WellbeingCampaignHealthCheckup |

Information Regarding the Driver Health Assessment

Purpose of the Assessment:

The Driver Health Assessment is designed to evaluate the physical and mental health of professional drivers. Our goal is to identify health risks, promote healthy lifestyle choices, and provide personalized feedback to enhance well-being. By participating in this assessment, you will contribute valuable insights that can help improve health outcomes for drivers in your community.

What to Expect:

Data Collection: During the assessment, we will collect various data points to gauge your health status, including:
Personal information (name, age, gender)
Physical measurements (weight, height, body mass index (BMI), waist circumference, blood pressure, blood glucose level, oxygen saturation (SpO₂))
Lifestyle habits (nutrition, hydration, sleep patterns, physical activity, and stress levels)

Health Measurements: Trained professionals will perform the necessary measurements. These will include:

Measuring weight and height to calculate BMI.
Taking waist circumference to assess abdominal fat.
Measuring blood pressure and blood glucose levels to evaluate cardiovascular and metabolic health.
Assessing oxygen saturation to determine respiratory health.

Duration: The entire assessment process will take approximately 20-35 minutes, depending on the number of measurements and questions answered.

Use of Your Data:

Confidentiality: Your privacy is important to us. All personal information collected during this assessment will be treated with the utmost confidentiality. Data will be stored securely and will only be accessible to authorized personnel involved in the assessment.
Purpose of Data Use: The information collected will be used solely for the purpose of this health assessment. It will help us identify trends in driver health, provide personalized feedback, and develop recommendations for improving overall health and well-being.
Aggregate Data: Individual data will be aggregated for analysis, and no personally identifiable information will be shared in any reports or publications resulting from this assessment.

Right to Withdraw:

Your participation is entirely voluntary. You have the right to withdraw from the assessment at any time, for any reason, without any consequences or negative implications for your employment.

Contact Information:

If you have any questions or concerns about the Driver Health Assessment, please do not hesitate to contact us: EWELLIN, info@ewellin.eu

Thank you for considering participating in the Driver Health Assessment. Your input is invaluable in promoting health and wellness among professional drivers!

Consent for Data Collection and Measurements

Participant Agreement:

By signing below, I acknowledge that I have read the information provided regarding the Driver Health Assessment. I understand that my participation is voluntary, and I can withdraw at any time without penalty. I agree to the collection of my personal data and measurements as outlined below:

Data Collection: I consent to the collection of the following data:
- Personal information (name, age, gender, etc.)
- Physical measurements (weight, height, BMI, waist circumference, blood pressure, blood glucose, SpO₂)
- Lifestyle habits (nutrition, exercise, hydration, sleep, stress levels)
Purpose of Data Collection: I understand that the data collected will be used to assess my health status, provide feedback, and develop recommendations for improving my health and well-being.
Confidentiality: I understand that my personal information will be kept confidential and will only be used for the purposes of this health assessment. My data will not be shared with unauthorized individuals or organizations.
Right to Withdraw: I understand that I have the right to withdraw my consent and participation at any time during the assessment process without any negative consequences.
Contact Information: I can contact Ewellin at info@ewellin.eu if I have any questions or concerns about this assessment or how my data will be used.

Signature

I agree to the above text

Date(Required)

Health assessment of professional drivers

Instructions:
Please complete the following assessment. Your responses will help us understand and improve the health and well-being of professional drivers.

Section 1: Personal Information

Name:(Required)

First Last

Email:(Required)

Age:(Required)

Gender(Required)

Male

Female

Other

Other Gender

Occupation/Job:

Years of Driving Experience:

Nationality:

Language(Required)

Section 2: Physical Measurements (To be filled during the assessment)

Weight (in kg):(Required)

(Measured)

Height (in cm):(Required)

(Measured)

Body Mass Index (BMI):(Required)

(Calculated based on height and weight)

Waist Circumference (in cm):(Required)

(Measured)

Blood Pressure:(Required)

Diastolic (mmHg)(Required)

Blood Glucose Level (in mg/dL):(Required)

(if available otherwise submit a default value of 99)

Oxygen Saturation Level (SpO₂ in %):(Required)

(Measured)

Section 3: Lifestyle and Habits

Average Hours of Exercise Per Week:(Required)

Average Hours of Sitting Per Day:(Required)

Average Hours of Sleep Per Night:(Required)

Average Daily Water Intake (in liters):(Required)

Units of Alcoholic Beverages Consumed Per Week:(Required)

(1 unit = 1 beer / 1 glass of wine / 1 shot):

Average Number of Cigarettes Smoked Per Day:(Required)

(or 0 if non-smoker):

Average Number of Cooked Meals per Week:(Required)

How often do you consume vegetables and fruits with your meals?(Required)

Almost never

1–2 days per week

3–4 days per week

5–7 days per week

Section 4: Work & Health

How many days of sick leave did you take in the past year?(Required)

Have you been involved in any traffic accident (as a driver) in the last 1 year?(Required)

Yes

If yes, how many?(Required)

Do you currently experience any of the following pains?(Required)

Shoulder pain

Low back pain

Cervical (neck) pain

None of the above

(Check all that apply)

Are you currently taking any medications or supplements regularly? (e.g., painkillers, vitamins, blood pressure medicine, sleeping pills, etc.)(Required)

Yes

Please specify

(optional)

Section 5: Mental Health Assessment

(Rate from 1 to 5)

How would you rate your stress level?

(1 = No stress, 5 = Extremely stressed)

How happy do you feel?

(1 = Very unhappy, 5 = Very happy)

How do you rate your life satisfaction?

(1 = Very dissatisfied, 5 = Very satisfied)

How would you rate the quality of your sleep?

(1 = Very poor, 5 = Excellent)

How often do you feel fatigued?

(1 = Rarely, 5 = Very often)

Section 6: Additional Feedback

Do you have any pre-existing medical conditions?

Yes

(Please specify)

Any additional comments or concerns regarding your health: