Risk Questionnaires
Does Your Applicant Have A Medical Condition or Participate In A Hazardous Hobby?

Click on the topic below to complete an impairment questionnaire.
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IMPAIRMENT

FILLABLE
QUESTIONNAIRE
PRINTABLE QUESTIONNAIRE
Acromegaly
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Addison's Disease
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Alcohol
Alzheimer's
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Aneurysm
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Ankylosing Spondylitis
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Anxiety
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Anemia
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Arrythmia
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Arthritis
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Asperger's Syndrome
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Asthma
Attention Deficit Disorder
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Aviation
Back Disorder
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Berger's Disease
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BiPolar
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Bladder Cancer
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Breast Cancer
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Cancer
Cardiomyopathy
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Cerebral Palsy
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Cervical Cancer
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Chiari Malformation
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Cholesterol
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Chronic Fatigue Syndrome
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Chronic Obstructive Pulmonary Disease (COPD)
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Climbing
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Colon Cancer
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Congestive Heart Failure
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Coronary Disease
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Crohn's Disease
Cushing's Disease
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Deep Vein Thrombosis
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Depression
Diabetes
Diverticulitis
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Down's Syndrome
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Drug Usage
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Epilepsy / Seizure Disorder
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Fibromyalgia
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Gastric Bypass
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Gastro Intestinal
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Grave's Disease
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Guillain-Barre Syndrome
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Heart Block
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Heart Bypass & Angioplasty
Heart Murmur
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Heart Valve Replacement
Hemophilia
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Hemochromatosis
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Hepatitis
High Blood Pressure
Hodgkins Lymphoma
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Huntington's Chorea
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Hypopituitarism
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Idiopathic Thrombocytopenic Purpura
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Intraocular Melanoma
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Leukemia
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Liver Enzyme Elevation
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Lung Cancer
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Lupus
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Lyme Disease
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Melanoma
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Mitral Valve Prolapse
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Multiple Sclerosis
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Muscular Dystrophy
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Myasthenia Gravis
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Non-Hodgins Lymphoma
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Organ Transplant
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Osler-Weber-Rendu Disease
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Ovarian Cancer
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Pancreatitis
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Paralysis
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Parkinson's Disease
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Peripheral Vascular Disease
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Pernicious Anemia
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Phlebitis
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Polycystic Kidney Disease
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Polycythemia
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Post Traumatic Stress Disorder
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Primary Sclerosing Cholangitis
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Prostate Cancer
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Prostatitis
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Psoriatic Arthritis
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Psychiatric Condition
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Pulmonary Hypertension
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Race Car Driver
Reiter's Syndrome
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Rheumatoid Arthritis
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Sarcoidosis
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Scleroderma
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Shingles
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Sickle Cell Anemia
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Skin Cancer
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Skin & Scuba Diving
Skydiving
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Sleep Apnea
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Smoker
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Spina Bifida
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Stickler Syndrome
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Stomach Cancer
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Stroke
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Takayasu's Arteritis
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Testicular Cancer
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Thalassemia
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Thyroid Cancer
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Tourette’s Syndrome
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Travel
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Tuberculosis
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Von Willebrand's Disease
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Wegener’s Granulomatosis
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Romore Associates, All rights reserved.