Employee Occupational Exposure Incident Form (pdf - mtech 2026

1. Click ‘Get Form’ to open the Employee Occupational Exposure Incident Form in the editor.
2. Begin by entering your personal information in the designated fields, including your name, SSN, date, department/building, and job title.
3. Fill in the incident details by specifying the date of the incident and when it was reported.
4. Select the type of exposure from the provided options. If applicable, describe any other exposure not listed.
5. In the section for describing the exposure incident, provide a detailed account of what occurred.
6. Document any immediate actions taken following the incident and check all precautions that were in use at that time.
7. Complete the vaccination dates for HBV and ensure both employee and supervisor signatures are added along with their respective dates.
8. Finally, indicate whether a follow-up was conducted regarding physician referrals and testing acceptance.

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