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	Supervisor Checklist for determining need for health assessment
All job duties for OPS and volunteers	lNOP Form (Individuals Not On Positions)
All job duties	Candidate Waiver Request   Word
All job duties for outside the Gainesville area	Fax Cover Sheet (for Medical Record Transfer)
All job duties except Animal Contact,   Contact with Human Blood, Noise and Patient Contact	Physical Exam and Medical History
Animal Contact	Risk Assessment for Animal Contact   Word Renewal Risk Assessment for Animal Contact   Word
Asbestos Work	Initial Medical Questionnaire Periodic Medical Questionnaire
BioPath (Human Pathogen Research)	BioPath: Biohazard Medical Monitoring Authorization Form BioPath: Biohazard Medical Assessment Questionnaire  BioPath: Biohazard Medical Monitoring Renewal Form
Contact with Human Blood or OPIM	Training and Vaccination Form
Law Enforcement	Hepatitis A Vaccination Form
Noise	New Hire Questionnaire Medical Update Form
Patient Contact	Preplacement Screening Patient Contact Form N-95 Respirators Medical History Questionnaire TB Surveillance Form
Patient Contact for Residents	Preplacement Screening Patient Contact Form N-95 Respirators Medical History Questionnaire   TB Surveillance Form
Pesticide Use	Annual Medical History Questionnaire for Pesticide Use
Respirator Use	Request for Respirator Use Initial Medical Questionnaire for Respirator Use N-95 Respirators Medical History Questionnaire Annual/Periodic Medical History Questionnaire for Respirator Use
Scientific Research Diving	Medical Evaluation of Fitness for SCUBA Diving Report SCUBA Diving Medical History  [Use the Same forms for both Preplacement and Periodic Requirements]