What this is
What is a pre-placement health assessment?
What is a pre-placement health assessment?
A pre-placement health assessment is a job-specific fitness check carried out after a conditional offer has been made and before the worker starts, to confirm they can safely perform the physical and exposure demands of the role and to record any baseline health measures the role's hazards require.
How is it different from a general medical or health screen?
It is narrower by design. Questions and tests must relate to the demands of the specific role, and the outcome shared with the employer is a fitness decision and any restrictions, never a diagnosis. Asking about health in general, rather than the role's demands, is screening it is not permitted to do.
Why must it happen after the offer, not before?
Because a medical inquiry made before an offer is extended can function as a way to screen out applicants on health grounds before their qualifications are weighed. Requiring the assessment after a conditional offer means the hiring decision on merit has already been made, and the assessment can only confirm or adjust it.
Scope
When is a pre-placement health assessment required?
This assessment is one step in a placement decision, and it only works if it happens at the right point in the hiring process and stays inside the role's actual demands. Used earlier, or used more broadly, it becomes a screening tool the law does not permit.
Use this template when
- A conditional offer has been made for a specific role, and the assessment is completed before the start date
- The role has documented physical demands or exposures the assessment needs to test against
- A worker is moving into a materially different role with different demands or exposures
- You are running the Occupational Health Surveillance programme and this is the entry point for a newly placed worker
- A linked record needs this one to exist: the worker's file and the job the offer was made against
Do not use it for
- Health Surveillance Plan, which sets out which workers need which recurring checks, how often and why, rather than the one-off check at hire
- Periodic Health Assessment, the recurring check run to the surveillance schedule once the worker is already in the role
- Exit Health Assessment, which records health status on leaving a role with hazardous exposure, for comparison against this baseline
- Any pre-offer medical inquiry or health questionnaire, which belongs nowhere in a hiring process before the offer stage
- General health screening unconnected to a specific role's demands, which is outside what a pre-placement assessment is for
Compliance mapping
Which ADA requirements does this satisfy?
The assessment sits less in a single technical standard and more in employment and human rights law governing when a medical inquiry can happen and what can be done with the result, with hazard-specific baseline requirements layered on where exposures call for them.
| Clause | Requirement | Where it lands |
|---|---|---|
| ADA s.102(d)(2)-(3), 42 U.S.C. §12112(d) | Medical exams and inquiries may only follow a conditional offer, must be required of the entire job category, and results held confidentially | Header |
| ADA s.102(d)(3)(B) | Medical information kept in separate, confidential files with restricted access | Header |
| Human rights legislation, duty to accommodate | A fitness outcome short of unrestricted fit triggers accommodation consideration before adverse action | Outcome |
| ADA, essential functions and direct threat | Fitness assessed against the essential functions and exposures of the specific role, not general health | Role demands |
| OSHA 29 CFR 1910.95(g) | Baseline audiogram required for workers entering a hearing conservation programme | Baselines established |
| OSHA 29 CFR 1910.134(e) | Medical evaluation required before a worker is fit-tested and cleared for respirator use | Baselines established |
| ADA s.102(d)(3)(C) | Supervisors informed only of necessary restrictions and accommodations, not the underlying medical condition | Outcome |
What it does not cover
- Health Surveillance Plan, which sets the recurring schedule of checks a role requires, rather than the one-time entry assessment.
- Periodic Health Assessment, the scheduled recurring check that follows this one once the worker is in post and exposed.
- Exit Health Assessment, which records the comparable health status at the other end of employment.
- A pre-offer medical inquiry or health questionnaire, not a permitted step before a conditional offer exists.
- A general health screen, which belongs to a wellness programme rather than a role-specific fitness decision.
Global
Pre-Placement Health Assessment requirements by country
Keeping medical inquiries job-specific and post-offer is a US statutory requirement; elsewhere the same outcome is reached through human rights and equality law rather than a disability-specific statute.
Americans with Disabilities Act, Title I, 42 U.S.C. §12112(d)
Medical examinations are only permitted after a conditional offer, required of the whole job category, and results held separately and confidentially.
