Services / Fitness to Work Testing Services

Fitness-to-Work Evaluation

The right hire is one that is not only physically fit to do the work now, but has the potential to continue performing it safely for years to come. SureHire's Fitness-to-Work Evaluations help to match your candidate’s abilities to the physical job demands of the position applied for with any potential restriction(s) and/or modification(s) required for successful employment. This provides a clear path forward for those in charge of hiring decisions, making it simpler to determine whether or not the employee is fit for the job.

Different Test Types

Various types of Fitness-to-Work Assessments can be completed based on your company's needs and the physical demands of the job being filled. The table below outlines each of SureHire's assessment packages and their components:

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

Past Medical History Paperwork

Candidates will be asked to 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 their 10-year cardiovascular disease risk percentage is calculated.

Health Check

A health check which consists of height, weight, waist circumference, and blood pressure measurements, is administered in order to help determine if there are any contraindications to performing the SureHire Critical Strength & Mobility portion 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 have been established using 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 reviewed and the assessor thoroughly examines the individual for any 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. Candidates will 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 will be closely monitored by certified SureHire staff member to ensure that proper lifting technique is demonstrated and performed. 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 our level 1-5 assessment scale. Employers have the ability to contact the SureHire Medical Review department at 1-866-315-6860 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 will be able to make an informed recommendation to hire.

SureHire’s Level 1-5 assessment scale 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 will be sent to SureHire Corporate Office to be analyzed by a team of Fitness-to-Work Reviewers. These medical professionals will provide expert recommendations based on the specific job requirements and evidence-based medical research. Fitness-to-Work Reviewers will issue their recommendation to hire via SureLink and are available for live calls to assist with results interpretation.

Understanding the Results

SureHire uses a Level 1-5 Fitness-to-Work Assessment Scale to determine the level of eligibility that applies to your candidate:

  • 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

Our Fitness-to-Work Evaluation Program is available across Canada through our exclusive national testing network to help support employers who have multiple work sites throughout the country. No matter where the testing takes place, SureHire ensures nationwide consistency is maintained through standardized training, testing equipment, and protocols.

Click here for SureHire's Fitness-to-Work position statement.

Certified Technicians

The SureHire Fitness-to-Work team is comprised of qualified health practitioners whose designations include physical therapists, chiropractors, certified athletic therapists, and physicians. These medical professionals have extensive knowledge with respect to the physical demands of the job, medical and musculoskeletal condition, strength, and mobility limitations.

SureHire provides a recommendation to hire by providing employers with an accurate picture of your candidate’s medical, musculoskeletal, and critical strength and mobility status, ensuring they are physically qualified for the position. This can improve your organization's workplace safety and reduce lost-time incidents by helping employers effectively place the right person in the right job.

When can I test?

It is the responsibility of the employer to inform workers of any potential hazards they may be exposed to on the job site and to protect their overall well-being. Fitness-to-Work assessments can help give employers the peace of mind of knowing workers are physically capable of completing the requirements of their positions, thus reducing the risk of accidents or injuries.


Booking a Fitness-to-Work test is simple. Get in touch with us:

Our Contact Centre Agents can assist you with finding the most convenient location within our extensive Canada-Wide network of facilities.


Results notifications are provided same business day - any further information that may be required will always be documented in SureLink, SureHire's online appointment and results portal.



  • 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.


  • 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.

Before starting a new position, it's important to know if you are physically fit to deal with any job tasks or challenges that may arise. A Fitness-to-Work Evaluation reviews your medical, musculoskeletal, and critical strength and mobility status to make sure you are physically capable of the requirements of the job you're applying for. This helps to improve workplace safety and reduce the chance of accidents or injuries.

SureHire's Fitness-to-Work Assessment consists of the following steps:

  • 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 to Expect

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

When you arrive for 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.

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 will check 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 desired, a family member or friend may be present during this exam to increase your level of comfort.

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.)

How to Prepare

  • Dress appropriately: bring shorts, a t-shirt, and closed-toed shoes. Bare feet and sandals are not allowed. It is also recommended that women come prepared wearing a tank top or sports bra.
  • Try to get a full 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, it is a good idea to bring your own water bottle as well.
  • 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, you should commute 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.

Know Your Rights

Your consent and release form states that you, as the candidate, are authorizing SureHire to use the information from the Fitness-to-Work assessment to assist your employer in safely managing their workforce. This form allows SureHire to share the Fitness-to-Work information with potential employers to safely manage your place 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.



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.


You must bring the following items with you 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/sandals.


If you are stopped at any point during Fitness-to-Work testing, a referral is issued which outlines what is either required or recommended for you to be able to return to SureHire to complete testing.

It is the employer or potential employer’s decision to determine if they you will be re-tested.


  • 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


  • 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.


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.


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. 


Please contact the SureHire Medical Review Department at 1-866-315-6860 Monday to Friday from 7:00 am to 6:00 pm MST.

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