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- Click ‘Get Form’ to open it in the editor.
- Begin by entering your personal information in the designated fields, including your name, EID#, and date of birth. Ensure all sections are filled out electronically for clarity.
- Complete the immunization review section by providing details about your vaccinations. If you have documentation, upload it directly through our platform.
- For residents, select your job title and department from the dropdown menus. Make sure to circle your status accurately.
- If you are a visiting resident, indicate your dates of stay clearly. Remember to sign the form using an approved electronic signature if applicable.
- Review all entered information for accuracy before submitting. If you have questions, contact Occupational Health Services at the provided phone number.
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