In brief
As a rule, the pre-employment report is obtained from the workplace physician. Only less hazardous workplaces with fewer than 50 employees may also obtain the report from a ÇASMER, a family doctor or other public health service providers. In hazardous and very hazardous jobs nobody may start work without a report; the cost of examinations and tests is borne by the employer in every case and cannot be passed on to the employee.
The short answer: look at two questions
Telling a candidate about to start a new job to "get a medical report from your family doctor and bring it in" is still a common habit. Yet the answer to the question of where a pre-employment medical report is obtained depends not on the candidate's preference but on two characteristics of the workplace: hazard class and number of employees. A report obtained from the wrong place may be treated in an inspection as employment without a report, and in hazardous jobs it makes starting the employee legally impossible.
The source of the rule is Art. 15 of Law No. 6331 on Occupational Health and Safety:
Paragraph 2 of the same article also states: those who will work in jobs in the hazardous and very hazardous classes may not start work without a medical report stating that they are fit for the work they will do.
Where is a pre-employment medical report obtained? Decision table
| Your workplace | Who issues the report? | Note |
|---|---|---|
| Less hazardous, fewer than 50 employees | Workplace physician, ÇASMER, family doctor or other public health service provider | The option gives the employer flexibility; it does not remove the examination obligation |
| Less hazardous, 50 or more employees | Workplace physician only | A family doctor's report is not among the options in the Law |
| Hazardous, regardless of number of employees | Workplace physician only | Nobody may start work without a report |
| Very hazardous, regardless of number of employees | Workplace physician only | Nobody may start work without a report |
Consider two examples from Bursa. A 12-person software office in Nilüfer (62.10.00, less hazardous) can obtain its new employee's report from a family doctor. A 30-person furniture workshop in İnegöl (31.00.01, hazardous), however, must obtain the report only from the workplace physician, even though its headcount is small. If you are not sure of your class, see our article on how to find out your hazard class; you can see your specialist and physician obligation by number of employees with the OHS obligation calculator.
"Workplace physician" here means the physician appointed to your workplace through ISG-KATİP (the Ministry's online OHS registration system): a physician on your own staff or the physician of the OSGB (joint health and safety unit) you use. A report issued at any private health facility that does not come from the workplace physician is not among the options listed in the Law.
What did Law No. 7538 change?
The option of obtaining a report from a family doctor is not new. In 2017, Law No. 7033 extended this flexibility from less hazardous workplaces with fewer than 10 employees to those with fewer than 50. Law No. 7538, which entered into force on 15 January 2025, changed the phrase "also from public service providers or family doctors" in the second sentence of the article to "also from ÇASMERs, family doctors or other public health service providers".
This amendment added the ÇASMER (employee health centre) to the system. According to the definition in the Law, a ÇASMER is a unit under the Ministry of Health, authorised by the Ministry to provide OHS services to workplaces, with the necessary equipment and staff. A ÇASMER medical report, like a family doctor's report, is an alternative to the workplace physician only for less hazardous workplaces with fewer than 50 employees. You need to ask the provincial health directorate whether there is a ÇASMER serving your province.
As a result, the basic rule did not change after Law No. 7538 either: the report is obtained from the workplace physician; the exception is only for small, less hazardous workplaces. We explained the obligations of these workplaces after the Constitutional Court decision in detail in our article on OHS in workplaces with fewer than 50 employees.
The limits of a family doctor's report
Even in a workplace where the pre-employment report can be obtained from a family doctor, you should pay attention to a few points for the report to be useful:
- The report must show fitness for the job. A general statement that someone "is healthy" does not show which job the candidate was assessed for. Give the doctor a short letter describing the work the candidate will do and the risks they will be exposed to: screen work, standing work, lifting, night work, driving and so on.
- The doctor does not know the workplace. The family doctor has not seen your risk assessment. If you do not provide this information, the examination on which the report is based may not cover the real risks of the job.
- Health surveillance does not end with the report. In less hazardous workplaces, the periodic examination is carried out at least every 5 years; for child, young and pregnant employees this interval is at most 6 months. Responsibility for follow-up lies with the employer.
- The examination is repeated on a change of job. When the employee's job changes (for example, moving from the office to the warehouse), the Law requires a new examination; if the hazard level of the work has changed, who issues the report may also change.
