Fitness for work

FITNESS FOR WORK – MEDICATION & CONDITION DECLARATION FORM

Instructions

Employees, contractors and visitors must comply with SAF-SWP-007 Fitness for Work – Drugs & Alcohol

·     Complete this form if taking prescribed or non-prescribed medication that may affect your safety & performance at work.

·     Complete this form if you have a condition which may put yourself or others at risk.

·     Complete this form if you have a condition which may require immediate access to medication.

·     Persons using prescribed or non-prescribed medication have the following responsibilities:

·     Notify the medical practitioner or pharmacist of the nature of their duties to ascertain if the side effects of a prescribed medication may impact on their safety & performance at work.

·     Take any medication strictly in accordance with the medical practitioner’s or manufacturer’s recommendations.

·     Notify their Supervisor of any medication they are taking that may impact on their safety & performance at work.

·     Immediately report any side effects to their Supervisor.

·     A new form must be completed if new medication is prescribed or previously declared medication is changed or a relevant condition becomes known.