Get Annual Health Review Request Form - Research Drexel

Filling out the Annual Health Review Request Form is an essential step for conducting research at Drexel University. This guide will provide you with detailed instructions to ensure that your form is completed accurately and efficiently.

Follow the steps to fill out your form correctly.

1. Press the ‘Get Form’ button to obtain the form and open it in your preferred document editor.
2. Enter today's date in the designated 'Date' field at the top of the form.
3. Fill in your email address in the 'Email' section to ensure that you can be contacted.
4. Provide your full name in the 'Name' field.
5. Input your telephone number in the 'Telephone' section so that it can be referenced if needed.
6. Specify the department in which you will be working in the 'Department' field.
7. Indicate the location where the research will be performed by filling out the 'Building Name' and 'Room Number' fields.
8. Enter the Principal Investigator’s (PI) name and their telephone number in the corresponding fields.
9. Check the box if this is your first Annual Health Review.
10. Check the box if you do not handle or work near laboratory animals.
11. Fill in your date of hire in the 'Date of Hire' section.
12. Select one relevant option from the provided categories (Principal Investigator, Drexel Employee, DUCOM Employee) and specify your position.
13. If you are a graduate student, medical student, or volunteer, complete the fields for fund number, org code, and account code.
14. Obtain the Principal Investigator’s signature in the appropriate section.
15. Indicate your availability for the health exam by selecting the desired appointment times listed in the schedule.
16. Ensure that you have entered the next available appointment date that the health review must be completed by.
17. Email the completed form to dd35@drexel.edu or fax it to 215-895-5926.
18. After submission, await confirmation from the Department of Environmental Health and Safety regarding your appointment details.

Complete your Annual Health Review Request Form online today to ensure your research is conducted smoothly.