Pre-Employment Medical Questionnaire Instructions
This Pre-Employment Medical Questionnaire is designed for prospective ExxonMobil employees. It outlines the necessary steps to complete and submit your medical questionnaire. Ensure all personal information is accurately filled out for successful processing.
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How do I fill this out?
Filling out the Pre-Employment Medical Questionnaire is essential for your onboarding process. Begin by gathering your personal information and medical history. Carefully follow the questions and provide honest answers to ensure the best assessment.

How to fill out the Pre-Employment Medical Questionnaire Instructions?
1
Gather your personal information and medical history.
2
Complete all sections of the questionnaire thoroughly.
3
Explain any positive medical responses in the provided space.
4
Sign and date the completed form, as electronic signatures are not accepted.
5
Return the completed questionnaire to the Occupational Health Division via email.
Who needs the Pre-Employment Medical Questionnaire Instructions?
1
New employees of ExxonMobil who must complete medical assessments.
2
Individuals applying for safety-sensitive positions requiring health evaluations.
3
Human Resources personnel needing standardized health documentation.
4
Occupational Health Division staff for processing employee records.
5
Health professionals assessing the suitability of candidates for specific roles.
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What are the instructions for submitting this form?
To submit the Pre-Employment Medical Questionnaire, please complete all required fields accurately. Once filled, scan the document and email it to OHD.Calgary.HC@esso.ca. Ensure that you submit the PMQ as early as possible to facilitate timely processing of your employment requirements.
What are the important dates for this form in 2024 and 2025?
Important dates for 2024-2025 include the ongoing requirement to submit completed PMQs prior to starting your employment. Follow up with your HR for specific deadlines. Make sure to plan accordingly to avoid any onboarding delays.

What is the purpose of this form?
The purpose of the Pre-Employment Medical Questionnaire is to gather comprehensive health information from prospective employees. It serves as a measure to evaluate if applicants can safely perform essential job functions related to their roles. This form facilitates a clear understanding of any medical conditions that may affect work performance.

Tell me about this form and its components and fields line-by-line.

- 1. Name: Full name including last and first name.
- 2. Mailing Address: Current residential address including unit number, street, province, and postal code.
- 3. Contact Information: Phone numbers including home and cell, along with email address.
- 4. Date of Birth: Date of birth in the format yyyy/mm/dd.
- 5. Work Details: Information about the position, company, and start date.
- 6. Health Questions: Series of yes/no questions regarding various medical conditions and restrictions.
What happens if I fail to submit this form?
If you fail to submit the PMQ, you may experience delays in your employment start date. This document is crucial for assessing your medical fitness for the job role. Missing it can lead to complications in onboarding, so it's critical to submit it on time.
- Delayed Onboarding: Not submitting the form may lead to postponed start dates.
- Health Assessment Gaps: Occupational health may not assess your fitness for duty without your form.
- Non-compliance with HR Policies: Failures in submission can lead to issues with adhering to company policies.
How do I know when to use this form?

- 1. Job Offer Acceptance: Upon accepting a job offer requiring medical clearance.
- 2. Safety-Sensitive Positions: For positions that are classified as safety-sensitive under company policy.
- 3. Health Monitoring: To inform Occupational Health of any existing conditions prior to employment.
Frequently Asked Questions
What is the purpose of the Pre-Employment Medical Questionnaire?
The PMQ assesses your ability to perform essential job functions and ensures you meet the health requirements for the role.
How do I submit the completed PMQ?
Email the completed questionnaire to OHD.Calgary.HC@esso.ca for processing.
What if I don't have a physical exam?
You are not required to complete a physical exam before filling out the questionnaire.
How can I access the PDF for editing?
Upload the PDF directly to PrintFriendly to begin editing.
Is my personal information safe?
Your data is handled with confidentiality and used solely for processing your application.
What happens if I miss the submission deadline?
Failure to submit the PMQ promptly may delay your onboarding process.
Can I save my changes to the PDF?
Yes, you can download the edited version of your PDF after making changes.
Are there specific formats for the PMQ?
Ensure your answers are clear and concise, following the questionnaire's format.
How do I handle questions I can't answer?
If you have difficulties, indicate this on the form so a health professional can assist you.
What should I do if I need help during the questionnaire?
You can indicate on the form that you require assistance, and a health professional will contact you.
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