The Health Risk Assessment Form serves as a crucial tool for evaluating and documenting individual health status and potential workplace risks in Malaysia. This document is essential for organizations seeking to maintain compliance with Malaysian occupational health and safety regulations while protecting employee wellbeing. The form combines comprehensive health evaluation with specific risk assessment components, enabling healthcare providers and employers to identify, assess, and manage potential health risks effectively. It includes sections for personal health information, occupational exposure assessment, and medical recommendations, all while adhering to Malaysian data protection and healthcare service requirements.
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1. Personal Information: Collection of basic personal and demographic data, including name, IC number, age, gender, and contact details
2. Consent Declaration: Written consent for data collection and processing, explaining purpose and usage of health information as per PDPA 2010
3. Medical History: Documentation of past medical conditions, surgeries, chronic illnesses, and family health history
4. Current Health Status: Assessment of present health conditions, medications, and ongoing treatments
5. Lifestyle Factors: Evaluation of diet, exercise, smoking, alcohol consumption, and other lifestyle-related health factors
6. Occupational Health Risks: Assessment of work-related health hazards and exposure risks
7. Vital Signs: Recording of basic health measurements including blood pressure, heart rate, height, weight, BMI
8. Risk Assessment Summary: Overall evaluation of health risks identified through the assessment
9. Recommendations: Proposed actions, follow-ups, or interventions based on identified risks
10. Healthcare Provider Information: Details and signature of the healthcare professional conducting the assessment
1. Psychological Health Assessment: Additional mental health screening questions, recommended for high-stress work environments
2. Specific Industry Hazards: Detailed assessment of industry-specific health risks, used when assessing workers in specialized sectors
3. Travel Health History: Assessment of travel-related health risks, particularly relevant during infectious disease outbreaks
4. Ergonomic Assessment: Detailed evaluation of workstation and posture-related risks, recommended for office-based assessments
5. Immunization History: Documentation of vaccination status, particularly important for healthcare workers
1. Risk Rating Matrix: Standard matrix for quantifying and categorizing identified health risks
2. Medical Testing Requirements: Schedule of required medical tests based on risk factors identified
3. Health Monitoring Schedule: Recommended timeline for follow-up assessments and health monitoring
4. Reference Values: Standard health parameters and acceptable ranges for various measurements
5. Emergency Contact Protocol: Procedures and contact information for medical emergencies
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