Form A11: Full Medical Examination Form to issue migrant worker’s Work Permit
Form A11 is the Ministry of Manpower medical examination form used when a migrant worker’s Work Permit is first issued. A Singapore-registered doctor completes it, and the results are submitted to MOM online.
This is the genuine MOM PDF, unmodified. Source: MOM official page.
What is Form A11?
Form A11 captures the worker’s personal particulars and FIN, a medical history the worker declares and signs, and the clinical examination and laboratory findings recorded by the doctor. The screening covers tuberculosis, HIV, syphilis and malaria, and assesses whether the worker is fit for the job they will be doing.
The clinical sections are detailed: blood pressure and heart, an ECG where indicated, respiratory and abdominal examination, skin, limb movement and spinal deformity, mental state, a chest X-ray taken in Singapore, urine tests, a syphilis screen, hearing, and vision of at least 6/12 in both eyes with or without glasses. Colour vision is checked for electricians and drivers. Every part is completed by a Singapore-registered doctor and any amendment must be endorsed by that doctor.
Who files Form A11?
- Employers arranging the pre-issuance medical examination for a newly arrived migrant worker
- Singapore-registered doctors and clinics recording the examination findings and test results
- Employment agents handling Work Permit applications for construction, marine, process and other sectors
- Workers themselves, who declare and sign the medical history in Part II
How to fill out Form A11
- Arrange the examination within two weeks of the worker arriving. Where a Primary Care Plan applies, the examination is done at the Anchor Operator’s facility for the worker’s residential zone, and Onboard programme participants are examined at MOM’s Onboard centre.
- Print Form A11 and send the worker with their travel document, which the doctor needs for identification.
- The worker completes and signs the medical history in Part II, covering conditions such as tuberculosis, epilepsy, diabetes, heart disease and past operations.
- The doctor completes the clinical examinations and other tests, including the chest X-ray taken in Singapore, then signs and stamps the form.
- The clinic submits the medical results to the Ministry of Manpower online within one week, using the medical examination portal printed on the form at go.gov.sg/mom-meportal.
Get Form A11
MOM publishes Form A11 as a flat PDF with no built-in form fields, so there is no quick-fill form here. Open it in the editor to type directly onto the pages, tick boxes and sign, or download the official blank and complete it in your PDF reader or by hand.
Frequently asked questions
Which conditions does the examination screen for?
It screens for four infectious diseases, tuberculosis, HIV, syphilis and malaria, and checks general fitness to work. Additional findings, such as significant limb deformity or poor vision, are recorded because they can affect the job the worker is permitted to do.
Can the medical examination be done before the worker travels?
No. Form A11 must be completed by a Singapore-registered doctor and the chest X-ray has to be taken in Singapore, so the examination happens after arrival.
What is the difference between Form A11 and Form B11?
Form A11 is used when the Work Permit is first issued. Form B11 is the full medical examination form used when a migrant worker’s Work Permit is renewed.