OCCUPATIONAL HEALTH ENROLLMENT FORM - uh 2026

1. Click ‘Get Form’ to open the OCCUPATIONAL HEALTH ENROLLMENT FORM in the editor.
2. Begin by filling in your personal details, including your name, date of birth, and contact information. Ensure all entries are clear and legible.
3. Indicate your supervisor or sponsoring agency, along with your job title and department. This helps maintain accurate records for your enrollment.
4. In the Animal/Biological Agent Contact section, check all applicable boxes regarding the animals you work with and any biological agents involved in your research.
5. Complete the Medical History section by answering questions about your health conditions honestly. This information is crucial for ensuring your safety.
6. Review the Animal Allergies section carefully. Mark any symptoms you have experienced and specify if they are work-related.
7. Finally, sign and date the form to confirm your enrollment or declination in the Occupational Health Program before submitting it via fax as instructed.

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