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Depot conducted?
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Conducted on
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Prepared by
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Location
Health Declaration
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Full name
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Suffered with back injury, back pain or neck pain?
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Suffered with disc injury?
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Suffered with Hernias?
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Suffered with nerve injury?
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Suffered with ligament or muscular injuries?
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Suffer with hearing problems or inner ear damage?
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Suffer from Tinnitus? (ringing of the ears)
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Suffer from Defective Vision?
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Suffer from Ear Infections?
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Suffer from Defective colour vision?
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Do you wear a hearing aid?
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Date of last hearing test?
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Do you wear glasses?
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Date of last eye test?
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Have you been inoculated against tetanus?
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Have you been inoculated against polio?
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Have you suffered from any of the following
- Pains in chest
- High Blood pressure
- Epilepsy
- Fainting Attacks
- Asthma
- Shortness of breathe
- Skin trouble
- Heart Attacks
- Angina
- Fits or blackouts
- Hay Fever
- Anxiety Or depression
- Reoccurring Headaches
- Diabetes
- None of the above
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Please give details of any medication you are taking
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How would you consider your weight.
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Is your general health good?
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Please tick if you are limited in these areas- walking, standing, lifting, using your hands, working at height, driving, climbing ladders?
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How Many days have you had off due to illness in the last six months?
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I DECLARE THAT TO THE BEST OF MY KNOWLEDGE THE ABOVE IS CORRECT
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Do you have any Physical Disabilities which should be noted?
Employee Record
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Full name
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Date of birth
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National Insurance Number
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Home Address
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Nationality
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Job Description
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Hourly rate agreed
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Relationship Status
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Employment commenced
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Employment ceased
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1. Emergency contact name
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1. Emergency contact relationship
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1. Emergency contact number
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1. Emergency contact address and postcode
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2. Emergency contact name
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2. Emergency contact relationship
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2. Emergency contact number
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2. Emergency contact address and postcode
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Are you submitting a p45?
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Please submit to wages@thomasplanthireltd.com
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Please speak to wages@thomasplanthireltd.com IMMEDIATELY , who will arrange for you to complete a P46 as soon as possible.
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Name of bank/building society?
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Banks address
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Sort code and account number
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Have the arrangements for travel been discussed?
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To be confirmed by a line manager
Licence/passport checks
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Can you provide a copy of your passport?
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Can you provide us a additional form of ID?
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Can you provided a copy of your driving licence?
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Please email your driving licence to tm@thomasplanthireltd.com
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By signing below you are agreeing for us to periodically check your driving licence information to establish licence entitlements and monitor offences. All information is used and treated under the Data Protection Act.
Working time directive opt out form
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The working time directive, states that an employee cannot be asked to work more than 48 hours per week, on average over a 17 week period. you can choose to work more than 48 hours a week on average if you're over 18. This is called opting out. your employer can ask you to opt out , but if you do you cant be sacked or treated unfairly for refusing to do so. You can opt out for a certain period or indefinitely. It must be voluntary and in writing. Driving (except for drivers of vehicles under 3.5 tons using GB Domestic drivers' hours rules) cannot opt out as your working hours are regulated and controlled.
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I agree that I may work for more than an average 48 hours a week over a 17-week period. If I change my mind, I will give my employer 7 days' notice i writing to end this agreement.
Eye Site test
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Name of Employee
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State the Number plate read at a distance of 20M+
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Result
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I hereby declare that i will report any changes to my vision or report any health impairments that may effect/impact my ability and entitlement to drive or work safely.
Learning agreement
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This Learning Agreement is designed to ensure that both the Company and employee understand their obligations regarding further education and training. It is a standard quality measure to ensure that: Employees understand what they have the right to expect from TPH LTD Employees understand what is expected of them during their course Line Managers are clear concerning their employees support needs. Company Pledge You will receive information, advice and guidance about your chosen course from your Line Manager TPH will fund an agreed proportion of your chosen course (subject to authorisation) Your progress will be reviewed periodically by your Line Manager TPH will provide adequate support for any specific learning needs you may have, either throughout the course, or at appropriate mutually identified times Line Manager’s Pledge Your Line Manager will agree to: Provide adequate support and guidance throughout your chosen training course Meet with you on a regular basis to discuss your progress and send a report to the Management regarding your progress on courses that are to take place over more than a week’s duration Employee Pledge You, the employee will agree to: Undertake sufficient study to maintain progress and achieve success on your chosen course Attend college/university/training center, where appropriate, when required to do so Complete assignments, where appropriate, on time Contact you’re Line Manager of a member of the Senior Management team if you are experiencing difficulties with the course Give us authorization to obtain regular reports from the appropriate college/university/Training Center regarding your progress/attendance Repay the costs of any course and examination fees in line with the table below if you resign from the Company’s employment during the course or for an unacceptable reason, withdraw or fail within twelve months. See below for the percentage of fees that need to be re-payed after leaving after a certain time scale. 3 months or less = 100% 3-6 months = 75% 6-9 months = 50% 9-12 months = 25% Following a successful period of 12 months or more, no training reimbursement is required.
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FOR EMPLOYER ONLY - Have all the below been discussed
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Induction to supervisors and managers
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Site specific hazards identified
- Yes
- No
- N/A
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Job Description
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Working hours and breaks
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QA 002 Health declaration completed and signed forms
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QA 003 employee/self employed record form
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P45 From previous employment
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Employee handbook (for direct employers only)
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Contract of employment
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Method of payment advised
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Travel and expenses
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QA 037 working time form
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Welfare facilities - walk around the depot
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Insurance of safe system of work
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Company policies
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FORS drivers handbook
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QA 034 Right to work in the uk
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QA 039 Driver mandate form and copy of driving licence
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QA 038 Night shift opt out form (optional)
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QA 0101 training reimbursement form
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Copy of any Training Certificates
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Method statement and SOP explained and signed off.
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Employee Signature
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Employer Signature
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