Sample referral for a medical examination from an employer. We issue a referral for a periodic medical examination. A referral for a medical examination upon admission.

A referral for a medical examination from an employer is used in circumstances where the company requires a candidate for a position or an existing employee to undergo medical examination. The article discusses the essence of this document and how to fill it out according to the sample offered on the site.

When is a referral for a pre-employment medical examination issued?

The employer has the right to prevent the employee from being allowed to perform his or her duties. labor responsibilities on the grounds that the last one did not pass medical checkup. This right is established for the employer under Art. 212 Labor Code of the Russian Federation.

Medical examination is mandatory for those employees who work:

• in dangerous or harmful conditions for work;
• at work involving driving vehicles.

These norms are given in another article of the Labor Code of the Russian Federation - 213th.

There are several types of medical examinations:

1. Preliminary, when hiring - is practiced if the management of the enterprise considers it appropriate. However, for example, in industries related to food products, an inspection prior to drawing up an employment contract must be carried out without fail.
2. Periodic - the everyday work of enterprises is associated with it. As a rule, it is carried out with a certain regularity, depending on working conditions or other reasons. Thus, every year, persons under 21 years of age should be examined, and drivers going on a trip must undergo a medical examination before receiving a waybill.

Small companies or individual entrepreneurs, in order to receive personnel examination services, enter into contracts with medical institutions where they send their employees. Large organizations sometimes employ their own doctors who conduct examinations.

The employee who is required to undergo such an examination is given a referral for a medical examination, with which he is sent to a medical institution.

Procedure for issuing a referral for a preliminary medical examination

When sent for a medical examination, the candidate for the position receives a blank document and signs for its receipt.

IMPORTANT! If a future employee of an enterprise decides not to take such a referral, or, having accepted it, does not undergo an examination, there will be no agreement with him labor contract, or it will be terminated without delay.

The list of doctors that an employee must see when applying for a job is not given in the referral. This list is determined by the medical institution, based on what type of work will be assigned to the candidate. The medical examination can be considered completed when the employee has visited all the doctors and passed all the examinations.

The results of the examination are indicated in the conclusion, the first copy of which is given to the person who underwent the examination, and the second copy remains in the medical institution and is filed with the employee’s personal medical record.

How to apply for a referral for a preliminary, periodic medical examination

The form is not legalized by law or ministerial orders for referral to a preliminary, periodic medical examination. However, when creating this document, you can rely on the draft order of the Ministry of Health and Social Development dated April 12, 2011 No. 302n (not registered with the Ministry of Justice), which contains information that should be reflected in the document. Thus, the referral form for a medical examination must contain the following details:

• employer's name;
• type of ownership;
• OKVED;
• name of the medical institution conducting the examination;
• type of inspection;
• Full name of the subject, his date of birth;
• the structure of the enterprise where the candidate is applying for a job;
• type of occupation (position, profession);
• working conditions that have a negative impact on health.

Where to download a referral form for a medical examination and a sample

As mentioned above, the mandatory form for the “inspection” referral was not approved at the legislative or ministerial level. Therefore, each enterprise or individual entrepreneur is free to create their own template with the mandatory entry of lines for mandatory information.

We present an approximate guideline for developing your own form on our website.

In addition, we decided to help the users of our site and present to their attention an already formed sample of a referral for a medical examination.

An employee must undergo a medical examination if this is required of him by the employer, the specifics of production, or if there are harmful or dangerous working conditions at the enterprise. Refusal to undergo an inspection entails refusal to provide work or termination of an already concluded employment contract.

Medical examinations can be preliminary (before hiring for a position) and regular (during the process). labor activity). When sending for inspection, the employer issues the candidate or employee a document - a referral, which is the basis for the inspection. Based on the results of medical measures, the employee will be given a conclusion, which he must submit to the employer.

Employees of those enterprises and specialties for which the process of undergoing a medical examination is mandatory must certainly go to the relevant institutions for preliminary or primary medical examinations, and also undergo periodic inspections in accordance with the order of their passage. Moreover, this procedure is carried out at the expense of the employer on the basis of a referral issued by him for a medical examination from the order of the Ministry of Health 302n dated April 12, 2011.

Before carrying out the medical examination procedure itself, each employer is obliged to give its employees the necessary directions, which are issued to everyone against signature, and are subject to accounting by the employer himself. The document in question is a standard sample referral from an order with form 302n, which the employee is obliged to submit to a medical institution and undergo the necessary doctors.

Depending on the information message specified in the referral, certain health workers and specialists will be assigned, and appropriate tests will be prescribed if necessary.

The form of referral for a preliminary or periodic medical examination is taken from the appendix to order 302 n.

