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A simplified version of the Simplified Employee Medical Health Questionnaire form I had to fill out recently

Explanation ::

I had to fill out an Employee Medical Health Questionnaire form recently since my company is changing insurance providers. The form I had to fill out had a huge list of questions I had to answer, like:

  • Is your heart currently exploding? []Yes []No
  • Will you die tomorrow? []Yes []No
  • Have you ever been sick? []Yes(You're icky!) []No

Ok, those aren't really questions on the EMHQ, but this one was:

"Have you, or any dependent ever had or been told they had, been medically counseled or treated for any of the following?


Alcohol or drug use, abuse and/or dependency?


Seriously? Since I drink beer occasionally, I have to answer "yes" to the same question to which alcoholics, crack smokers, and meth addicts also have to answer "yes?" No distinction between, "I drank wine 10 years ago and hated it and have never touched alcohol since," and "I use meth every day. I just can't get enough meth. Meth, meth, meth, it's all I need. Hey, why am I filling out this form? There's no meth in it!" is needed?

In order to help this insurance company save on printing costs, I redesigned their EMHQ form for them, completely free of charge. I hope this kind gesture will help them look past the fact that I either drank beer once or smoke 5 pounds of crack everyday so that they will insure me, because I really need someone to deny my medical claims.

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Owned by UnkieMidriff - Created on 09/19/2007 - Last edited later the same day
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