Employee Review of Occupational Health Report

I am happy for the report to be sent to my referring party as indicated on the referral.

I have identified a factual inaccuracy in the report that I would like reviewed.

I wish to withdraw my consent for the report to be sent to my referring party. I understand that the referring party indicated on the referral will be informed of this and that any decision relating to my employment may be taken without Occupational Health advice.

Declaration