The Employee Health Declaration Form is a critical document used in Philippine workplaces to gather and maintain essential health information from employees. It is implemented in compliance with various Philippine regulations, including the Data Privacy Act of 2012, Labor Code of the Philippines, and Occupational Safety and Health Standards Act. The form becomes particularly relevant during employee onboarding, annual medical examinations, return-to-work scenarios, or during public health emergencies. It typically includes sections for personal information, current health status, medical history, emergency contacts, and necessary consent declarations. The document helps organizations maintain workplace safety while ensuring proper handling of sensitive health information according to Philippine legal requirements.
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1. Employee Information: Basic personal details including name, employee ID, department, and contact information
2. Health Status Declaration: Current health condition, presence of specific symptoms, and recent health issues
3. Medical History: Relevant medical conditions, chronic illnesses, and ongoing medications that may affect work performance
4. COVID-19 Exposure Assessment: Recent travel history, potential exposure to infectious diseases, and vaccination status
5. Emergency Contact Information: Details of persons to contact in case of medical emergencies
6. Data Privacy Notice: Statement explaining how the health information will be used, stored, and protected as per Data Privacy Act
7. Declaration and Consent: Employee's confirmation that information provided is true and consent for data processing
8. Certification: Space for employee signature, date, and witness verification if required
1. Vaccination Records: Section for detailed vaccination history, optional unless required by specific industry regulations
2. Regular Medical Test Results: Space for recording periodic medical examination results, relevant for high-risk occupations
3. Occupational Health History: Previous work-related health issues or injuries, relevant for specific industries
4. Fitness Assessment: Physical fitness declaration for roles requiring specific physical capabilities
5. Mental Health Declaration: Optional section for mental health status, used when relevant to job requirements and with appropriate privacy protections
1. Schedule A - List of Notifiable Diseases: Comprehensive list of diseases that must be reported as per Philippine health regulations
2. Schedule B - Medical Information Handling Protocol: Detailed procedures for processing and storing health information
3. Schedule C - Privacy Policy: Detailed privacy policy and data protection measures specific to health information
4. Appendix 1 - Symptom Checklist: Detailed checklist of symptoms for specific conditions relevant to the workplace
5. Appendix 2 - Contact Tracing Form: Supplementary form for recording potential exposure contacts when necessary
Relevant legal definitions
Clauses
Relevant Industries
Healthcare
Manufacturing
Education
Financial Services
Information Technology
Retail
Construction
Food Service
Transportation
Hospitality
Mining
Agriculture
Pharmaceutical
Government Services
Business Process Outsourcing
Relevant Teams
Human Resources
Occupational Health and Safety
Legal
Compliance
Risk Management
Employee Relations
Medical Services
Data Protection
Administration
Corporate Services
Relevant Roles
Human Resources Manager
Compliance Officer
Occupational Health and Safety Officer
Medical Director
Privacy Officer
Risk Management Officer
Employee Relations Manager
Health and Safety Coordinator
HR Business Partner
Recruitment Manager
Benefits Administrator
Corporate Medical Officer
Workplace Safety Inspector
Data Protection Officer
Legal Counsel
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