Services / Fitness to Work Testing Services

Fitness-to-Work Evaluation

SureHire provides a recommendation to hire by providing employers with an accurate picture of the candidate’s medical, musculoskeletal, and critical strength and mobility status. We have helped  organizations improve workplace safety and reduce lost-time incidents by helping employers effectively place the right person in the right job.

A Standardized National Protocol

SureHire’s Fitness-to-Work program is available across Canada via our Exclusive National Testing network. SureHire ensures standardization through training, testing equipment, and protocols to maintain consistent national testing. An employer may book anywhere in Canada by calling a live booking agent or by using our online booking service.

Information For Candidates: What to Expect at Your Appointment

You will be required to present photo identification at the time of your appointment. Once your ID is verified, you will receive paperwork to fill out. This paperwork includes an authorization allowing SureHire to perform applicable testing, as well as provide testing results to your employer/potential employer.

How to Prepare

  • Dress appropriately: shorts, t-shirt, and closed toed shoes. You will not be allowed to testing bare feet or sandals. It is also recommended that women come prepared wearing a tank top or sports bra.
  • Try to get 8 hours of rest the night before your scheduled appointment.
  • Stay hydrated with water before, during, and after the testing. However, if you are booked in for a drug test, please follow drug testing hydration recommendations. Water is provided at the testing facility, however, you may bring your own water bottle.
  • Eat a light, healthy meal no sooner than one hour prior to your scheduled test, or a larger healthier meal three hours prior to your scheduled test.
  • It is recommended that if you have a long commute to the testing facility, the commute is done the day prior to testing.
  • Do not consume alcohol the evening prior to your test.
  • Expect to participate in a full body musculoskeletal assessment followed by a series of lifting stations and positional and mobility activities. Weights range from 15 to 100 pounds (dependent upon the physical demands of your occupation). The level of Critical Strength and Mobility testing is determined by your potential employer, prior to scheduling testing.
  • If you have been diagnosed with hypertension, please ensure that you take your medications as prescribed your physician, as an in-office blood pressure reading is included in Fitness-to-Work testing.

SureHire Medical Testing – What to Expect:

  • An occupational health technician will record your height, weight, waist circumference, and blood pressure.
  • You will then be taken into a private assessment room, where you will be asked to change into your shorts and T-shirt.
  • A licensed rehabilitation practitioner will review your medical and musculoskeletal history and then perform a full body musculoskeletal assessment. The musculoskeletal assessment assesses the stability, strength, range of motion, and integrity of your muscles, joints, ligaments, tendons, and bones.
  • Grip strength testing will be completed during the musculoskeletal examination.
  • If the assessor identifies any safety concerns during the medical/musculoskeletal examination, you will not be allowed to proceed to the Critical Strength & Mobility portion of testing. You will be issued a referral which you will identify what is required or recommended for you to be able to complete your testing (i.e. medical clearance note, copy of MRI report etc.)

Schedule of Acceptable Identification


  • Valid permanent driver’s licence issued in Canada or the United States of America, as permitted to be used for identification purposes under provincial law.
  • Valid passport issued by the government of residing country.
  • Certificate of Indian Status issued by the Government of Canada.
  • Firearms licence or military ID
  • Homeless Aid Centre photo identification
  • Correctional Centre photo identification
  • A document or card, bearing the individual’s photograph and signature, issued by any of the following 6 authorities:

  1. Insurance Corporation of British Columbia
  2. Alberta Registries
  3. Saskatchewan Government Insurance
  4. Department of Service Nova Scotia, Department of Transportation, Province of Prince Edward Island
  5. Service New Brunswick, Department of Government Service, Province of Newfoundland and Labrador
  6. Department of Transportation of the Northwest Territories, Department of Community Government and Transportation of the Territory of Nunavut

Please note: photos or photocopies of ID will NOT be accepted.



  • Employee photo identity card, issued by an employer that is well-known in the community.
  • Certificate of Canadian Citizenship or a Certification of Naturalization, in the form of a paper document or card, but not a commemorative issue.
  • A provincial health insurance card, as permitted to be used for identification purposes under provincial law.
  • Social Insurance Number card issued by the Government of Canada (note: printable SIN cards will not be accepted).
  • Birth certificate issued in Canada.
  • Interim Driver’s License.


  • Employee ID card – from a reputable company within the community
  • Oil Sands ID card
  • Student ID card – from a reputable educational institution within the community
  • Gym membership
  • Costco ID card


  • If no ID is available, the tester will call your employer and speak to their DER. If the manager gives the tester a satisfactory physical description of the client or confirmation of personal information, the testing can proceed.
  • Management ID: 3 contact attempts within 30 minutes. If the tester cannot obtain management ID, online bookings will be advised that the client does not have sufficient ID to continue with testing. You will need to contact your company to re-book the appointment.


