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How to use or fill out FIU MEDICAL SURVEILLANCE PROGRAM HEALTH QUESTIONNAIRE FOR EMPLOYEES WITH ANIMAL CONTACT
- 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.
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| Versions | Form popularity | Fillable & printable |
|---|---|---|
| 2013 | 4 Satisfied (38 Votes) |
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