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Medical Questionnaire

Please answer YES or NO to the following questions, if YES please detail so we can offer you the correct support. Please answer all questions honestly to the best of your knowledge.

Applicant Type
Do you have any medical conditions relating to your heart?
Do you have abnormal blood pressure, as diagnosed by a doctor?
Do you have Diabetes?
Have you had a serious head injury in the last 5 years?
Are you being treated for any mental health concerns?
Have you had any dependency issues with alcohol or drugs in the last 5 years?
Do you have any profound issues with your hearing or sight?
Do you have any other conditions not listed you would like us to be aware of?

Medical Declaration

I declare all the information provided is true and correct to the best of my knowledge and i will update G&D Solutions LTD if my circumstances change

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