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This “Medical Questionnaire Form (Long)” is prepared and issued by a company mainly to collect information for the employer/insured to determine ability to perform job duties and/or to analyse or evaluate employee’s compensation claims submitted in the future.
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This “Medical Questionnaire Form (Long)” should be signed by the applicant/employee. |
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Jurisdiction |
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This form is intended for use in the UAE. |
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Before Execution |
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- The information on this front page or contained in the headers and footers of this instrument are for guidance purposes only. - Please delete this front page together with the information contained in the headers, footers and the endnotes prior to circulating this form. Where square brackets […] and highlights are used in the document, it indicates that there is missing or incomplete information which will need to be incorporated prior to signature. - Please remove the square brackets and all highlighting prior to signature. |
Disclaimer
This document is provided for reference only and is not intended to be, and should not be considered, legal advice. Determinations about whether this document will be appropriate in your particular situation or jurisdiction should be made after consultation with a legal counsel. Kanoony will not assume any legal liability that may arise from the use of this document.
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