Exposure Form - Edison Fire Fighters Association IAFF Local 1197 - iafflocal3249-2026

1. Click ‘Get Form’ to open it in the editor.
2. Begin by entering your Local Union Number and Name at the top of the form. Ensure accuracy as this information is crucial for identification.
3. Fill in your Social Security Number, Incident Date, Alarm Time, and Incident Time in the designated fields. This data helps track exposure incidents effectively.
4. In Section I, check the appropriate box for the type of incident or exposure you experienced. Provide additional details about the structure involved if necessary.
5. For Section II, indicate the length of exposure during various fire stages and activities by writing in the minutes or hours exposed.
6. In Section III, assess smoke conditions and chemical exposures. Select options that best describe your experience and provide comments if needed.
7. Document any symptoms experienced during and after the incident in Section IV. Be thorough to ensure proper medical follow-up.
8. Complete Sections V through VII with relevant medical diagnoses, protective equipment used, and co-workers present during exposure.

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