OCCMED 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). Health Assessment Matrix can be filtered for applicable job duties and display one-page worksheet.
UF Employee Preplacement Health Assessments: Policies and Procedures lists job duties and health assessment components. OCCMED Clinic requires submission of the Payment Authorization Form prior to scheduling appointment in order for services to be rendered.
Please read instructions and fill out forms carefully! Failure to complete forms correctly may delay processing.
Save a completed copy of the form for your records before submission/e-mailing.
As a best practice for fillable .pdf files:
- “Save As” with appropriate name to your PC to download form
- Complete using Acrobat Reader and Save
- Click “submit” to open email
- Attach if necessary and Send
DESCRIPTION |
FORMS |
| All job duties for OPS and Volunteers | INOP Form (Individuals Not On Positions) |
| All job duties for Positions Assigned Numbers | Supervisor Checklist for determining need for health assessment |
| Animal Contact | Do not make any changes to page 1 of Animal Contact form after supervisor signature is entered. Risk Assessment for Animal Contact Risk Assessment for Animal Contact – VetMed Only |
| Asbestos Work | Medical Questionnaire |
| Biopath (Work with risk group 3 agents in a BSL3 laboratory) | BioPath: Biohazard Medical Monitoring Authorization Form BioPath: Biohazard Medical Assessment Questionnaire OneStop Medical Auth Form |
| Bloodborne Pathogens (BBP) or OPIM | Training and Vaccination Form |
| CareSpot Authorization | Carespot Authorization Form (Interactive PDF with links to definitions and descriptions) |
| Fax Cover | Fax Cover Sheet (for Medical Record Transfer) |
| Hearing Conservation (Excessive Noise) | New Hire Questionnaire Word.docx |
| Patient Contact | Post Offer Screening Patient Contact Form – UF Employee/Volunteer Post Offer Screening Patient Contact Form – Residents TB Surveillance Form |
| Physical/Exam | Medical History Form Physical Exam Form |
| Respirator Use | Review for Respirator Use |
| Scientific Research Diving | Diver Medical Evaluation of Fitness | Word Diver Medical History [Use the Same forms for both Preplacement and Periodic Requirements] |
| Waiver Request | Candidate Waiver Request Word |