[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"doc-seo-270542-105":3,"detail-sidebar-cat-0-en-105":81,"doc-detail-270542-en":131},{"code":4,"msg":5,"data":6},0,"ok",{"site_id":7,"language":8,"slug":9,"title":10,"keywords":11,"description":12,"schema_data":13,"social_meta":74,"head_meta":76,"extra_data":78,"updated_unix":80},105,"en","faculty-of-health-work-integrated-learning-wil-health-assessment-form","Faculty of Health - Work-Integrated Learning (WIL) - Health Assessment Form","","Health Assessment Form for Work-Integrated Learning (WIL) placement within the Faculty of Health. Students complete key sections when they answer YES to items on the Fitness to Practice Declaration or are advised the assessment is required. A medical practitioner completes the practitioner section covering medical, physical, and psychological concerns, diagnosis information, functional capacities for physical and psychological activities, and additional requirements such as special equipment and allergies. The form ends with medical practitioner and student declarations, signatures, and dates.",{"@graph":14,"@context":73},[15,34,56],{"@type":16,"itemListElement":17},"BreadcrumbList",[18,23,27,31],{"item":19,"name":20,"@type":21,"position":22},"https://docshare.wps.com","Home","ListItem",1,{"item":24,"name":25,"@type":21,"position":26},"https://docshare.wps.com/document/","Document",2,{"item":28,"name":29,"@type":21,"position":30},"https://docshare.wps.com/document/healthcare/","Healthcare",3,{"item":32,"name":10,"@type":21,"position":33},"https://docshare.wps.com/document/faculty-of-health-work-integrated-learning-wil-health-assessment-form/270542/",4,{"url":32,"name":10,"@type":35,"image":36,"author":41,"headline":10,"publisher":44,"fileFormat":47,"inLanguage":8,"description":12,"dateModified":48,"datePublished":49,"encodingFormat":47,"isAccessibleForFree":50,"interactionStatistic":51},"DigitalDocument",{"url":37,"@type":38,"width":39,"height":40},"https://docshare.wps.com/thumbnails/faculty-of-health-work-integrated-learning-wil-health-assessment-form/270542.png","ImageObject",300,407,{"name":42,"@type":43},"Eden","Person",{"url":19,"name":45,"@type":46},"DocShare","Organization","application/pdf","2026-10-22","2026-09-15",true,{"@type":52,"interactionType":53,"userInteractionCount":55},"InteractionCounter",{"@type":54},"ViewAction",13,{"@type":57,"mainEntity":58},"FAQPage",[59,65,69],{"name":60,"@type":61,"acceptedAnswer":62},"When is a student required to complete the Health Assessment Form for WIL placement?","Question",{"text":63,"@type":64},"Students must complete the form if they answered YES to any question on the Fitness to Practice Declaration or were advised by their unit and/or course coordinator that a health assessment is necessary.","Answer",{"name":66,"@type":61,"acceptedAnswer":67},"What information does the medical practitioner provide in the Health Assessment section?",{"text":68,"@type":64},"The practitioner records patient history, whether the student has been diagnosed with a condition, how the condition relates to physical and mental capabilities, and selects capacity levels for physical and psychological activities, including any additional comments or recommendations.",{"name":70,"@type":61,"acceptedAnswer":71},"What happens if the medical practitioner indicates the student cannot undertake the placement?",{"text":72,"@type":64},"The medical practitioner answers NO for placement capability and specifies when the student is expected to be able to undertake the placement, along with completing identification, signature, date, and business stamp/address details.","https://schema.org",{"og:url":32,"og:type":75,"og:title":10,"og:site_name":45,"og:description":12},"article",{"robots":77,"canonical":32},"index,follow",{"doc_id":79,"site_id":7},270542,1789455945,{"code":4,"msg":82,"data":83},"success",[84,88,92,96,101,106,110,115,120,123,127],{"id":22,"doc_module":4,"doc_module_name":25,"category_name":85,"show_sort_weight":86,"slug":87},"Story & Novel",90,"story-novel",{"id":26,"doc_module":4,"doc_module_name":25,"category_name":89,"show_sort_weight":90,"slug":91},"Literature",80,"literature",{"id":33,"doc_module":4,"doc_module_name":25,"category_name":93,"show_sort_weight":94,"slug":95},"Exam",70,"exam",{"id":97,"doc_module":4,"doc_module_name":25,"category_name":98,"show_sort_weight":99,"slug":100},5,"Comic",60,"comic",{"id":102,"doc_module":4,"doc_module_name":25,"category_name":103,"show_sort_weight":104,"slug":105},6,"Technology",50,"technology",{"id":107,"doc_module":4,"doc_module_name":25,"category_name":29,"show_sort_weight":108,"slug":109},7,40,"healthcare",{"id":111,"doc_module":4,"doc_module_name":25,"category_name":112,"show_sort_weight":113,"slug":114},8,"Research & Report",30,"research-report",{"id":116,"doc_module":4,"doc_module_name":25,"category_name":117,"show_sort_weight":118,"slug":119},9,"Religion & Spirituality",20,"religion-spirituality",{"id":118,"doc_module":4,"doc_module_name":25,"category_name":121,"show_sort_weight":118,"slug":122},"World Cup","world-cup",{"id":124,"doc_module":4,"doc_module_name":25,"category_name":125,"show_sort_weight":124,"slug":126},10,"Lifestyle","lifestyle",{"id":128,"doc_module":4,"doc_module_name":25,"category_name":129,"show_sort_weight":97,"slug":130},19,"General","general",{"code":4,"msg":82,"data":132},{"doc_id":79,"user_id":133,"nickname":42,"user_avatar":134,"doc_module":4,"category_id":107,"category_name":29,"doc_title":10,"doc_description":12,"doc_content":135,"file_id":136,"file_url":137,"file_type":138,"file_size":139,"view_count":55,"is_deleted":4,"is_public":22,"is_downloadable":22,"audit_status":22,"page_count":33,"language":140,"language_code":8,"site_id":7,"html_lang":8,"table_of_contents":141,"faqs":142,"seo_title":143,"seo_description":12,"update_tm":80,"read_time":124},1374391974468,"https://ap-avatar.wpscdn.com/davatar_29158cc5080c5b710cf443261637dec0","Faculty of Health  \nWork-Integrated Learning (WIL) -Placement  \nHealth Assessment Form  \nSECTION 2 NEEDS TO BE COMPLETED BY A MEDICAL PRACTITIONER  \nStudents need to complete this form if they have answered YES to any questions on the Fitness to Practice Declaration or if they have been advised by their unit and/or course coordinator the health assessment is necessary. The Head of School in conjunction with the Associate Dean Work-integrated Learning can also request a health assessment from an independent medical practitioner in cases where a student has been withdrawn from a placement or if a ‘fitness to practice’ concern has been raised.  \nThe health assessment has been developed to guide students regarding the inherent requirements needed to undertake workplace learning for their course. Students undertaking health-related placements will be required to undertake a range of competencies & tasks that require students to be physically and psychologically fit. The health assessment will assist in finding a suitable placement for the student.  \nPlease complete SECTION 1 and SECTION 4 and ask your medical practitioner to complete SECTION 2 and SECTION 3  \n\n| SECTION ONE: Student Details (to be completed by the student) |  |\n| --- | --- |\n| Student Name: |  |\n| Date of Birth: | Student ID: |\n| University Email: | Mobile: |\n| Course Name: | Course Code: |\n\n\n| SECTION TWO: Health Assessment (to be completed by the medical practitioner) |  |\n| --- | --- |\n| This student has indicated they have medical, physical, or psychological concerns that may affect their capability to undertake a placement. This health assessment will assist in finding a suitable placement for the student. |  |\n| How long has this student been your patient or a patient of your practice? |  |\n| Has the student been diagnosed with a condition? | 􀂅 Yes 􀂅 No |\n| If YES, please provide the diagnosis |  |\n| Have you discussed how their condition relates to their physical and mental