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Get Pregnancy Risk Assessment

Been certified pregnant? Have you notified your Manager? Yes No Yes No Expected due Date Date of Assessment Section 2: Preliminary Job Assessment (To filled out by the employee and her manager) Does the employee s work involve exposure to or work with any of the following? YES NO Excessive noise Chemicals (drugs, specific chemicals such as lead, pesticide, Lab chemicals with the following Risk Phrases R40, R45, R61, R63 and R64) Biological Agents (in particular infectious diseases) Na.

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