All medical and sensitive personal information you provide will be held in confidence by the University Occupational Health Service. The school will only be informed of the need to make adjustments if it is relevant to your educational needs or the safety of children or patients. You will be fully involved before these recommendations are made.
Please complete the questionnaire and send it to the Occupational Health Service as soon as possible. If you have an impairment which affects you in your studies or everyday living or have had any of the illnesses or psychological difficulties identified in the questionnaire please provide information to help us appreciate how it affects you, and describe any special support measures that you use.
When completing the questionnaire please answer each of the questions, providing brief detail on any questions answered ‘yes’. You should then complete the declaration in Section 3 and then arrange for your general practitioner, or usual doctor, to complete Section 4 – doctor’s Certificate. You will be responsible for any fee charged. This may be in the region of £50.
Once you have completed all sections, you should then send the form to the University Occupational Health Service.
Keep a copy as other universities are likely to need the same information.
Please contact us by emailing email@example.com or phone 592174 (UEA internal ext 2174) if you have any problem with our web pages especially downloading documents and we will send them to you.
Please return your completed health questionnaire to the Occupational Health Department at the address below:
STAFF & STUDENT OCCUPATIONAL HEALTH SERVICE
Student applicant (In medical confidence)
UNIVERSITY MEDICAL SERVICES
UNIVERSITY OF EAST ANGLIA
Please inform Occupational Health if there is any change in your health between completing the questionnaire and starting at UEA.