Follow the steps to successfully complete the health questionnaire form

1. Click ‘Get Form’ button to acquire the form and open it in the editor.
2. Begin by entering the employee's name in block letters. This ensures that the information is clear and legible.
3. If applicable, provide the employee code number and joining date. Also, enter a contact phone number for any follow-up questions.
4. List the family members to be covered under the insurance policy. For each member, fill in the name, relationship to the employee, date of birth, height in feet, and weight in pounds. Use additional sheets if necessary.
5. Carefully read the questions in the medical history section. For each question, tick the appropriate box to indicate a 'yes' or 'no' answer. If any answer to questions 1(a) to 1(e) is 'yes', provide detailed information including the nature of the illness, medicines taken, and the name of the hospital and attending physician.
6. Complete the declaration and authorization section by confirming the truthfulness of the provided information. The employee should sign and date this section.
7. At the end of the form, the employee should sign with the date and also ensure the employer's signature and stamp are included.
8. Finalize the process by saving any changes, downloading the completed form, or printing it for distribution.

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