SAMPLE DISCRIMINATORY PREOPFER OF EMPLOYMENT INQUIRIES

SAMPLE DISCRIMINATORY PREOPFER OF EMPLOYMENT INQUIRIES

(Unlawful after July 26, 1991)

1. Are you disabled?
2. Do you have a disability?
3. Do you have a visual, speech, or hearing disability?
4. What is the extent of any disability you may have?
5. How severe is any disability you may have?
6. Have you ever been treated for any of the following diseases?

epilepsy

muscular dystrophy

multiple sclerosis

AIDS

cancer

heart disease

diabetes

mental retardation

emotional illness

high blood pressure

any other disease

1. Do you wear contact lenses?
2. Are you night blind/color blind?
3. Please list any diseases for which you have been treated in the past two years.
4. Have you ever been hospitalized? If so, for what condition?
5. Have you ever suffered any mental impairment or been treated for any mental conditions?
6. Have you ever been treated by a psychiatrist or psychologist? If so, for what condition?
7. Are you on any constant medication?
8. Are you taking any prescribed drugs?
9. Have you ever been treated for drug addiction or alcoholism?
10. Do you smoke?
11. Have you ever filed for workers’ compensation insurance?
12. Is there any health-related reason that might keep you from performing the job for which you are applying?