An assessment scheduled before the offer is extended is not a timing technicality, it is the specific harm the statute exists to prevent.
Equality Act 2010, s.60
Questions about health or disability before a conditional offer are prohibited except in narrow circumstances, including fitness for an inherent role requirement.
The exceptions are narrow; relying on one to justify a broader pre-offer health screen will not hold up.
ILO Convention 161 and Recommendation 171, Occupational Health Services
Pre-placement examination is a legitimate occupational health function, provided the outcome shared with the employer is limited to fitness for the specific work.
The confidentiality boundary between occupational health and the employer is treated internationally as core to the instrument.
How to complete it
How to complete a pre-placement health assessment, step by step
The form's fields will always get filled in. What determines whether the record is defensible is whether timing, scope and disclosure boundaries were respected while it was being done.
The start date being in the future is not evidence the offer came first. The record should show an offer date preceding the assessment date, because that sequence is the entire basis on which the assessment is lawful to run.
Physical demands and exposures should already be on file for the role before the assessment is designed, and questions should trace back to them. An assessment that cannot point to a documented demand behind each question has drifted toward general screening.
An audiometric or spirometry baseline is only meaningful against a role with the corresponding exposure. Taking it routinely produces data nobody compares against anything, and skipping it where the exposure exists removes a data point a later claim will need.
The manager-facing outcome is fit, fit with restrictions, temporarily unfit or unfit, plus any restriction detail, nothing else. If a diagnosis or test result reaches a hiring manager, the confidentiality boundary the instrument depends on has already failed.
What auditors find
Most common pre-placement health assessment findings
Findings here rarely concern whether the form was filled in. They concern whether the sequence and the disclosure boundary held.
| Finding | Clause | What fixes it |
|---|---|---|
| Assessment date precedes or has no confirmed relationship to the offer date. | ADA s.102(d)(2) | Record the offer date on the job record and require it precede the assessment date before the record can be marked complete. |
| Assessment questions are not traceable to a documented physical demand or exposure of the role. | ADA, essential functions | Require physical demands and exposures documented on the role before the assessment is designed, and reference them directly. |
| Diagnosis or clinical detail reaches the hiring manager rather than fitness and restrictions alone. | ADA s.102(d)(3)(C) | Route only the fitness outcome and restriction summary to the manager; keep clinical detail in the occupational health file. |
| Baseline testing taken or skipped without reference to whether the role carries the relevant exposure. | OSHA 29 CFR 1910.95(g) / 1910.134(e) | Tie each baseline test to the exposure it protects against, and mark it not required where the exposure is absent. |
| Fitness outcome other than unrestricted fit recorded with no accommodation consideration on file. | Human rights legislation, duty to accommodate | Record what accommodation was considered and why, before any adverse placement decision. |
| Worker consent to share the fitness outcome not obtained or not recorded before disclosure to the employer. | ADA s.102(d)(3)(B) | Capture consent as a discrete, dated step before the outcome is passed to the manager. |
Case in point
Case in point: the offer that arrived after the appointment
A warehouse operator scheduled pre-placement assessments in batches to fit the occupational health provider's visit dates, while offers went out from recruitment on a separate, slower track. For most candidates the offer arrived first; for one, a scheduling clash meant the assessment was completed two days before the written offer was sent.
That candidate was later found unfit for the role due to a lifting restriction and the offer was withdrawn. The employer could produce both records, but the offer letter postdated the assessment. The sequence the instrument depends on could not be shown, and the withdrawal could not be defended as post-offer rather than a pre-offer filter.
The template
The template, field by field
The form exactly as it installs. Every field, option, score and conditional rule is editable, and the links to other templates come with it.
4 sections
- Reference
- HLT-010
- Archetype
- Assessment
- Record ID
- PPH-2026-000
- Scoring
- Fit, fit with limits, unfit
- Direction
- n/a
- Singleton
- No
- Basis
- ADA, human rights legislation
- Links
- Links Worker, Job
- Tags
- Health, Surveillance
- Sections
- 4
- Fields
- 43
- Follow up fields
- 1
- Repeating sections
- 0
- Links out
- 7
Header
16 fieldsAssessment ID*
Auto sequence. Format PPA-2026-000.
