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TitleShort DescriptionEHS ProgramContact
Accident Report Form FlowchartFlow chart outlining all forms to complete for an occupational accidental incidentOccupational Health919-515-6852
Amendment for BUA formForm to submit amendment(s) to Biosafety for a Biological Use AuthorizationBiosafety919-515-6858
Autoclave Performance Verification Log For Biohazard WasteAutoclave Performance Verification Log For Biohazard WasteBiosafety919-515-6858
Biological Inventory Sample FormDownload this document as a sample of biological inventoryBiosafety919-515-6858
Biological Material Shipping ChartStep by step process for shipping any biological materialBiosafety919-515-3695
Biological Use Authorization (BUA) formRegistration and approval for use of biological materialsBiosafety919-515-6858
Biosafety Cabinet Out of ServiceBiosafety cabinets must be posted prominently with this form if the unit goes into alarm, needs service for any reason, upon setting up or moving a biosafety cabinet prior to certification, or if the units last certification is beyond 12 months.Biosafety919-515-6858
Biosafety Clearance FormClearance for maintenance/surplus of biosafety cabinets, freezers, fridges, incubators, etc.Biosafety919-515-6858
Biosafety in Teaching LabsForm to be completed by the Course Instructor and submitted with the Biological Use Authorization for courses that require level 2 containment.Biosafety919-515-6858
BSL-2 Checklist
The checklist is required to ensure that laboratories meet basic requirements at the federal, state, and local levels for work at biosafety level 2 (BSL-2).Biosafety919-515-6858
Chemical Hood Owner Reference InformationInforms users about the fume hood program and their responsibilities in using and maintain a safe and dependable fume hoodLab Safety919-513-1282
EHS Equipment And Process Approval (QR) Form QR17-001EHS Equipment And Process Approval (QR) FormLab Safety919-515-1282
Exam Request and Authorization For Release Of Medical Information Form The forms to been seen by a doctor for an Occupational Medicine Exam and the release of the exam resultsOccupational Health919-515-6862
Fume Hood Project Tracking FormFume hood installation/renovation project tracking formLab Safety919-513-1282
Hazardous Waste Experiment In Progress LabelEnvironmental Affairs919-515-6859
Hazardous Waste LabelEnvironmental Affairs919-515-6859
Hearing Conservation Program LogFillable form for logging hearing protection use and requirementOccupational Health919-515-6862
Laboratory Relocation Guidance and Start-up Checklistforms can be used to open a new lab, close or move your existing laboratory space on campusLab Safety919-515-6860
Periodic InspectionsRequirements and forms for annual inspections of lockout/tagout devicesOccupational Safety919-515-0988
Medical SurveillancePurpose of medical surveillance is early identification of conditions, that could present an increased risk of adverse health effects related to the task being performed.Occupational Health919-515-6862
Minors As Volunteer Workers Involved In Field, Laboratory, or Teaching ActivitiesFor persons under 18 years of age this document contains the release of lability and waiver claim, and outlines the proper training requirements Administration919-515-6860
New Principal Investigators & Lab ManagersOutlines the forms required during the application process to use radioactive materials (excluding human or animal use)Radiation Safety919-515-2894
OCCUPATIONAL MEDICINE PROGRAM HEP B DECLINATION FORMAcknowledging the risk of not vaccinating for HEP BBiosafety919-515-6858
Part D: Biological Agents Section of BUAUse the Part D as indicated in the instructions of the BUA.Biosafety919-515-6858
Radiation Safety FormsSummary of all the Radiation Safety FormsRadiation Safety919-515-2894
Requirements For Startup of BSL-3 FacilitiesThis form provides a summary of key steps to verify new BSL-3 facilities meet university requirements.Biosafety919-515-6858
RS-1/RS-2: Instruction For The Completion of RS-2/ Application For Non-Human Use of Radioactive MaterialThis form is for researchers desiring to use radioactive materials in a laboratory settingRadiation Safety919-515-2894
RS-3: Radiation Worker Registration FormThis form is used for new employees who will be working with radioactive materials or radiation-producing devicesRadiation Safety919-515-2894
RS-4: Dosimetry Service Assessment and Exposure History FormThis form is used to determine what dosimetry is appropriate for each worker and to obtain any prior exposure recordsRadiation Safety919-515-2894
RS-5: Radioactive Material Authorization Amendment FormThis form may be used to amend an approved protocolRadiation Safety919-515-2894
RS-6: Application For Radiation Material Use In AnimalsRThis form is to be used for new researchers wishing to use radioactive materials in animalsRadiation Safety919-515-2894
RS-7: Radioactive Material Package Receipt Information Form used to certify that radioactive materials are properly classified, described, packaged, marked and labeled, and are in proper condition for transportation Radiation Safety919-515-2894
RS-8: Radioactive Material Log of UseThis form will be issued with every primary vial of unsealed radioactive materialRadiation Safety919-515-2894
RS-9: Laboratory Contamination Survey RecordThis form may be used for monthly contamination surveys in the laboratoryRadiation Safety919-515-2894
RS-10A: CVM VTH Radiation Producing Device Authorization FormThis form should be used for research involving animals and radiation-producing devices within the College of Veterinary MedicineRadiation Safety919-515-2894
RS-10A: CVM VTH Radiation Producing Device Authorization Form;/aThis form should be used when acquiring radiation-producing devicesRadiation Safety919-515-2894
RS-11: Pregnancy Declaration, Instruction & Dosimetry Evaluation This form is used to formally declare a pregnancy to the Radiation Safety Office through voluntary means. Other paperwork and further consultation may be required at that time.Radiation Safety919-515-2894
RS-12: Radiation Safety Administrative Amendment Form used to indicate a charge of status for principal InvestigatorsRadiation Safety919-515-2894
Safety Feature Evaluation of Safety SyringesForm to document annual review according to the OSHA bloodborne pathogens standard if listed in your BBP Exposure Control Plan.Biosafety919-515-6858
Sample Biological InventoryUse this form to maintain a formal inventory of all biological material received and sentBiosafety919-515-6858
Shipping Declaration Papers For Dangerous GoodsGuidance/example shipping forms for dangerous/hazardous materialsLab Safety919-515-3695
Skin Protection in Laboratories Yes/No form for analyzing skin protection needs in a laboratoryLab Safety919-515-1282
Stormwater Exposure Management Program Annual Facility Evaluation and CertificationYearly program that ensures proper stormwater management for a given facilityEnvironmental Affairs919-515-6859
Supervisor's Safety Self-Assessment ChecklistThis checklist is a tool to aid the supervisor and their employees in identifying those activities and conditions that need attention to achieve and maintain a safe work environmentLab Safety919-515-6860
Volunteer Workers Involved In Field, Laboratory, or Teaching ActivitiesContains the release of lability and waiver claim, and outlines the proper training requirements Lab safety919-515-6860
Waste - Weekly Inspection LogEnvironmental Affairs919-515-6859
Waste management planEnvironmental Affairs919-515-6859
Waste type formEnvironmental Affairs919-515-6859