Special cases: employers handling OHS themselves, short-term employees
The three situations that generate the most questions in practice are:
An employer who handles OHS services themselves. In a less hazardous workplace with fewer than 50 employees, the employer or their representative may provide the specialist and physician service themselves after completing the Ministry's training and making a declaration on ISG-KATİP. However, Art. 6 of the Law excludes pre-employment and periodic examinations from this option. In other words, the examinations do not fall within the scope of the service the employer takes on; the employer must have the examination carried out by a workplace physician, a ÇASMER, a family doctor or another public health service provider.
Short-term or seasonal employees. The Law does not provide an exception for the pre-employment examination based on length of employment. A seasonal employee hired for a few weeks may not start without a report in a hazardous or very hazardous job either. If you are doing mass hiring before a busy period, plan examination days with your physician in advance.
A report with restrictions. The physician may find the employee fit for work while imposing a specific restriction: no heavy lifting, no work at height or no night shift, for example. Reflecting this restriction in the shift and duty plan is the employer's responsibility; a foreman who does not know about the restriction effectively invalidates the report. Putting the report in the personnel file is not enough; also record that the restriction has been communicated to the relevant supervisor.
Who pays for the pre-employment report?
The Law is clear: under Art. 15/4, the cost of health surveillance and any additional cost arising from it is borne by the employer and cannot be passed on to the employee. This rule does not depend on where the report is obtained. If the candidate paid a fee when obtaining the report from a public health facility, or if there was a charge for the tests the physician requested, this amount is the employer's obligation. Deducting the cost from wages, making the candidate pay it as a condition of hiring or showing a "medical report deduction" on the payslip is contrary to the Law.
Failing to provide health surveillance or obtain a fitness-for-work report is subject to an administrative fine of 22,194 TL per employee in 2026. As this fine is calculated per employee, it is not increased according to workplace size and hazard class; but it is applied separately for each employee without a report. You can find the other amounts on the OHS administrative fines page.
The report process step by step for the employer
- Check the hazard class and number of employees. Who issues the report is determined by these.
- Schedule the examination before the start date. In hazardous and very hazardous jobs, the employee may not start work until the report arrives; add examination and test time to your hiring schedule.
- Give the physician the job description. State clearly the exposures in the risk assessment (noise, dust, chemicals, work at height, night shift).
- The physician decides on tests. Apart from a few firm rules such as for noise and dust, the workplace physician determines which tests are done according to the risk; we plan tests with authorised laboratories and health institutions.
- Receive the result correctly. The employer is told whether the employee is fit for work and any restrictions imposed on their duties; health information such as the diagnosis and test details is kept confidential.
- Keep the record and set up the calendar. The report goes into the personnel file; the periodic examination date is scheduled on the same day.
- Know the objection route. If the employee or the employer wishes to object to the report, the application is made to the referee hospitals designated by the Ministry of Health, and the decision given is final.
For examination intervals and test decisions, see our article on periodic examinations and tests, and for the other obligations of less hazardous workplaces, our guide to less hazardous workplace obligations.
In Bursa and the surrounding provinces, we carry out pre-employment and periodic examinations through the physician appointed to your workplace as part of our health surveillance service; details of physician appointment are on the workplace physician page.
Frequently Asked Questions
Is a pre-employment report from a family doctor valid in every workplace?
No. A family doctor's report is among the options in the Law only for less hazardous workplaces with fewer than 50 employees. In hazardous and very hazardous workplaces, and in less hazardous workplaces with 50 or more employees, the report is obtained from the workplace physician.
Who pays for the pre-employment report?
The employer pays. The cost of health surveillance and any additional cost arising from it is borne by the employer and cannot be passed on to the employee. This rule is the same whether the report is obtained from the workplace physician, a ÇASMER or a family doctor.
Can the employee start work before the report arrives?
Not in jobs in the hazardous and very hazardous classes; the Law explicitly prohibits starting work without a report. The pre-employment examination is also mandatory in less hazardous jobs. Scheduling the examination before the start date is the safest approach in every class.
Can a pre-employment report be challenged?
Yes. Objections to reports are made to the referee hospitals designated by the Ministry of Health, and the decisions given are final. Until the objection is concluded, duty planning should be based on the outcome and restrictions in the existing report.
An exposure-based test plan, pre-employment and periodic examinations, confidential health files and an examination schedule tracked per person.
Bursa SİSTEMER OSGB Technical Team — written from the field experience of our OHS specialists and workplace physicians. Legal information is valid as of the publication/update date; contact us for an assessment specific to your business.