Wormald Medical Service Request Form

Requestor Details

Invoicing Details

(For Field Testing Officers and Bunzl Safety Testing / Manufacturing Positions only)

Partcipant Details

At least one phone number is required

Service Details

Participant Availability

Injurynet will contact the participant to obtain their availability and location for the medical.

Please select at least 9 hours over a minimum of 2 weekdays. If you would like to add additional days to your selection please click on +.

Injurynet will book the participant's medical based on the date and times you have provided. Please note, all cancellations and non-attendances will incur a fee.