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:

  1. “Save As” with appropriate name to your PC to download form
  2. Complete using Acrobat Reader and Save
  3. Click “submit” to open email
  4. Attach if necessary and Send



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 AcrobatCover Sheet (for Medical Record Transfer)

Acrobat Physical Exam (outside the Gainesville area)

All job duties except Animal Contact,
Contact with Human Blood, Noise and Patient Contact
Acrobat Physical Exam and Medical History
Animal Contact Do not make any changes to page 1 of Animal Contact form after supervisor signature is entered.

Acrobat Risk Assessment for Animal Contact

Acrobat Risk Assessment for Animal Contact – VetMed Only

Asbestos Work Acrobat Medical Questionnaire

Acrobat Review for Respirator Use

Acrobat Initial & Annual Medical Questionnaire for Respirator Use

BioPath (Work with risk group 3 agents in a BSL3 laboratory) Acrobat BioPath: Biohazard Medical Monitoring Authorization Form

Acrobat BioPath: Biohazard Medical Assessment Questionnaire

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

Acrobat Medical Update Form

Patient Contact Acrobat Post Offer Screening Patient Contact Form

Acrobat Respirator Medical History Questionnaire

Acrobat TB Surveillance Form

Patient Contact for Residents Acrobat Post Offer Screening Patient Contact Form

Acrobat TB Surveillance Form

Pesticide Use Acrobat Medical History Questionnaire for Pesticide Use has been combined with the Respirator Medical Questionnaire
Respirator Use Acrobat Review for Respirator Use

Acrobat Initial & Annual Medical Questionnaire for Respirator Use

Acrobat Initial & Annual Medical Questionnaire for Respirator Use for Vet Med only

Scientific Research Diving Acrobat Diver Medical Evaluation of Fitness   Word Word

Acrobat Diver Medical History

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