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MOM · PDF

Migrant-worker Medical Form A11: Sections and Online Submission

Personal particulars, nine medical-history categories, examinations, vaccinations and doctor certification.

Source reviewed: 2026-10-12 · 2026-03-17

Doctor completion and identity

A Singapore-registered doctor completes the form and endorses amendments; the worker produces the travel document for identification. The worker declares/signs medical history. This explains the form; the doctor performs examinations and fitness certification.

Parts I–II: Particulars and history

Enter name, travel-document number, sex, height/weight, occupation, birth date and nationality; A11 also includes FIN. History covers mental illness, epilepsy, chronic asthma, diabetes, hypertension, tuberculosis, heart disease, malaria and operations, with yes/no and details.

The worker signs/dates the truth declaration and consents to release to MOM, employer and the EA assisting the Work Permit.

Part III: Clinical examination

Tick abnormalities and provide separate brief details.

ItemFields
CardiovascularBlood pressure systolic/diastolic, heart disease, ECG and severe varicose veins
AnaemiaHaemoglobin if clinically anaemic
RespiratoryRespiratory system
AbdomenHernia, enlarged liver/spleen and genitourinary system
SkinChronic conditions such as leprosy, widespread eczema and psoriasis
Locomotor/neurologicalAmputation/deformity, coordination, spinal and other work-relevant abnormalities
EndocrineConditions such as thyrotoxicosis
Mental statePractitioner examination record

Other tests and qualifications

Chest X-ray is performed in Singapore. Tests include urine albumin/sugar/pregnancy, syphilis/VDRL, ability to hear ordinary conversation at two metres, at least6/12 in both eyes with/without glasses, each eye’s acuity, colour vision only for electricians/drivers, organic eye disease, malaria blood film and HIV. Malaria/HIV laboratories must be MOH approved.

ECG is compulsory for male Thai workers and others above fifty and for younger candidates with indications such as murmurs or symptoms suggesting myocardial ischaemia.

Parts IV–V: Vaccination and fitness

Record vaccine type, brand and first/second/third dose. The doctor certifies Fit or Unfit for the stated occupation, deletes the inapplicable option and enters block-letter name, signature, clinic address, date and telephone.

A11 result states and online submission

Retain the radiology report for employer requests. A11 distinguishes abnormal/no referral, abnormal cleared by NTBCC and pregnancy exemption; syphilis distinguishes currently infectious from treated/inactive positive results.

Starred online-required results are blood pressure, chest X-ray, urine, syphilis/VDRL, occupation-specific colour vision, malaria and HIV. Submit online within one week at go.gov.sg/mom-meportal.

Official source

Written independently from official MOM source material.

MOM official source ↗

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