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Ny volunteer fire transmission

Volunteer notification 2026

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4.9 out of 5

213 votes

The document is a notification form for volunteer firefighters and ambulance workers in New York, informing their executive officers of potential exposure to HIV while on duty. It outlines the requirement for medical examination authorization within 8 hours of exposure and includes instructions for both the volunteer and the executive officer regarding reporting and privacy protections.

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Click ‘Get Form’ to open the volunteer notification in the editor.
Begin by entering the 'Name of Volunteer Firefighter/Ambulance Worker' and their 'Date of Birth' in the designated fields.
Fill in the 'Residential Address' and 'Social Security No.' to ensure proper identification.
Provide a contact 'Telephone Number' and, if applicable, a different 'Mailing Address'.
Specify the 'Name and Address of Fire/Ambulance Company' where you serve.
Document the 'Date and Time of Exposure', along with any 'Specific Parts of Body Exposed'.
Indicate the 'Address Where Exposure Occurred' and list any potential 'Witnesses'.
Describe how the exposure occurred in the provided space.
Sign and date the form at the bottom as a confirmation of your submission.

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Versions	Form popularity	Fillable & printable
2011	4.9 Satisfied (213 Votes)

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