Requiring medical intervention: Topics by Science 2026

1. Click ‘Get Form’ to open it in the editor.
2. Begin by entering your general student information, including your name, contact number, email address, and today's date.
3. In the exposure information section, provide the date and time of exposure. Notify your faculty/preceptor and document when they were informed.
4. Describe the incident briefly in the designated field. Specify the location of the exposure from the provided options.
5. Indicate the type of injury/exposure by selecting from the list of options such as needlestick exposure or high-risk body fluid.
6. Document what precautions were in use at the time of the incident, selecting all that apply.
7. Complete the source information section regarding HIV and Hepatitis status if applicable.
8. Outline your follow-up plan by providing details for your primary care provider or any urgent care appointments scheduled.
9. Finally, sign and date at the bottom of the form before submitting it to ensure proper documentation.

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