Gogoro 健康檢查授權聲明書 Health Examination Authorization Form
依職業安全衛生法第20條規定,雇主對於在職勞工應施行健康檢查,勞工有接受檢查的義務。

依勞工健康保護規則第9條規定,雇主應使醫護人員臨廠服務辦理勞工體格、健康檢查紀錄之分析、評估、管理與保存及健康管理,故員工之健康檢查記錄將由護理師存檔備查;並將依員工簽名名單為依據給付健檢費用予簽訂合約之健檢診所或醫院。

本人已清楚瞭解告知內容蒐集、處理、利用及傳輸本人個人資料之目的及用途。本人並依據個資法規定同意提供本人個人資料。

有相關疑問請與 ESH護理師 Iris Tsai  蔡淑如 (分機1814)聯繫。

According to Article 20 of the Occupational Safety and Health Act., employers shall conduct health inspections for currently employed laborers, and the laborers are obligated to accept the examinations.

According to Article 9 of the Labor Health Protection Regulations, employers shall make medical staff on-site to provide services for the analysis, evaluation, management and preservation of labor physical examination records, as well as health management. Therefore, the health examination records of employees will be archived by nurses for future reference; and The medical examination fee will be paid to the contracted medical examination clinic or hospital based on the employee signature list.

I have clearly understood the purpose and purpose of the collection, processing, utilization and transmission of my personal data. I also agree to provide my personal data in accordance with the provisions of the Personal Information Law.

For further questions, please contact ESH Nurse  Iris Tsai (ext. 1814).
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