The Self-Assessment Medical Form

I don't think that a lot of people think too much about the Self-Assessment Medical Form very early on. It seems simple and not one or the top concerns. It certainly isn't the big ordeal that references or your SoP are, but it is just as important to have done and done correctly. So, I figure I'll put this up here so that people can take a look and know whether or not they will need to get a doctor's appointment or the Physician's Form or whatever else. Here is what the Self-Assessment Medical Form asked last year.

Name
Interview Location
Date of Birth
To the Applicant: (long thing I won't put here)
Important Note: If you have ever had any physical or mental condition/illness (including, but not limited to, those listed in Question 3,4, or 5) you must use the attached Physician's Form. In this form, your physician must state whether or not you are fit to participate in the JET Program, and as such, to live and work overseas.
1. When and for what reason did you last consult a physician? (Colds, fevers, and visits to OB/GYN facilities or consultations for the requesting of contraception may be omitted.)
2a. What diseases, ailments, or injuries have you had in the past five years? If any of these resulted in hospitalization, please give details as to when, why, and the duration of the treatment.
2b. What is your current status with regards to the condition(s) detailed above?
3. Are you currently seeing a physician and/or undergoing treatment of any kind? If yes, please detail below AND have your doctor fill out the Physician's Form.
4. Have you ever been diagnosed and/or treated for any nervous or mental condition (including, but not limited to, anxiety, depression, ADD, ADHD, and/or eating disorders)? If yes, you must detail below AND have your doctor fill our the Physician's Form. Please note that we may contact your doctor if further information is necessary.
5. Have you ever been diagnosed and/or treated for any other illness or condition previously undisclosed on this Medical Form (including physical conditions, but excluding minor colds, feversm sprains)? If yes, you must detail below AND have your doctor fill out the Physician's Form.
6. Do you foresee any physical challenges resulting from the need to go up and down several flights of stairs on a daily basis? If yes, please explain.
7. What allergies do you have, if any? Are you currently being treated? If so, how?
8. If you are currently taking, or have taken in the last five years, any prescription medication other than oral contraceptives, please give details (including medication's name, purpose, and dates taken). Make sure to describe the condition(s) for which you have taken any medications listed here in questions 4 and/or 6, above.
9. Are there any foods, which, for medical or personal reasons, you do not eat? If yes, please give details.
10. Please explain any other health-related issues or disabilities that you have below (i.e. if you are legally blind/deaf, use a wheelchair, etc.).
Signature and Date

Hopefully this can help you make sure you have a doctor's appointment if needed and prepare you to get your Physician's Form if you need one. I got one last year because I am severely allergic to peanuts, cherries, and apples (as in anaphylaxis) , so I have to carry an Epi-Pen. The general rule with medical stuff is to disclose it, if you have to ask because it is better to be safe than sorry. You don't want to seem like you were hiding something or be disqualified because you didn't disclose something that you should have. This information can also be really important for you because it can help make sure you get placed near the help you will need.