FIU MEDICAL SURVEILLANCE PROGRAM HEALTH QUESTIONNAIRE FOR EMPLOYEES WITH ANIMAL CONTACT 2025

See details

4 out of 5

38 votes

The document is a health questionnaire for employees at FIU who have contact with animals. It collects personal information, occupational history, latex history, infectious diseases, and medical history to assess the health risks associated with animal handling. Employees are instructed to take the completed form to their medical provider rather than returning it to Environmental Health & Safety.

Here's how it works

01. Edit your fiu ehs online

Type text, add images, blackout confidential details, add comments, highlights and more.

02. Sign it in a few clicks

Draw your signature, type it, upload its image, or use your mobile device as a signature pad.

03. Share your form with others

Send it via email, link, or fax. You can also download it, export it or print it out.

How to use or fill out FIU MEDICAL SURVEILLANCE PROGRAM HEALTH QUESTIONNAIRE FOR EMPLOYEES WITH ANIMAL CONTACT

Ease of Setup

DocHub User Ratings on G2

Ease of Use

DocHub User Ratings on G2

Click ‘Get Form’ to open it in the editor.
Begin by entering your personal information, including your name, date, Panther ID, position, date of birth, and contact details. Ensure accuracy as this information is crucial for your medical provider.
Proceed to the Occupational History section. Answer questions regarding your job duties and any previous occupational illnesses or injuries. Be thorough in detailing any animal species you may work with.
In the Latex History section, respond to questions about any allergic reactions you may have experienced. This is important for your safety and health assessments.
Complete the Infectious Diseases section by indicating any relevant medical history related to tuberculosis and other infectious diseases. Provide dates for tests and treatments where applicable.
Finally, fill out the Medical History section carefully. Include current health problems, medications, allergies, and any necessary work accommodations.

Start using our platform today to complete your questionnaire easily and efficiently!

See more FIU MEDICAL SURVEILLANCE PROGRAM HEALTH QUESTIONNAIRE FOR EMPLOYEES WITH ANIMAL CONTACT versions

We've got more versions of the FIU MEDICAL SURVEILLANCE PROGRAM HEALTH QUESTIONNAIRE FOR EMPLOYEES WITH ANIMAL CONTACT form. Select the right FIU MEDICAL SURVEILLANCE PROGRAM HEALTH QUESTIONNAIRE FOR EMPLOYEES WITH ANIMAL CONTACT version from the list and start editing it straight away!

Versions	Form popularity	Fillable & printable
2013	4 Satisfied (38 Votes)

be ready to get more

Complete this form in 5 minutes or less

Get form

Got questions?

We have answers to the most popular questions from our customers. If you can't find an answer to your question, please contact us.

What are the four components of a medical surveillance program?

Health Surveillance and Health Monitoring This can involve medical examination, medical imaging, pathology and other types of testing (such as audiometry or spirometry), or a combination of these depending on the type of hazard/s involved.

What should medical surveillance exams include?

However OSHA medical surveillance requirements are generally clinically focused (e.g.,medical and work histories, physical assessment, biological testing) with information obtained from the clinical processes used in the monitoring and analysis elements of medical surveillance.

What can trigger a medical surveillance program?

Some laboratory activities that might trigger medical surveillance include: Work with laboratory animals. Use of a respirator. Work with lasers. Work with bloodborne pathogens. Work with carcinogens. Work with noise-producing equipment that exceeds 85 dBA as an 8 hr-time weighted average.

What does medical surveillance include?

The components of a medical surveillance program include: Identifying workers for whom surveillance is needed. Identifying potential hazards and assessing the risk of exposure. Selecting appropriate tests and examinations. Conducting initial tests and examinations along with medical and occupational histories.

How often do employees in the medical surveillance program get tested for lead?

Unless an employees exposure to lead or work with lead falls under one the exceptions described above, blood lead testing under the standard must be provided on the following schedule: at least every two months for the first six months after initial placement, and also for the six months after any change in task

What must an employer give an examining physician as part of a medical surveillance program?

The employer must provide examining and consulting physicians with the following specific information: a copy of the lead regulations and all appendices, a description of the employees duties as related to exposure, the exposure level to lead and any other toxic substances (if applicable), a description of personal

FIU MEDICAL SURVEILLANCE PROGRAM HEALTH QUESTIONNAIRE FOR EMPLOYEES WITH ANIMAL CONTACT 2025

Here's how it works

How to use or fill out FIU MEDICAL SURVEILLANCE PROGRAM HEALTH QUESTIONNAIRE FOR EMPLOYEES WITH ANIMAL CONTACT

See more FIU MEDICAL SURVEILLANCE PROGRAM HEALTH QUESTIONNAIRE FOR EMPLOYEES WITH ANIMAL CONTACT versions

Complete this form in 5 minutes or less

Got questions?

What are the four components of a medical surveillance program?

What should medical surveillance exams include?

What can trigger a medical surveillance program?

What does medical surveillance include?

How often do employees in the medical surveillance program get tested for lead?

Complete this form in 5 minutes or less

People also ask

What must an employer give an examining physician as part of a medical surveillance program?

Related links

Try more PDF tools

FIU MEDICAL SURVEILLANCE PROGRAM HEALTH QUESTIONNAIRE FOR EMPLOYEES WITH ANIMAL CONTACT 2025

Here's how it works

How to use or fill out FIU MEDICAL SURVEILLANCE PROGRAM HEALTH QUESTIONNAIRE FOR EMPLOYEES WITH ANIMAL CONTACT

See more FIU MEDICAL SURVEILLANCE PROGRAM HEALTH QUESTIONNAIRE FOR EMPLOYEES WITH ANIMAL CONTACT versions

Complete this form in 5 minutes or less

Got questions?

What are the four components of a medical surveillance program?

What should medical surveillance exams include?

What can trigger a medical surveillance program?

What does medical surveillance include?

How often do employees in the medical surveillance program get tested for lead?

Related Searches

Related forms

Complete this form in 5 minutes or less

People also ask

What must an employer give an examining physician as part of a medical surveillance program?

Related links

Try more PDF tools