Blooborne pathogen expusre form 2025

1. Click ‘Get Form’ to open it in the editor.
2. Begin by entering the 'Date of Report' and 'Time of Report' at the top of the form. This information is crucial for tracking exposure incidents.
3. Fill in your personal details, including your name, sex, social security number, address, date of birth, and contact numbers. Ensure accuracy as this information is vital for follow-up.
4. Indicate your status at the time of exposure (Employee, Student, Faculty, or Other) and provide your job title along with duties related to the exposure.
5. Answer questions regarding hepatitis B immunization status and provide dates if applicable. This section helps assess risk levels.
6. Document details about the exposure incident including location, date, time, and whether it occurred during university employment.
7. List any witnesses present and describe personal protective equipment used at the time of exposure.
8. Complete sections on type and severity of exposure, source individual details if known, and describe activities leading to exposure.
9. Finally, detail immediate interventions taken post-exposure and provide your signature along with contact information before submitting the form.

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