The record's own ID. Other templates point at this value.
Status*
Drives who this goes to next.
- Planned2 pts
- In progress2 pts
- Complete3 pts
- Deferred0 pts
- Open0 pts
- Closed3 pts
- Overdue0 pts
Date and Time*
Completed By*
Site*
Site ID*
Format SITE-000.
Links to FDN-001 Site ID
Worker*
Person ID*
Format PER-0000.
Links to FDN-003 Person ID
Record Confidentiality
Clinical detail stays with occupational health. Management receives a fitness outcome and any restrictions, never a diagnosis. Restrict access to this template accordingly.
Clinical Detail Held Separately*
- Yes3 pts
- No0 pts
Access Restricted To Occupational Health*
- Yes3 pts
- Partly1 pt
- No0 pts
Worker Consent Obtained*
Consent to share the fitness outcome with the employer. Withdrawal is the worker's right.
- Yes3 pts
- No0 pts
Proposed Role*
Start Date*
Assessment Completed Before Start*
- Yes3 pts
- No0 pts
Fitness, Not Screening Out
This assessment establishes a baseline and identifies adjustments. It is not a mechanism for excluding people, and questions must relate to the actual demands of the role.
Role demands
8 fieldsTask
Job ID
Format JOB-000.
Links to FDN-004 Job Task ID
Physical Demands Documented*
- Yes3 pts
- Partly1 pt
- No0 pts
Exposures In Role Documented*
- Yes3 pts
- Partly1 pt
- No0 pts
Safety Sensitive Role*
Cold Environment Work*
Noise Exposure*
- Below action level3 pts
- Above action level0 pts
Respirator Use Required*
Baselines established
9 fieldsAudiometric Baseline Taken*
- Yes3 pts
- Not required3 pts
- No0 pts
Audiometry Record ID
Links to HLT-027 Record ID
Spirometry Baseline Taken
- Yes3 pts
- Not required3 pts
- No0 pts
Skin Condition Baseline Recorded
- Yes3 pts
- Not required3 pts
- No0 pts
Vision Screening Completed
- Yes3 pts
- Not required3 pts
- No0 pts
Respirator Medical Clearance
- Yes3 pts
- Not required3 pts
- No0 pts
Clearance Record ID
Links to HLT-032 Record ID
Vaccination Status Reviewed
- Yes3 pts
- Not required3 pts
- No0 pts
Vaccination Record ID
Links to HLT-014 Record ID
Outcome
10 fieldsFitness Outcome*
Fit, fit with adjustments, temporarily unfit, or unfit for this role. No diagnosis is shared.
- Fit3 pts
- Fit with restrictions2 pts
- Temporarily unfit1 pt
- Unfit0 pts
Adjustments Recommended
Restrictions Apply*
- No3 pts
- Yes1 pt
Restriction Record ID
Links to HLT-017 Record ID
Manager Informed Of Outcome Only*
- Yes3 pts
- More was shared0 pts
Next Assessment Due*
Occupational Health*
Signature*
Worker*
Second Signature*
HLT-010 · record IDs look like PPH-2026-000 · Links Worker, Job
Open in KnowellaRun it with agents
From a document you fill in to a programme that runs itself
The form is straightforward. What fails is the sequence around it: the offer date never checked against the assessment date, and clinical detail that reaches a manager because nobody enforced the boundary.
Holds the pre-placement record against the worker and job it links to, and blocks completion until an offer date on file precedes the assessment date.
Supplies the documented physical demands and exposures for the role so the assessment is written against real hazards rather than a generic template.
Watches for a fitness outcome other than unrestricted fit with no accommodation reasoning on file, and raises it before a placement decision is made.
This template lives in KnowHealth — employee wellbeing. Exposure monitoring, health surveillance, case management and return to work.
Meet KnowHealth→Glossary
Pre-Placement Health Assessment definitions and key terms
- Conditional offer
- A job offer made subject to conditions, such as passing a pre-placement assessment, which must exist before the assessment can lawfully take place.
