In order to establish a harmonious and unified labor relationship and clarify the rights and interests of both employers and employees, new employees must answer the following questions about personal health:
Do you have any of the following diseases at present or in the past? Please also explain the onset time and current situation.
1, brain, nervous system and mental diseases, such as recurrent headache or dizziness, brain needs or has undergone surgery or other symptoms.
□ Yes □ No curing conditions.
2. Cardiovascular diseases. For example: palpitation, chest pain, unexplained dizziness, heart disease, hypertension, cardiomyopathy, aneurysm, etc.
□ Yes □ No curing conditions.
3. Respiratory diseases. For example: repeated cough, expectoration, hemoptysis, emphysema, pulmonary heart disease, tuberculosis and so on.
□ Yes □ No curing conditions.
4, digestive system diseases. For example: unexplained short-term weight loss, liver pain, hepatitis B or other hepatitis, enteritis.
□ Yes □ No curing conditions.
5, endocrine, blood system diseases. For example: diabetes, gout, uremia, leukemia, lymphoma or others.
□ Yes □ No curing conditions.
6. Ear, nose and throat diseases. For example: recent unexplained hoarseness, hearing loss, tinnitus, Meniere's disease, history of facial features or other hand operations.
□ Yes □ No curing conditions.
7. Other cancers.
□ Yes □ No curing conditions.
I promise:
1. I have filled in all the above information carefully. If I conceal the facts, all the consequences and economic losses arising therefrom shall be borne by myself alone, and have nothing to do with the company.
2. Once employed by the company, if the above-mentioned diseases occur in the late stage of my employment and are verified by the company as incurable diseases before my employment, I shall bear the responsibility.
Commitment:
date month year