Drivers Medical Questionnaire

Drivers Medical Questionnaire

Medical Questionairre Required For FORS D6 (Drivers Health & Eyesight)


As part of our commitment to FORS (Fleet Operator Recognition Scheme) We are obliged to have all our drivers answer a short medical questionairre

You will be asked for your driving licence number if you drive company vehicles, (so please ensure you have it to hand)

Driver Details

Medical Questionnaire

Do you have, or have you ever had any of the following?
Impairment of vision.
Difficulty seeing well enough to drive when there is glare or poor visibility such as fog.
Fits, epilepsy, fainting or blackouts.
Attacks of dizziness or vertigo.
Weakness, loss of sensation or clumsiness affecting part of your body.
Severe head injury or brain surgery.
Difficulty hearing normal conversation.
Trouble with your back or neck causing absence from work or a change in duties.
Any form of cancer.
Psychiatric illness including depression or anxiety.
Dependency on or misuse of alcohol, drugs or other substance
Disease of the heart or circulation including angina, heart attack or heart valve problems.
High blood pressure.
Any serious medical condition that may result in you being a danger to yourself or others when driving.
Abnormal heart rhythm or irregular heartbeat.
Are You Taking Any Medication?