• Tomago Aluminium - Medical Form

  • This form must be completed personally by the worker to whom it applies and must not be completed by a representative, supervisor, or any third party on the worker’s behalf.

    It collects personal and sensitive health information for the purposes of workplace health, safety, and compliance, and all information will be handled confidentially in accordance with applicable privacy laws and company policies.

    By completing this form, the worker confirms that the information provided is true, accurate, and completed by them personally.

    For workers attending the Tomago Aluminium site, it is essential that all registration and compliance requirements are completed at least 48 hours prior to attendance.

    Please note that new access cards will not be issued between 5:00 AM and 9:00 AM; workers requiring an access card are therefore advised to collect it the day prior to their scheduled attendance to avoid delays.

    Your cooperation in meeting these requirements is appreciated to ensure smooth site access.

  • Worker's Date of Birth*
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    2 digit day, 2 digit month, 4 digit year
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  • Medical Details

    With respect to the critical aspects of your role, the area you will be working, and/or the exposure to magnetic fields, exposure to coal tar pitch volatiles and/or the emergency response which may be required, can you please respond to the following:
  • In the most recent 24 months, have you experienced fits/seizures, epilepsy, blackouts or issues affecting your balance?*
  • Do you have a surgically implanted device for the management of pain?*
  • Do you have any metallic implants, screws, pins and/or plates?*
  • In the last year, have you been newly diagnosed with a cardiac condition?*
  • Do you have a cardiac pacemaker or other electrically activated device?*
  • Are you, or could you be pregnant?*
  • Do you have a history of asthma or other chronic respiratory disease?*
  • Do you have any allergies?*
  • Are you currently receiving medical/surgical treatment that means you are not currently fit for work?*
  • Do you currently take medication that could make you drowsy or affect driving/operating machinery?*
  • Should be Empty: