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

A referral from an employer for a medical examination is used in circumstances where the business requires a candidate for a position or an employee who is already working to complete medical examination... The article deals with 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 medical examination at hiring

The employer has the right to prevent the employee from being admitted to the performance of his job duties on the grounds that the latter did not pass medical checkup... This right is established for the employer of Art. 212 of the Labor Code of the Russian Federation.

A medical examination is mandatory for those employees who work:

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

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

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 the execution of an employment contract must be carried out without fail.
2. Periodic - 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. So, every year, persons under the age of 21 should be examined, and drivers who embark on a flight must undergo a medical examination before receiving a waybill.

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

An employee who is obliged to undergo such an examination is issued 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 sending for a medical examination, a blank document of the same name is received by the candidate for the position and signed for its receipt.

IMPORTANT! If the future employee of the enterprise decided not to take such a direction, or, having taken it, did not undergo a survey, he will not be concluded labor contract, or it will be terminated without delay.

The list of physicians that an employee must bypass when hiring is not provided in the direction. This list is determined by the medical institution, based on what type of work will be entrusted to the candidate. Completed medical examination can be considered when the employee bypassed all doctors and passed all examinations.

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

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

Legislation or ministerial orders for referral for a preliminary, periodic medical examination, the form is not legalized. However, when creating this document, one can be guided by the draft order of the Ministry of Health and Social Development of 12.04.2011 No. 302n (not registered with the Ministry of Justice), which contains information that should be reflected in the document. So, the following details should be given in the form for a referral for a medical examination:

• employer name;
• type of ownership;
• OKVED;
• the 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 gets a job;
• type of occupation (position, profession);
• working conditions that have a negative impact on health.

Where to download a referral form and sample

As mentioned above, the mandatory form for the "inspection" referral was not approved at the legislative or ministerial level. Therefore, each company or individual entrepreneur is free to create its own template with the mandatory input of lines for mandatory information.

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

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

An employee must undergo a medical examination if the employer requires it, the specifics of production or the company has harmful or dangerous working conditions. Refusal to inspect will entail refusal to provide work or termination of an already concluded employment contract.

Medical examinations are preliminary (before hiring) and regular (in the process labor activity). When sending for inspection, the employer issues a document to the candidate or employee - a referral that is the basis for the examination. Based on the results of medical measures, the employee will be issued an opinion, which he must submit to the employer.

Employees of those enterprises and specialties for which the process of passing a medical examination is mandatory must certainly follow the appropriate institutions for preliminary or primary medical examinations, and also undergo periodic inspections in accordance with the order of their passage. At the same time, this procedure takes place at the expense of the employer on the basis of a referral for a medical examination issued by him from the order of the Ministry of Health 302n dated 04/12/2011.

Before carrying out the medical examination procedure itself, each employer is obliged to hand over to its employees the necessary referrals, which are issued to everyone against signature and are subject to registration by the employer himself. The document in question is a standard sample of a referral from the order with form 302n, which the employee must provide to medical institutions and go through the necessary doctors.

Depending on the information message, which is indicated in the direction, certain health workers and specialists will be appointed, and appropriate tests will be assigned if necessary.

The form of a referral for a medical examination, preliminary or periodic, is taken from the annex to Order 302 N.

The procedure for issuing a referral for a medical examination is clearly detailed in Order No. 302n. The following must be indicated:

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

Also, in the direction of 302n, all hazards and harmful factors that are established for a certain position or for certain types works. IN in this case the drawn up 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 get a physical

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

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

Note: medical examination for the specified categories of workers is paid by the employer. Expenses can be recorded in tax and accounting.

Why do you need a medical examination

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

In order for the whole procedure to take place in a certain order, a special legislative document is provided in the form of order number 302n of 05/17/16. This document clearly states for which persons it is necessary to undergo a medical examination, and this document also defines a clear procedure for the entire procedure. In addition, the order has a standard referral form attached, which you can use to fill out.

Below we propose to download a sample of filling out the directions for both periodic and preliminary medical examination.

In accordance with the rules, all enterprises must have a standard format direction from Order 302n. Also, the employer must have a list or list of those persons who are obliged to undergo all the necessary medical examinations. In addition, everyone who needs to undergo such medical examinations must be notified in advance that they need to go to a medical institution for the necessary examinations, and they must also be notified of the frequency of their passage. In this case, the list is the basis for issuing a referral to an employee in order for him to undergo a medical examination.

Every subject business activitiesusing labor employees, should take care of their health... All staff members must periodically or in accordance with an approved schedule undergo medical checkup... Many business entities require a certificate or medical record from persons planning to find a job with them.

In some sectors of the national economy, for example, in trade, catering, school and preschool institutions, workers must with regular intervals be examined by certain specialists. In order for an active staff member to undergo a medical examination, he must be issued appropriately formalized referral.

