HAVS Surveillance Medical form - Paper Version

The Control of Vibration at Work Regulations 2005 require assessment of vibration exposure. If the exposure level exceeds 2.5 m/sec2, employees require regular surveillance to highlight possible health problems at an early point.

The surveillance is carried out by a paper based screening before start of using hand held, hand-guided or hand-fed vibrating tools or machines and then at regular intervals, usually yearly. Every 3 years a face to face medical examination by a qualified health professional is required.

This form is for the medical exmination every 3 years and divided into 2 parts.
Part 1 has to be completed by the employee and
Part 2 by the health practitioner.
It does need to be assessed by an approved and certified health practitioner and does therefore provide an address to send it to. After the assessment by an approved Occupational Health Practitioner a fitness certificate will be issued.

The form can be used more than once within your company and does not include costs for the medical assessment and certificate.

Price: net £10.00; VAT £1.75; gross £11.75