This form is required for completion by all Staff participating in overseas and/or high-risk activity-based trips and visits.
Where no health issues are identified as a concern for the outlined required visit type, the occupational health practitioner will send a certificate of fitness to participate. This will be issued to yourself, the trip leader, Human Resources, and the health and safety team (healthandsafetysupport@easterneducationgroup.ac.uk).
Eastern Education Group is required to safeguard you, and the organisation, against potential health issues that may result in the prevention of participation. You will only be required to attend an appointment if deemed necessary by the screening occupational health practitioner. Specifically, where further information may be required to form a professional decision. Where you have answered ‘yes’ to a question please provide detail as applicable.
No medical information will be disclosed without your consent. Confidential personal information will be held by the occupational health practitioner in accordance with Data Protection 2018 and the General Data Protection Regulations 2018.
By submitting this form, I declare that the information I have provided is true to the best of my knowledge. I further declare that I have not omitted or falsified any material facts or details, which could have a bearing on my state of health. I am aware to notify my Manager/Supervisor should any symptoms develop.
Outcome
The outcome of your assessment will be provided to EEG in the form of certification.
1. Certificate confirmation to participate
2. Reasonable adjustments requested for consideration
3. Certification declined not suitable to participate