Every leader has a legal right not allow his 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 duty to undergo periodic medical examination... This group includes blue-collar occupations associated with:

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

The basis for passing a mandatory or periodic medical examination is in addition to the regulations of the Labor Law referral issued at the place of official employment.

With this document individual goes to the clinic or other medical institutionwith whom the employer has previously entered into an appropriate agreement.

Form of referral for a medical examination by an employee is not a uniform form, since it was not legalized either by ministerial orders or by regulatory legal acts.

That is why business entities can independently develop the form of the document, which should subsequently be fixed 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 the Order of the Ministry of Health and Social Development No. 302n of 12.04.2011. This document provides recommendations on what information should reflect a referral for a physical examination.

Stages of personnel work

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

The employee will be required to sign the receipt and date in the referral log. Such a register legal entities and individual entrepreneurs can draw up in 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 be staff listswho have to pass a mandatory or periodic physical examination... In the future, on the basis of these lists, employers will write out referrals to their employees.

The list of staff members must be approved by the head. After that, the document is sent to a medical institution with which an appropriate agreement has been concluded for the provision of specialized services. This is done no later than two months before the agreed date for the medical examination.

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

• Name of employees (in alphabetical order);
• dates of their birth;
• gender;
• registration address;
• profession or position;
• work experience in the organization;
• the name of the harmful type of work or production factor;
• the name of the organization or its separate subdivision;
• date of compilation;
• the date of the 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 examination of employees, which is agreed with the employer.

The business entity, in turn, will have to inform staff members about the timing of the medical examination.

Periodic

Periodic medical examinations should be performed by individuals who are still under 21 years old... Also, such a survey is shown to other persons officially employed in the organization in order to prevent the development of occupational diseases.

Federal legislation defines a list of blue-collar occupations for which a periodic medical examination is required before each shift, for example, drivers of cars, trucks or specialized vehicles.

If the employer requires staff members to undergo a medical examination, then they are required to comply with such an order. This may be due to the presence of harmful or dangerous conditions labor, the specifics of the business area, the requirements of Labor legislation.

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

Preliminary

Many business entities send applicants for obtaining vacant post on preliminary medical examinations... An individual will have to transfer the received expert opinion to a potential employer. If he has any health problems that may interfere with performing professional duties, he will be denied employment.

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

Without fail, employees pass all basic tests: urine, feces, blood. They will have to do fluorography, cardiogram and possibly an ultrasound of the internal organs. According to the survey results, specialists will give their conclusion, on the basis of which the corresponding certificate will be issued.

Instructions for filling out and content of the form

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

1. Full name fits commercial organization or individual entrepreneur.
2. The form 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 entered into an agreement for the provision of specialized services is indicated.
5. The type of inspection that the employee will undergo.
6. Name of the employee who is sent for a medical examination.
7. Employee's date of birth.
8. Position or profession.
9. Working conditions that can have a detrimental effect on the health of the worker.

Individuals who are officially employed in a commercial organization or with 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 in a medical facility will be grounds for dismissal or denial to work.

An employee who agrees with the employer's request receives a referral against his signature, with which he goes to the clinic or hospital. After passing all the specialists and passing the tests, the employee receives a document in his hands, one copy of which is transferred to the management of the organization, and the second remains in the medical institution.

For more information on hiring medical examinations, check out this legal aid video blog.

The employer, in whose production there are (a full list of factors is indicated in the order), must send workers to. He has no right to admit to work people who for any reason did not take part in this event. Periodic check-ups to prevent development occupational diseases without fail pass:

• persons under the age of 21;
• other employees whose professional duties are capable of causing any specific disease.

The employer issues an order on the frequency of the medical examination and the sequence of its passage. Persons sent for prophylactic medical examination must familiarize themselves with it under the signature no later than 10 days before the start of the check.

Sample order for referral to a periodic medical examination

What is the document for?

Each person who must pass the examination is issued a referral from the employer against signature. It is drawn up on the basis of the list of persons and on the basis of the contingent list, which indicates harmful and (or) dangerous production factors and harmful types of work (Appendix 1. and 2. Order of 12.04.2011 N 302n). With him, the employee needs to come to a medical facility, with which the director of the company concluded an agreement for the provision of medical services.

A medical examination is considered passed if a citizen has visited all doctors and passed the necessary tests. Based on the results of the check, he is given a conclusion in his hands, 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 wound up immediately after showing them a referral for a medical examination.

Is it possible to refuse inspection?

Refusal to receive a referral or undergo a medical examination may result in an 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 can be terminated with such an employee.

Registration 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. Usually drawn up personnel worker... The required details are:

• the name of the employing company;
• type of ownership and type of activity of the company according to OKVED;
• the 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);
• title 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 company for this purpose. The main thing is that you need to specify all the required details in it.