Forms

The need for any of the following forms depends on the department’s identification of specific job duties covered by the University of Florida’s Occupational Medicine Program. This can be done both during the hire process and during a change of duties process.

For those individuals hired on a specific position, the job duties are identified by position number in myUFL’s position information on the UF Hr Position Data tab.
(Navigation: Organizational Development, Position Management, Maintain Positions/Budgets, Add/Update Position Info)

For those individuals hired with no position attached (OPS or volunteers), the job duties are identified outside of PeopleSoft on the form
Job-Related Health Risk Checklist for Individuals Not On Positions (see INOP Form below).

JOB DUTY

FORMS

All job duties for positions assigned numbers Acrobat Supervisor Checklist for determining need for health assessment
All job duties for OPS and volunteers Acrobat lNOP Form (Individuals Not On Positions)
All job duties Acrobat Candidate Waiver Request   Word Word
All job duties for outside the Gainesville area Acrobat Fax Cover Sheet (for Medical Record Transfer)
All job duties except Animal Contact,
Contact with Human Blood, Noise and Patient Contact
Acrobat Physical Exam and Medical History
Animal Contact Acrobat Risk Assessment for Animal Contact   Word Word

Acrobat Renewal Risk Assessment for Animal Contact   Word Word

Asbestos Work Acrobat Initial Medical Questionnaire

Acrobat Periodic Medical Questionnaire

BioPath (Human Pathogen Research) BioPath: Biohazard Medical Monitoring Authorization Form
(as fillable Word template)

Acrobat BioPath: Biohazard Medical Assessment Questionnaire

Acrobat BioPath: Biohazard Medical Monitoring Renewal Form

Contact with Human Blood or OPIM Acrobat Training and Vaccination Form
Law Enforcement Acrobat Hepatitis A Vaccination Form
Noise Acrobat New Hire Questionnaire

Acrobat Medical Update Form

Patient Contact Acrobat Preplacement Screening Patient Contact Form

Acrobat N-95 Respirators Medical History Questionnaire

Acrobat TB Surveillance Form

Patient Contact for Residents Acrobat Preplacement Screening Patient Contact Form

Acrobat N-95 Respirators Medical History Questionnaire

Acrobat TB Surveillance Form

Pesticide Use Acrobat Annual Medical History Questionnaire for Pesticide Use
Respirator Use Acrobat Review for Respirator Use

Acrobat Review for Respirator Use

Acrobat Initial Medical Questionnaire for Respirator Use

Acrobat N-95 Respirators Medical History Questionnaire

Acrobat Annual/Periodic Medical History Questionnaire for Respirator Use

Acrobat Medical History Questionnaire for PAPR Hood-Type Respirators

Scientific Research Diving Acrobat Diver Medical Evaluation of Fitness   Word Word

Acrobat Diver Medical History   Word Word

[Use the Same forms for both Preplacement and Periodic Requirements]