Asbestos referral

 

Asbestos Medical Referral Form

 

Referral form for HSE medical examination

for licensed or non-licensed asbestos work

Referrer's Information

The referring manager or HR advisor information


Type of asbestos medical required

Please choose the type of asbestos medicals you require


Worker/s Information

Information about the Worker being referred for their asbestos medical.


 

Worker Information

Information for the workers before licensed asbestos medicals

Please forward this information to the worker/s

 

1. For clinic directions, please see: www.workableoh.uk/contact

 

2. ⚠️ Please do not attend if you have a new cough, fever or high blood pressure. The doctor will not be able to undertake the spirometry and issue the certificate.

 

Thank you.

Referrer's declaration