  • If no ID is available, the client must get a notarized letter with a photo attached to the actual letter. Any lawyer, doctor, pastor or other notary can provide this.

Various types of Fitness-to-Work assessments can be completed based on the physical demands of the job. The table below outlines each assessment and its components.

Fitness to Work Assessments

Past Medical History Paperwork

Candidates complete the following prior to Fitness-to-Work testing:

  • Self-disclosure of pre-existing injuries and medical conditions
  • Physical Activity Readiness Questionnaire (PAR Q)
  • QRISK2 Cardiovascular Risk Assessment
  • Full consent and release form

Cardiovascular Risk Assessment (QRisk2)

SureHire uses the QRISK2 Cardiovascular Risk Assessment to help determine the risk of developing cardiovascular disease over the next 10 years. This tools asks various questions about the candidate’s personal and family medical history. The information is entered into an algorithm by a SureHire Fitness-to-Work Reviewer and the 10 year cardiovascular disease risk percentage is calculated.

Health Check

A health check is administered, which consists of height, weight, waist circumference, and blood pressure measurements, which helps determine if there are any contraindications to performing the SureHire Critical Strength & Mobility of testing. 

Upon successful completion of the health check, candidates then undergo a full body musculoskeletal examination by a licensed physical therapist, chiropractor, or certified athletic therapist.

Full Body Musculoskeletal Exam

A full body musculoskeletal assessment is a head-to-toe objective evaluation that determines whether a candidate’s medical and musculoskeletal state safely matches the physical demands of the job being applied for. The assessment is based on standardized testing protocols which are established on evidence-based research.

Unlike other occupational testing companies, SureHire uses certified physiotherapists, chiropractors, and athletic therapists to perform the musculoskeletal assessment, as these medical professionals are movement specialists that specialize in understanding the integrity of a candidate’s muscles, bones, ligaments, tendons, and past/current soft tissue injuries.

The candidate’s injury and past medical history self-disclosure is used as a guide, but the assessor thoroughly examines the individual to discover any undiagnosed or omitted conditions and injuries using their specialized skill-set.

Critical Strength & Mobility Testing

Critical Strength & Mobility testing is the final step in SureHire’s Fitness-to-Work program. Candidate’s participate in a series of stations, which match the physical demands of the job, and these stations analyze the candidate’s strength and conditioning.

Candidates are required to perform 30-40 minutes of job specific lifting to confirm that the candidate possesses the necessary strength and conditioning to safely work at the job they are applying for. Each candidate’s performance is objectively evaluated through the measurement of heart rate following the completion of each station, oxygen saturation levels, and standardized time limits and rest periods.

All lifting is closely monitored by certified SureHire staff to ensure that proper lifting technique is demonstrated. Testing is immediately ceased if the candidate is at risk of injury.

Medical Professional Review

Fitness-to-Work testing results are reviewed by a team of medical professionals which consists of physical therapists, chiropractors, certified athletic therapists, and physicians. The results from the Fitness-to-Work testing are used to give employers a recommendation to hire using the level 1-5 assessment scale. Employers have the ability to contact the SureHire Medical Review department at 1-866-944-4473 for assistance in interpreting the recommendations and in making a hiring decision.

Level 1-5 Fitness to Work Recommendation to Hire

Based on the information gathered from these assessments SureHire is able to make an informed recommendation to hire.

SureHire’s Level 1-5 assessment scale is used as a hiring recommendation which matches the candidate’s abilities to the physical job demands of the position applied for. Each level provides employers with potential restriction(s) and/or modification(s)required for successful employment.

Upon completion of Fitness-to-Work testing, results are sent to SureHire Corporate office and are analyzed by a team of Fitness-to-Work Reviewers. The SureHire Fitness-to-Work team is comprised of health practitioners whose designations include physical therapists, chiropractors, certified athletic therapists, and physicians. These medical professionals have extensive knowledge regarding the physical demands of the job, medical and musculoskeletal conditions and strength and mobility limitations. They provide expert recommendations based on the specific job requirements and evidence-based medical research. Fitness-to-Work reviewers issue a recommendation to hire via SureLink and are available for live calls to assist with results interpretation.

Level 1-5 Fitness-to-Work Assessment Scale

  • Level 1: Successful Completion
  • Level 2: Restriction and/or Modification Recommended
  • Level 3: Limited Level of Work – Safety sensitive site access
  • Level 4: Limited Level of Work – Non safety sensitive site access
  • Level 5: Stoppage

What are the advantages of a Level 1-5 Fitness-to-Work Assessment Scale?

