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Fainting, Blackouts, Epilepsy Or Fits
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Eczema or skin trouble
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Heart trouble or high blood pressure
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Joint, ligaments or tendon trouble
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Claustrophobia or vertigo
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Difficulty in climbing stairs
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Difficulty in writing
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Diabetes
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Back pain
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Asthmatic Attacks or chest problems
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Arthritis, rheumatism or gout
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Difficulty in standing for long periods
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Mental / emotional illness
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Any medical condition that may affect your suitability for employment?
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If you answered yes to any of the above questions give details(if you have not answered yes, please enter NONE):
On signing this is agree that all information has been provided honestly and have declared any medical issues both physically and mentally.