capabilities? | 􀂅 Yes 􀂅 No |\n\n| PHYSICAL ACTIVITIES\u003Cbr>(select those applicable – blank will be considered not applicable) |  |  |\n| --- | --- | --- |\n|  | Able Require adjustments Unable |  |\n| Standing/walking | 􀂅 􀂅 􀂅 |  |\n| Pushing/pulling a trolly | 􀂅 􀂅 􀂅 |  |\n| Sitting | 􀂅 􀂅 􀂅 |  |\n| Kneeling | 􀂅 􀂅 􀂅 |  |\n| Squatting | 􀂅 􀂅 􀂅 |  |\n| Working above shoulder height | 􀂅 􀂅 􀂅 |  |\n| Working below knee height | 􀂅 􀂅 􀂅 |  |\n| Lifting | 􀂅 􀂅 􀂅 |  |\n| Neck movement | 􀂅 􀂅 􀂅 |  |\n| Additional comments:\u003Cbr>(limits on duration, weight, movements, length of time, etc., and suggested recommendations) |  |  |\n| Do you have any concerns about the student’s capacity to undertake a placement?\u003Cbr>If YES please provide details. |  | 􀂅 Yes 􀂅 No |\n| PSYCHOLOGICAL ACTIVITIES\u003Cbr>(select those applicable – blank will be considered not applicable) |  |  |\n|  | Not affected Affected |  |\n| Communication | 􀂅 􀂅 |  |\n| Concentration & attention | 􀂅 􀂅 |  |\n| Memory | 􀂅 􀂅 |  |\n| Judgment & decision making | 􀂅 􀂅 |  |\n| Additional comments:\u003Cbr>(effect of psychological health and suggested recommendations) |  |  |\n\n| Do you have any concerns about the student’s capacity to undertake a placement?\u003Cbr>If YES please provide details. | 􀂅 Yes 􀂅 No |\n| --- | --- |\n| Is there any special equipment or resources that could assist the student to undertake these activities while they are on placement? | 􀂅 Yes 􀂅 No |\n| If YES please provide details. |  |\n| ALLERGIES\u003Cbr>(select those applicable – blank will be considered not applicable) |  |\n| Do you believe that the student is suffering from an allergy to: | 􀂅 Latex 􀂅Environment |\n| Does the student require a management plan? | 􀂅 Yes 􀂅 No |\n\n\n| SECTION THREE: Medical Practitioner Signature |  |  |\n| --- | --- | --- |\n| Do you believe this student can undertake a placement at this time? |  | 􀂅 Yes 􀂅 No |\n| If NO, when do you believe they will be able to undertake their placement? |  |  |\n| Doctor’s Name: | Provider Number: |  |\n| Signature: | Date:   /  /   |  |\n| Business Stamp/address","cbCairxEk7CiMVy7","https://ap.wps.com/l/cbCairxEk7CiMVy7","pdf",308403,"English","# Section 2 - Medical Practitioner Requirements\n## Student eligibility and purpose of the assessment\n# Section One - Student Details\n## Personal and course information\n# Section Two - Health Assessment (Medical Practitioner)\n## Patient history and diagnosis\n## Physical activities capacity and adjustments\n## Psychological activities capacity and adjustments\n## Additional equipment and allergies\n# Section Three - Medical Practitioner Signature\n## Placement capability and review timing\n## Practitioner identification and stamp\n# Section Four - Student Signature\n## Consent and acknowledgment","[{\"question\":\"When is a student required to complete the Health Assessment Form for WIL placement?\",\"answer\":\"Students must complete the form if they answered YES to any question on the Fitness to Practice Declaration or were advised by their unit and/or course coordinator that a health assessment is necessary.\"},{\"question\":\"What information does the medical practitioner provide in the Health Assessment section?\",\"answer\":\"The practitioner records patient history, whether the student has been diagnosed with a condition, how the condition relates to physical and mental capabilities, and selects capacity levels for physical and psychological activities, including any additional comments or recommendations.\"},{\"question\":\"What happens if the medical practitioner indicates the student cannot undertake the placement?\",\"answer\":\"The medical practitioner answers NO for placement capability and specifies when the student is expected to be able to undertake the placement, along with completing identification, signature, date, and business stamp/address details.\"}]","Faculty of Health - Work-Integrated Learning (WIL) - Health Assessment Form | PDF"]