The procedure for registering a referral for a medical examination is clearly detailed in Order No. 302n. Must be indicated:

• all data about the company itself that offers the job. That is, the name of the company, its form of ownership, as well as OKVED, and the like;
• all information about the medical institution with which the company has entered into an agreement to provide such medical services. The name of the clinic, its address, as well as the OGRN must be indicated;
• type of medical examination to be completed - periodic or preliminary examination;
• information about the employee who must undergo such an examination;
• position or type of activity of the employee.

Also, in direction 302n all danger and harmful factors that are established for a specific position or for certain types works IN in this case the completed referral form for periodic or preliminary medical examinations is signed by a certain person of the company or organization who represents its interests in this direction.

Who should undergo a medical examination

A referral for a preliminary medical examination is issued in accordance with the provisions of Law 302n, which clearly states that such an examination is necessary:

• if there are dangerous and harmful factors production;
• for hazardous types of work;
• when the employee’s position involves interaction with children;
• for health workers;
• for those in contact with products;
• employees under 18 years of age;
• working in waterworks.

Note: Medical examination for these categories of employees is paid for by the employer. Expenses can be taken into account in tax and accounting.

Why do you need a medical examination?

Based on the results of the preliminary medical examination, the employee medical center They will issue a special document that the person must provide to the employer. A sheet filled out by doctors allows the latter to determine the level of health of a potential employee and understand whether a candidate for a vacancy can perform the tasks assigned to him without much harm to his health.

In order for the entire procedure to take place in a certain order, a special legislative document is provided in the form of an order numbered 302n dated May 17, 2016. This document clearly states for which persons it is necessary to undergo a medical examination, and this document also defines a clear procedure for carrying out the entire procedure. In addition, the order has a standard referral form attached that can be used to fill out.

Below we offer you to download a sample of filling out a referral for both periodic and preliminary medical examinations.

In accordance with the rules, all enterprises must have a standard format direction from Order 302n available. The employer must also have a list or list of those persons who are required to undergo all necessary medical examinations. In addition, anyone who needs to undergo such medical examinations must be notified in advance that they need to go to a medical facility for the necessary examinations, and they must also be notified of the frequency of such examinations. In this case, the list is the basis for issuing a referral to the employee to undergo a medical examination.

Each subject entrepreneurial activity using labor employees, must take care of their health. All full-time employees must periodically or in accordance with an approved schedule undergo medical checkup. Many business entities require a certificate or medical book from persons planning to find employment with them.

In some sectors of the national economy, for example, in trade, catering, schools and preschool institutions, workers must at regular intervals undergo examination by certain specialists. In order for a current full-time employee to undergo a medical examination, he must be issued appropriately issued direction.

Every leader It has legal right not allow your staff member to perform professional duties if he has not passed the mandatory medical examination, in accordance with Article 212 of the Labor Code of the Russian Federation.

For some categories of workers, the Labor Code () provides obligation to undergo periodic medical examination. This group includes working professions related to:

• harmful working conditions;
• working in hazardous production;
• management of automobile and specialized transport.

The basis for undergoing a mandatory or periodic medical examination is in addition to the regulations Labor legislation direction issued at the place of official employment.

With this document individual sent to a clinic or other medical institution, with whom the employer previously concluded a corresponding agreement.

Referral form for a medical examination by an employee is not a unified form, since it was not legitimized either by ministerial orders or regulations.

That is why business entities can independently develop the form of the document, which should subsequently be enshrined in their accounting policies.

It is worth noting that in the process of developing a referral form for legal entities and individual entrepreneurs, it is necessary to take into account the regulations of Order of the Ministry of Health and Social Development No. 302n dated April 12, 2011. This document provides guidance on what information should be included in a referral for a medical examination.

Stages of personnel work

Each business entity that has a staff must register each issued referral for a medical examination in the appropriate accounting register.

The employee will be required to sign and date the receipt in the referral log. Such a register legal entities and individual entrepreneurs can compile it in a tabular form, thanks to which it will be easy for them to enter the necessary data.

In accordance with Order No. 302n, business entities must make up staff lists who have to undergo mandatory or periodic medical examination. In the future, based on these lists, employers will issue referrals to their employees.

The list of staff members must be approved by the director. After this, the document is sent to a medical institution with which a corresponding agreement has been concluded for the provision of specialized services. It's done no later than two months in advance before the agreed date for the medical examination.

The list form is the same as the directions is not unified. Business entities can draw up a document in free form, but it must contain following data:

• Full name of employees (in alphabetical order);
• their dates of birth;
• gender;
• registration address;
• profession or position;
• work experience in the organization;
• name of the hazardous type of work or production factor;
• name of the organization or its separate division;
• date of compilation;
• date of last medical examination;
• signatures of responsible persons.

