Referral form for medical examination from employer sample 2020

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

The employer has the right to prevent an employee from being allowed to perform his or her job duties on the grounds that the latter has not passed a medical examination. 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 working conditions;
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:

Preliminary, when hiring - is practiced if the management of the enterprise considers it appropriate. However, for example, in food-related industries, an inspection prior to drawing up an employment contract must be carried out without fail.
Periodic - it is associated with the everyday work of enterprises. 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.

How to refer an employee for a medical examination - sample referral 302n in 2020

Certain categories of working citizens must undergo a special medical examination.

In order to undergo a medical examination, they must provide the staff of the medical institution with a referral.

The technology for filling out and issuing a document of this nature has a number of features and rules.

https://youtu.be/SGV0V-tpUt4

[upto]

There are several types of medical examinations. Among these, it is necessary to highlight 2 main ones - preliminary and periodic.

The first type of examination is carried out directly during the employment process. It is necessary to determine whether the health status of a potential employee meets the standards necessary to perform job duties for the proposed position.

The name of the periodic inspection speaks for itself - it is carried out at certain intervals. Its purpose is to confirm the professional suitability of the employee.

In general terms, it can be said that the employer is obliged to:

organize medical examinations;
do not allow citizens who have not passed a medical examination to work.

Each employee must receive the referral personally. Receipt of the document must be confirmed by the worker’s signature.

The enterprise must maintain a journal in which the issuance of referrals will be recorded.

It must indicate the following information about the documents issued:

assigned paper serial number;
date of issue of the referral;
initials of the citizen who received the document;
the position in which the employee is expected to work (or is already working);
personal signature of the person receiving the referral.

If a refusal to undergo a medical examination is received, the employer has the right to apply disciplinary sanctions against the employee.

The current legislation does not prohibit the right of a working citizen to independently undergo a medical examination, i.e. without a referral from the employer.

For example, many people undergo screening before employment to save time in the future. It is important to take into account some points.

In the event that a visit to a medical facility occurs on the initiative of the head of the enterprise, the employer fully reimburses all necessary financial expenses.

In this case, financing is provided from the funds of the Federal Social Insurance Fund of the Russian Federation.

In order to eliminate the possibility of misunderstandings, it is better to undergo an examination in the direction issued by management.

A standard form for submitting a referral for a medical examination is presented in the Appendix to Order No. 302n.

It is important to remember that using it is not necessary, but it is advisable.

The form only contains the information required to be reflected:

information about the employer company. All available information about the company is indicated here - its name, form of ownership, address of the main office, OKVED;
information about the medical institution to which the citizen is sent. Just as in the previous paragraph, the full name of the organization, the address of its location, OGRN are indicated;
date of issue of documentation;
name of paper;
assigned serial number;
the type of medical examination that the employee must undergo;
information about the employee. It is important to reflect the citizen’s initials and date of birth. His status is indicated - working or getting a job;
characteristics of professional activity - type of work for which a medical examination is required;
the citizen’s work experience;
the name of the structural unit in which the employee will work/is already working.

The referral must be signed by the employer or his responsible person who has the right to prepare documentation of this nature.

The document must be free of errors and corrections.

To undergo a medical examination from the enterprise, the employee must receive this form.

An examination in an institution with which the employer has entered into an agreement is carried out only if this document is available.

The referral must include detailed information about the employer, medical institution, prospective employee and the specifics of his work.

More detailed information required to be reflected is indicated in the previous paragraph.

After receiving the referral, responsibility for its safety and timely completion of the inspection is transferred to the employee.

The procedure for filling out the directions to:

periodic inspection;
preliminary inspection.

{amp}gt; other documents {amp}gt; How to refer an employee for a medical examination - sample referral 302n in 2020

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, as well as undergo periodic examinations in accordance with the order of their completion.

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.

We invite you to familiarize yourself with Responsibility in the field of fire safety

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 for 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 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 hazards and hazards that are established for a specific position or for certain types of work must be indicated. 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.

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 production factors;
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.

Please note: medical examinations for these categories of employees are paid for by the employer. Expenses can be taken into account in tax and accounting as follows.

Based on the results of the preliminary medical examination, the employee at the medical center will be given a special document, which 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.

In addition, the order has a standard referral form attached that can be used to fill out.

Compiling a list of employees who must undergo a medical examination. Within 10 days it must be sent by registered mail with notification to the territorial body of Rospotrebnadzor (in the notification procedure, approval is not required).
Concluding an appropriate agreement with a medical institution, agreeing on a schedule and deadlines.
Issuing an Order to conduct a medical examination and familiarizing staff with it.
Issuing referrals for medical examinations.
Collection of signed and sealed reports with the results of the medical examination. The conclusion is signed in two copies - one of them is given to the employee, the other remains in the institution that conducted the medical examination.
Within a month, the medical center, together with representatives of the employer and the sanitary and epidemiological service, draws up a final act. After it is approved by the chairman of the medical commission, the act is drawn up in four copies, one of which remains in the medical institution, and the others are sent to the employer, to the territorial body of Rospotrebnadzor and to the center of occupational pathology to replenish statistical data.
The results of preliminary and periodic medical examinations are recorded in the employee’s personal medical record.

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, an employment contract will not be concluded with him, or it will be immediately terminated.

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.

Who is required to undergo periodic medical examinations?

Instructions for filling out a referral for a preliminary (periodic) medical examination (examination).
DIRECTION FOR PRELIMINARY (PERIODIC) MEDICAL EXAMINATION (EXAMINATION). FORM.

