- Have you ever been diagnosed with Tuberculosis (TB)? Have you ever had to take treatment for Tuberculosis (TB)?
- Have you ever been in close contact at work or at home with a person known to have Tuberculosis?
- Have you ever been in admitted to hospital and/or received medical treatment for an extended period for any reason (including for a major operation or treatment of psychiatric illness)?
- Do you suffer, or have you ever suffered, from mental health problems?
- Have you ever been told you are HIV positive?
- Do you have, or have you ever had, hepatitis, problems with your liver or yellowing of the skin?
- Do you have or have you had cancer in the last 5 years?
- Do you have high blood sugar/diabetes?
- Do you have heart problems, including high blood pressure or a heart condition that you were born with?
- Do you have a blood condition?
- Do you bladder or kidney problems?
- Do you have a physical or intellectual disability that make it difficult for you to function independently (for example, to move around or learn) or work full-time?
- Do you need to take drugs or drink alcohol regularly?
- Are you pregnant?
- Are you taking prescribed pills or medication (excluding oral contraceptives, over-counter medication and natural supplements)? If yes, please list these.