C - Previous Medical Procedures: Template for detailing past surgeries and medical procedures with dates
4. Appendix 1 - Medical Terms Glossary: Definitions of medical terms used in the form to ensure clear understanding
5. Appendix 2 - Privacy Policy: Detailed information about data protection and privacy rights under Maltese law
Relevant legal definitions
Clauses
Relevant Industries
Healthcare
Insurance
Education
Aviation
Maritime
Sports and Recreation
Manufacturing
Food Service
Hospitality
Construction
Public Service
Transportation
Childcare
Pharmaceutical
Relevant Teams
Human Resources
Occupational Health
Compliance
Health and Safety
Medical Administration
Risk Management
Legal
Privacy and Data Protection
Employee Relations
Medical Records
Administrative Services
Relevant Roles
Human Resources Manager
Occupational Health Officer
Medical Administrator
Compliance Officer
Health and Safety Manager
School Administrator
Insurance Underwriter
Recruitment Specialist
Employee Relations Manager
Medical Records Officer
Privacy Officer
Healthcare Administrator
Company Doctor
Risk Assessment Officer
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