To be covered under any employer's employment group insurance, a typical job application form will have a 'Declaration' section at the end of the form just before your signature, which usually read,
"Have you been or are you suffering from any medical condition/
disease/ illness/ major medical condition/ mental disorder or
physical impairment?"
"Yes/ No"
"If your answer to any of the above is yes, please give details in
the space provided."
I declare that all information given herein are true and
correct. I understand that a misrepresentation or omission of facts
will be sufficient cause for cancellation of consideration for
employment or dismissal from the Company’s service if I have been
employed.
(Signature)
(Date)