I agree to complete this health questionnaire and if requested, I will also be available for a health assessment by an Occupational Health Nurse or Physician appointed by Pypers Produce. I undertake to give true and complete answers in regard to my past and present health. I will not withhold any relevant information concerning this matter.
Any information given, known to be untrue may exclude me from employment or may be grounds for dismissal following my appointment. I understand that any workers compensation claim arising from such information will be disputed. I understand that this record will remain confidential to Pypers Produce.