The list can be submitted to a medical institution both on paper and in in electronic format. After receiving of this document medical facility within ten days is obliged to draw up a schedule for the inspection of employees, which is agreed upon with the employer.

The business entity, in turn, will have to convey to staff employees information about the timing of the medical examination.

Periodic

Individuals who are not yet under 21 years of age. Also, such an examination is indicated for other persons officially employed in the organization in order to prevent the development of occupational diseases.

Federal legislation defines a list of working professions that require periodic medical examinations before each shift, for example, drivers of cars, trucks or specialized vehicles.

If an employer requires full-time employees to undergo a medical examination, they are required to comply with such an order. This may be due to the presence of harmful or hazardous conditions labor, the specifics of the business direction, the requirements of Labor legislation.

Refusal to undergo a medical examination may lead to termination of the employment agreement between the employer and employee.

Preliminary

Many business entities send applicants to receive vacant position on preliminary medical examinations. The individual will have to pass on the received expert opinion to the potential employer. If he is diagnosed with any health problems that may prevent him from performing professional responsibilities, he will be denied employment.

When undergoing a standard medical examination, an employee of the organization will have to contact:

Employees are required to undergo all basic tests: urine, feces, blood. They will have to do a fluorography, cardiogram and possibly an ultrasound of the internal organs. Based on the survey results, experts will give their conclusion, on the basis of which the corresponding certificate will be issued.

Instructions for filling out and contents of the form

When drawing up a referral for a medical examination, the person responsible for issuing the document must indicate following data:

1. Enter the full name commercial organization or individual entrepreneur.
2. The type of ownership of the employer is indicated.
3. Codes are entered, in particular OKVED.
4. The full name of the medical institution with which the employer has an agreement for the provision of specialized services is indicated.
5. The type of examination that the employee will undergo.
6. Full name of the employee who is sent for a medical examination.
7. Date of birth of the employee.
8. Position or profession.
9. Working conditions that may have a detrimental effect on the health of the worker.

Individuals who are officially employed in a commercial organization or an individual entrepreneur are required to undergo a medical examination at the request of the employer.

This procedure is regulated by Article 213 of the Labor Code of the Russian Federation. Refusal to undergo examination at a medical institution will be considered grounds for dismissal or exclusion from the workplace.

An employee who agrees with the employer’s requirement receives a written referral with which he goes to the clinic or hospital. After passing all the specialists and tests, the employee receives a document, one copy of which is handed over to the management of the organization, and the second remains in the medical institution.

Additional information about pre-employment medical examinations can be obtained from this legal aid video blog.

The employer in whose production there are (the full list of factors is indicated in the order) must send workers to. He does not have the right to allow people to work who, for any reason, did not take part in this event. Periodic medical examinations to prevent the development of occupational diseases are required to pass:

• persons under 21 years of age;
• other employees whose professional duties can cause any specific disease.

The employer issues an order on the frequency of the medical examination and the order in which it is completed. Persons sent for medical examination must familiarize themselves with it and sign it no later than 10 days before the start of the inspection.

Sample order for referral for periodic medical examination

What is the document for?

Each person who must undergo an inspection is given a referral from the employer against signature. It is drawn up on the basis of a list of persons and on the basis of a list of contingents, which indicates harmful and (or) dangerous production factors and hazardous types of work (Appendices 1. and 2. Order No. 302n dated April 12, 2011). With it, the employee needs to come to the medical institution with which the director of the company has entered into an agreement for the provision of medical services.

The medical examination is considered completed if the citizen has visited all doctors and passed the necessary tests. Based on the results of the inspection, he is given a conclusion, which will then be provided to the employer.

The second copy of the report is kept in the medical center. It is attached to the employee’s medical card, which is created immediately after they present a referral for a medical examination.

Is it possible to refuse an examination?

Refusal to receive a referral or undergo a medical examination may result in the employee not being allowed to work. Wage in this case it will not be charged. As a result of malicious refusal to participate in the event employment contract You can terminate your employment with such an employee.

Design rules

A referral for a periodic medical examination (form 302n) is issued in free form, but it must contain the necessary information specified in paragraph 8 of Appendix No. 3 to order 302n. As a rule, it is issued personnel worker. The required details are:

• name of the employing company;
• form of ownership and type of activity of the company according to OKVED;
• name of the medical institution, its registration data, address;
• type of medical examination;
• Full name of the employee and his date of birth;
• the name of the division of the company in which the employee works (or is employed);
• name of position/type of work/profession;
• factors harmful to health at work.

As we mentioned above, there is no strictly established form of referral. In this regard, each employer can use a form developed by the enterprise for this purpose. The main thing is that you need to indicate all the required details.