1300 316 774
Pre-Employment Medicals
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Pre-Employment Medicals
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Referral Form
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Referral Form
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Please fill out the below to make a booking request with Logic Health, or call the bookings team on
1300 316 774
Company Name
*
Recruiter/Requestor Contact Name
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Recruiter/Requestor's Telephone Number
*
Recruiter/Requestor's Email
*
Candidate Name
*
Candidate Date of Birth
*
DD slash MM slash YYYY
Candidate Telephone Number
*
Candidate Email - a confirmation will be sent to this email
*
Candidate Location (State & Suburb)
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Candidate Job Role
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Site (What site will the Candidate be Mobilized to)
Candidate Availability
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Next Available
Contact Candidate Directly
Monday
Tuesday
Wednesday
Thursday
Friday
AM
PM
Next Available
Other
Other (Candidate Availability)
Medical Components Required
*
SET 1 Full Pre-Employment Medical with Lab DAS - (LH-COMP) (Medical, Audio, Spiro, Lab DAS, Functional)
SET 2 Full Pre-Employment Medical with instant DAS - (LH-COMPI) (Medical, Audio, Spiro, instant DAS, Functional)
Standard Medical - (LH-MED) (medical history and medical exam (BP, HR, height weight, colour vision, vision, urinalysis, body system check by doctor)
Functional Assessment (LH-FUNC) (Functional)
Instant Drug & Alcohol (LH-IDAS) (instant DAS)
LAB Drug & Alcohol (LH-LDAS) (Lab DAS)
Audiology (LH-AUD) (Audio)
Spirometry (LH-SPIRO) (Spiro)
ECG (LH-ECG) (ECG)
Drivers Medical - (LH-DRIVE) (Drivers Medical, Audio)
Dangerous Goods Certificate - (LH-DG)
National Rail Cat 1 Medical - (LH-CAT1) (Rail Cat 1 Medical, Audio, Instant DAS, ECG, Path: Non-Fasting Bloods - Lipids Profile (Total Cholesterol, HDL, LDL, Triglycerides), HSCRP, HbA1c
National Rail Cat 2 Medical - (LH-CAT2) (Rail Cat 2 Medical, Audio, Instant DAS)
National Rail Cat 3 Medical - (LH-CAT3) (Rail Cat 3 Medical, Audio, Instant DAS)
NSW Rail Category 1 - (LH-CAT1NSW) (Rail Cat 1 Medical, Audio, ECG, Lab DAS, Breath Alcohol, Fasting Bloods - Lipids Profile (Total Cholesterol, HDL, LDL, Triglycerides) & HbA1C
NSW Rail Category 3 - (LH-CAT3NSW) (Rail Cat 3 Medical, Audio, Lab DAS, Breath Alcohol))
NSW Coal Board (Order 43) - (LH-ORD43) (NSW Coal Board Medical (Order 43), Audio, Spiro, Chest X-Ray, Respiratory Fit Test)
Rio Tinto G&I High (LH-RIOH) (Medical, Audio, Spiro, Lab DAS, Chester Step Test, ECG, NON-Fasting Total Cholesterol, HDL, HbA1C)
Respiratory Fit Test - (LH-RFT) (Respiratory Fit Test) (Site and Mask Type must be provided)
Hearing Protection Fit Test - (LH-HPF)(Hearing Protection Fit Test)
Training - Manual Handling Certificate - (LH-MANH)
OGUK Medical (LH-OGUK) (OGUK Medical, Audio)
QLD Coal Medicals - Please contact us directly for further information 1300 316 774
South East Queensland & Northern Rivers NSW Aviation Medicals (Class 1, Class 1 & 2, Class 3) – Please contact us directly for further information 1300 316 774
Other
Other (Medical Components)
Specification for Respiratory Fit Test (Site & Mask Type) / Hearing Protection Fit Test (Site)
PO Number (enter N/A if not required)
*
Comments/Notes to the booking team