1. A referral for a preliminary (periodic) medical examination (examination) (hereinafter referred to as the Referral) is the basis for conducting a mandatory preliminary (upon entry to work) and periodic, including extraordinary, medical examination (examination) of the employee and for filling out a medical report on results of preliminary (periodic) medical examination (examination).

2. The direction is filled out by an authorized representative of the employer.

3. The Direction indicates:

name of the organization (enterprise), form of ownership, type of economic activity; name of the medical organization, its registration address and OGRN code;

in paragraph 1 - last name, first name, patronymic of the employee (being examined);

in paragraph 2 - the date of birth of the employee (the person being examined);

in paragraph 3 - the employee (inspected) enters work or is already working;

in paragraph 4 - the workshop, the area where the employee (the person being examined) is employed;

in paragraph 5 - the name of the type of work in which the employee is being examined;

in paragraph 6 - length of service in this type of work;

in paragraph 7 - the previous professional route (types of work in which the employee (the person being examined) was previously employed and the length of service in them);

in paragraph 8 - harmful and (or) dangerous production factors, as well as the type of work in accordance with the List of Factors and the List of Works.

4. The referral is signed by an authorized representative of the employer, indicating the position, surname, name, patronymic, and is issued to the employee.

5. After receiving the Referral, the employee is responsible for timely completion of the mandatory preliminary and periodic medical examination (examination).

6. All records in the Direction are kept clearly and legibly. Strikethroughs and corrections are not allowed.

________________________________________

(name of organization (enterprise),

type of ownership, economic sector)

(address)

DIRECTION for preliminary (periodic) medical examination (examination)

Heading to ___________________________________________________________________

https://www.youtube.com/watch?v=w_mKNHpcnyI

(name of medical organization, registration address, OGRN code)

1. Full name _______________________________________________________________

2. Date of birth______________________________________________________________

(day month Year)

3. Applying for a job/working (underline as appropriate)

4. Workshop, area__________________________________________________________

5. Type of work in which the employee is examined ________________________

6. Work experience in the type of work in which the employee is examined_________________________________________________

7. Previous professions (jobs), position and length of service in them _______________________________________________________________________

8.1. Chemical factors _________________________________________________

(number of item or items of the List[*], list)

8.2. Physical factors _________________________________________________

(line number, item or items of the List*, list)

8.3. Biological factors _______________________________________________

(number of item or items of the List*, list)

8.4. Difficulty of work (physical overload) ___________________________________

(number of item or items of the List*, list)

9. Profession (work) _____________________________________________________

(position of authorized representative)

(signature of authorized representative)

(FULL NAME.)

[*] List of harmful and (or) dangerous production factors, in the presence of which mandatory preliminary and periodic medical examinations (examinations) are carried out.

[top]

The categories of workers who must undergo it without fail are provided for in Article 213 of the Labor Code of the Russian Federation and the above-mentioned Order. But this does not prevent representatives of any profession from being sent for examination if an agreement has been reached on this matter between management and the team.

So, current legislation obliges people who work to undergo regular medical examinations:

in harmful and dangerous production;
for steeplejack, high-altitude work;
in transport (drivers, machinists, etc.);
in the field of catering;
in the field of education and child care institutions;
in medical and sanitary institutions (this includes spas, baths, saunas and laundries);
in hairdressing and beauty salons;
at pharmaceutical enterprises;
in the cleaning service;
in the field of water supply;
at livestock enterprises and poultry farms.

Employees who have not reached the age of 21 must be added to the list. This category of workers must undergo a medical examination annually, the rest - at least once every 1-2 years. The frequency depends on the working conditions and production environment and is specified in detail in Appendix No. 1 to the Order.

Before sending people for a medical examination, the employer must correctly complete the referral for each employee. It contains all the information necessary for a medical organization (working conditions, risk factors and hazardous production, etc.), according to which members of the commission will be able to select criteria for assessing the health status of workers and make a decision about their ability to continue working.

Your company has the right to choose any medical institution - both public and private. The main thing is that it has a license to conduct medical examinations and has the necessary specialists.

We invite you to familiarize yourself with a driver's characteristics for awarding, sample

Thus, regardless of specialty, each employee is examined by a therapist, psychiatrist and narcologist. If the work activity has any specifics, then an ophthalmologist, a neurologist, a dermatologist, an allergist are invited to the medical commission - the list is not exhaustive.

Where are the directions for a medical examination and 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 employment). 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.

Types of medical examinations, direction

Art. 212 of the Labor Code of the Russian Federation contains instructions that the employer’s administration in some cases is obliged to:

organize medical examinations, including at the request of the workers themselves;
do not allow employees to work who have not passed the mandatory medical commission, as well as if they have medical restrictions.

These provisions indicate that a referral form for a medical examination must be issued to a future employee before signing an employment agreement with him. This fact in itself does not prove that the employee has been hired for the specified position or that an agreement will be signed with him.

Moreover, if it is discovered that the candidate is not suitable for the position due to health reasons, based on the corresponding conclusion, he will be denied employment, as stated in Part 3 of Art. 84 Labor Code of the Russian Federation.

You can find more complete information on the topic in ConsultantPlus. Full and free access to the system for 2 days.

Art. 213 of the Labor Code of the Russian Federation establishes several types of medical examinations:

Preliminary, that is, before employment.
Periodic, that is, mandatory after a certain period. Details in our article Periodic medical examination of enterprise employees.
Extraordinary (unscheduled), that is, established for a separate category of employees.

Referral form for medical examination from employer - sample