Get Employee Occupational Exposure Incident Form (pdf - Mtech

This guide will assist you in accurately completing the Employee Occupational Exposure Incident Form, a crucial document for reporting work-related exposure incidents. Following the provided instructions will help ensure that the necessary information is submitted correctly and efficiently.

Follow the steps to fill out the Employee Occupational Exposure Incident Form online:

1. Click ‘Get Form’ button to obtain the form and open it in the editor.
2. Begin by filling in the employee name and Social Security Number (SSN) in the designated fields to identify the individual involved.
3. Enter the date of the incident as well as the date the incident was reported to ensure proper tracking and documentation.
4. Specify the department or building where the incident took place, along with the job title of the employee to provide relevant context.
5. Select the type of exposure from the list provided, checking off the appropriate options that best describe the incident.
6. In the section labeled 'Describe exposure incident in detail', provide a thorough description of how the incident occurred.
7. Detail what actions were taken immediately following the incident to address the exposure.
8. Check all precautions that were in use at the time of the incident to ensure compliance with safety protocols.
9. List the dates of any Hepatitis B vaccinations received by the employee to document their immunization status.
10. Have the employee sign and date the form, confirming that the information provided is accurate.
11. Request the supervisor to sign and date the form, validating the report.
12. For follow-up, check the appropriate boxes regarding the referral to a physician, blood draw, and HIV testing offer, ensuring all post-incident procedures are documented.
13. Finally, review all entered information for completeness and accuracy before saving changes, downloading, printing, or sharing the completed form.

Complete the Employee Occupational Exposure Incident Form online to ensure safety and compliance.