- Essential function
- A core duty of the role a candidate must be able to perform, with or without accommodation, which the assessment tests fitness against.
- Baseline
- The first measurement against a hazard-specific exposure, such as hearing or lung function, held as the reference point for later comparison.
- Reasonable accommodation
- An adjustment allowing a worker to perform essential functions, considered whenever fitness is anything short of unrestricted.
- Fitness outcome
- The employer-facing conclusion, fit, fit with restrictions, temporarily unfit or unfit, distinct from and never including the clinical basis for it.
FAQ
Frequently asked questions about pre-placement health assessment
Can a pre-placement assessment happen before a job offer?+
No. It must follow a conditional offer. An assessment run beforehand functions as a health-based filter on the hiring decision, precisely what the post-offer requirement exists to prevent, regardless of how the questions are worded.
What can the employer be told about the result?+
Fitness, fit with restrictions, temporarily unfit or unfit, and any restrictions that follow. Not the diagnosis, not the test results. Occupational health holds the clinical detail; the employer receives the placement decision.
Can the assessment ask about health history in general?+
Only where relevant to the demands of the specific role. A general health history disconnected from a documented physical demand or exposure is outside what a pre-placement assessment is permitted to ask.
Does every role need a baseline test?+
No. Baseline tests such as audiometry or spirometry are only meaningful where the role carries the corresponding exposure. Running them regardless produces data with nothing to compare against.
What happens if the outcome is fit with restrictions?+
The employer considers reasonable accommodation before any adverse placement decision. A restriction is not automatically a reason to withdraw an offer, and the record should show accommodation was actually weighed.
Who can see the assessment record?+
Access should be restricted to occupational health. The manager sees only the fitness outcome and restriction summary, not the underlying record, and that separation is enforced by access control, not by trust.
Keep going
Related templates and programmes
Industries this is written for
Programmes this belongs to
Used together in Occupational Health Surveillance
Similar Exposure Group Register
Groups workers who share the same tasks, agents and exposure patterns
Qualitative Exposure Assessment
Rates likely exposure using professional judgement, task knowledge and existing data, before any sampling
Personal Air Sampling Record
Records a sample taken from a worker's breathing zone over a shift
Area Monitoring Record
Records fixed point sampling in a work area rather than on a person
Noise Dosimetry Record
Records a worker's noise exposure over a full shift using a personal dosimeter
Chemical Exposure Assessment
Assesses exposure to a specific chemical across the tasks where it is used
More in Health Surveillance
Health Surveillance Plan
Sets out which workers need which health checks, how often and why
Periodic Health Assessment
A scheduled health check for workers exposed to specific hazards
Exit Health Assessment
Records a worker's health status when they leave a role with hazardous exposure
Health Referral Record
Records a referral to occupational health, with the reason and what is being asked
Vaccination Record
Records vaccinations offered and given where a role carries biological risk
Health Surveillance Compliance Review
Checks that scheduled health assessments are actually happening on time
Written and reviewed by
Siddarth Singh
Founder & Chief Executive Officer, Knowella
Certified Safety Professional and industrial and systems engineer with more than a decade inside food supply chain, freight and manufacturing operations. This page was written against the current text of the standards it cites, not against secondary summaries of them.
- Certified Safety Professional (CSP), Board of Certified Safety Professionals
- MBA, University of Chicago Booth School of Business
- MS and BS, The Ohio State University, Industrial and Systems Engineering
- Six Sigma Black Belt
Sources and last review. Reviewed 16 August 2026 against:
- Americans with Disabilities Act, Title I, 42 U.S.C. §12112(d), medical examinations and inquiries
- Equality Act 2010, section 60, enquiries about disability and health (UK)
- OSHA 29 CFR 1910.95(g), hearing conservation baseline audiogram
- OSHA 29 CFR 1910.134(e), respiratory protection medical evaluation
- ILO Convention 161 and Recommendation 171, Occupational Health Services
This page is general guidance, not legal advice. Confirm requirements with your jurisdiction’s regulator.