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GEP Wellness Day Test

GEP Wellness Day

GEP Wellness Day

Name of Employee
Name of Employee
First
Last
Gender

Full Screening

Do you want to take a biometrics test
Do you have diabetes ?
Do you smoke?
Have you been diagnosed with heart disease?
Result

Weight

Unit of measurement (height in cm, weight in kg)
cm
kg
ft
in
lbs

BMI

Underweight
Normal weight
Overweight
Obese
Would you like to take a HIV rapid test
IF POSITIVE I understand that if this test shows that I have the HIV virus, I am most probably infected and could spread this to someone else. I could pass the virus to someone I am having sex with, someone I am sharing a needle with, or to my unborn baby if I am pregnant. I understand that I will have to take an additional full blood test with a doctor to confirm my HIV status. It is still recommended to do follow-up tests once every 6 months.
IF NEGATIVE If the test results are negative for the HIV virus, I understand I might still have the virus but that it is too early to tell by the HIV test. I understand that it is still recommended to do follow-up tests once every 6 months.
Results

I understand and consent to all of the above tests and have been informed of what each test means. I hereby authorize Company Wellness Solutions, by whom and where I have been tested to give full medical particulars to the relevant Occupational Health Practitioner. I give Company Wellness Solutions permission to refer me to a medical practitioner should my results be bad or pose a serious risk to my health.