Post Offer Employment Health Questionnaire (4-15-2011) Enterprise Salaried Employees (non-California) The Genetic Information Nondiscrimination Act

of 2008 (GINA) prohibits employers and other entities covered by GINA Title II from requesting or requiring genetic information of an individual or family member of the individual, except as specifically allowed by this law. To comply with this law, we are asking that you not provide any genetic information when responding to this request for medical information. `Genetic information' as defined by GINA, includes an individual's family medical history, the results of an individual's or family member's genetic tests, the fact that an individual or an individual's family member sought or received genetic services, and genetic information of a fetus carried by an individual or an individual's family member or an embryo lawfully held by an individual or family member receiving assistive reproductive services. The Boeing Health Services staff support the health and safety of employees in the workplace. Boeing Health professionals will review this questionnaire in relation to your work assignment to identify potential health concerns and accommodations that you may require to perform the job you have been offered. It is very important that your answers are complete and accurate. Boeing Health professionals maintain the confidentiality of your health information in compliance with applicable laws and regulations. When appropriate, information regarding necessary restrictions on your work and necessary accommodations will be shared with Human Resources or your prospective manager so that we can determine whether you can perform the essential functions of the job and whether or not there an accommodation that will allow you to complete your work assignment within your capabilities. Please Note: Some specific jobs require additional occupational health examinations (such as DOT Driver, respirator user, or vision screening). Boeing Health Services will contact you if an occupational health exam is also required for the job you have been offered. Instructions for Questionnaire: All questions that are answered yes will be followed by an additional question to describe your condition, including dates, any treatment, and whether you require ongoing treatment for your condition. Complete information will help the Boeing nurse to assess if there is a medical concern related to the job you have been offered.

SECTION 1 YES NO Do you currently have:

*Numbness, tingling, pain, weakness, or limited use of one or more hands, wrists, or fingers? *Limited strength, movement, overhead reach, or limited use of one or both arms, elbows, shoulders? *Limited ability to stand or walk at work? *Limitation in lifting, bending, twisting, or ability to work overhead? *Sensitivity, irritation, allergy or reaction to any chemical? *Any vision problems not corrected by glasses or contact lens? *Any limitations to hearing that require accommodation? *Any condition that has resulted in the implantation of an electronic medical device (e.g., cardiac pacemaker, automatic defibrillator, nerve stimulator, insulin pump, cochlear implant)? *Any medical condition requiring surgery, hospitalization or leave of absence (other than uncomplicated childbirth) within the last three years? *Do you currently take any prescribed medications?

SECTION 2 YES NO Have you ever had:

*Restrictions for any type of work for medical reasons? *Periodic physical examinations because of your work duties or exposures? *Any work-related injury or illness? *Any medical condition for which you received a medical discharge or disability from military service or from prior employment

SECTION 3 YES NO The following questions are specific to the job for which you have been offered:
*Do you have any medical conditions or limitations which would keep you from performing the functions of the job for

which you have been offered? *Do you require any modifications of the job in order to perform the functions of the job you have been offered? *Do you have any specific medical conditions which you think might affect your ability to perform your job safely? *Do you have any health concerns about the Boeing job you have been offered? *Do you currently have a condition that would prevent you from regular and predictable job attendance?

I have answered the questions and certify that all my answers are true and correct. I understand that misrepresentations or deliberate omissions of relevant information are sufficient grounds for denying employment or for dismissal. Schroder, Tyler (On File) 04/08/2013 Signature Date (month/day/year)