  • Expanded hiring pool as employers are empowered to hire and effectively accommodate and/or restrict workers based on their medical, musculoskeletal, or critical strength and mobility status
  • Better placement of workers in positions which match their medical, musculoskeletal, and critical strength and mobility status
  • Provides the foundations for a safer work force

What happens if I am stopped at any point during Fitness-to-Work testing?

  • If a candidate is stopped at any point during Fitness-to-Work testing, a referral is issued which outlines what is either required or recommended for the candidate to return to SureHire to complete testing.
  • It is the employer or potential employer’s decision to determine if they will have the candidate re-tested.

Fitness-to-Work Assessments

None Comprehensive FTW Standard HA #1 Standard HA #2 Standard HA #3
Past Medical History Paperwork - Completed by candidate prior to FTW testing x x x x
Cardiovascular Risk Assesment (Q-Risk) x x x x
Health Check x x x x
Full Body Musculoskeletal Exam x x x None
Full Critical Strength & Mobility Testing x None None None
Modified Critical Strength & Mobility Testing None x None None
Medical Professional Review x x x Blood Pressure Only
Level 1-5 Fitness-to-Work Recommendation to Hire x x x None


What determines which FTW assessment should be completed?

A Physical Demands Analysis (PDA) is completed by a certified health practitioner for each individual work position before employers implement a Fitness-to-Work program. The testing protocol is based on the weights determined by the PDA.

What does the SureHire Fitness-to-Work assessment consist of?

  • STEP 1 – Paperwork, including medical history, consent, and release forms.
  • STEP 2 – Health check (height, weight, blood pressure)
  • STEP 3 – Musculoskeletal examination
  • STEP 4 – Critical strength & mobility protocol
  • STEP 5 – Review of information

What should I bring to the testing facility for my Fitness-to-Work Assessment?

The following items must be presented at the facility in order for testing to occur:

  • Government-issued photo ID
  • Shorts or sweat pants, running shoes (closed-toed shoes), t-shirt (women are encouraged to wear a sports bra or tank top)
  • List of all current medications
  • Prescription glasses, reading glasses or contact lenses (if applicable)
  • Inhaler, if you have asthma or any other lung condition which requires its use

You will not be allowed to proceed with bare feet or open-toed shoes.

What are the credentials of the health care professionals administering the testing?

  • HEALTH CHECK: occupational health technicians
  • MUSCULOSKELETAL EXAM: physiotherapists, certified athletic therapists, chiropractors
  • CRITICAL STRENGTH & MOBILITY: exercise therapists, kinesiologists, athletic therapists, fitness trainers
  • FINAL REVIEW: physiotherapists, chiropractors, physicians

If desired, a family member or friend may be present during the musculoskeletal exam to increase your level of comfort.

How long does it take to complete the Fitness-to-Work protocol?

The Fitness-to-Work protocol takes approximately 90 minutes to complete, not including any additional occupational testing (e.g. drug, alcohol, audio).

The consent and release form states that the candidate is authorizing SureHire to use the information from the Fitness-to-Work assessment to assist the employer in safely managing their workforce. It allows SureHire to share the Fitness-to-Work information with potential employers to safely manage a candidate in the workforce.

If you choose not to sign the consent and release form, SureHire will not be able to proceed with the assessment and the appointment will need to be rescheduled for another date/time. The test will be recorded as a refusal to test and your potential employer will be invoiced.

What can I expect in terms of personal privacy and privacy of results?

  • TESTING PRIVACY: All assessments are done in a private room. Please note that you will be asked to remove your socks and shirt and expose your lower back during the musculoskeletal assessment.
  • INFORMATION PRIVACY: The consent and release form only authorizes SureHire to release the Fitness-to-Work information to the employer identified on the form.

How are the results interpreted and who decides my work status?

The results are centrally reviewed by the SureHire Medical Review Department. The Medical Reviewer will interpret the results of your health check, musculoskeletal exam, and critical strength & mobility testing and make appropriate recommendations with regards to workplace modifications if needed.

SureHire uses a level 1-5 rating scale to provide a recommendation to the employer. Please note that the final decision regarding employment status lies with the employer.

What is a SureHire referral form?

Candidates that rate Level 3, 4, 5 will receive a SureHire referral form that will provide the candidate with a voluntary recommendation of action which will allow them the opportunity to retest and change their level. Referrals are issued for various reasons with safety being the main concern that requires follow up by an appropriate health care provider. The Medical Review Department, along with the information gathered by the medical assessors, helps determine what kind of health practitioner follow-up is needed in order to assist the candidate in getting all the relevant medical information that is required.

All referral requirements must be fulfilled prior to your potential employer scheduling a re-test at SureHire.

Who can I contact if I have any questions/concerns?

Please contact the SureHire Medical Review Department at 1-866-944-4473 Monday to Friday from 7:00 am to 6:00 pm MST.

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