My order

Your basket is empty

Subtotal

£0.00

OH Direct Login

Forgotten your password?
Dont have an account? Sign up here

Signing up as a customer means that you can seamlessly access all your occupational health needs without having to go through an online payment process. When you register an account, you will become a Optima Health customer and we will invoice your business for any online orders.

OH Direct

Pre-placement Referral

Complete form

Privacy Information

I have provided the employee I am referring with access to Optima Health's Privacy Statement which clearly explains in detail how, where and when their personal and health data will be processed.

In ticking this box, I confirm that I have made the employee aware that I am making this referral and I can confirm that the employee is aware of the purpose and content of the referral.

I understand that all information about the employee I am referring will be held securely, and if the employee wishes to gain access to their medical information, they can do so by requesting access in writing to Optima Health.

Line Manager/HR Details

Line Manager's Name*

Line Manager's Email*

Line Manager's Telephone*

Employee Details

Title*

First Name*

Last Name*

Date of Birth*

Unique Employee ID (E.g. Employee Number)

Secondary Reference Number

Job Role/Title*

Email (Work or Personal)*

Confirm email address*

Mobile Telephone

Home Telephone

Work Telephone

Postcode*

Organisational Info

Organisation*

Hazard/Risk Associated with the post

Please do not submit referrals for job roles that include hazards not listed below.

Prolonged Repetitive Movements / Actions

Moving or handling heavy loads

Working shifts

Working nights

Lone Working

Working Outside

Work with VDUs (>5hrs per week)

Working with children

Exposure to persons with challenging or aggressive behaviour

My order

Your basket is empty

Subtotal

£0.00

OH Direct Login

OH Direct

Pre-placement Referral

Complete form

Pre-placement Health Questionnaire

Complete form

Privacy Information

Line Manager/HR Details

Employee Details

Organisational Info

Hazard/Risk Associated with the post

Please do not submit referrals for job roles that include hazards not listed below.

Subtotal

£43.50