Get Initial Laser User Ocular History Questionnaire Form - University Of ...

Completing the Initial Laser User Ocular History Questionnaire Form is an essential step for ensuring your safety and compliance with laser use. This guide provides you with clear, step-by-step instructions for filling out the form online, ensuring all necessary information is accurately captured.

Follow the steps to successfully complete the form online.

1. Press the 'Get Form' button to access the questionnaire, and open it in your chosen editing tool.
2. Begin by filling out Section A: General Information. Enter your name (last, first, middle initial), email, position, CNetID, date of birth (MM/DD/YYYY), and home phone number. Ensure that all details are correct to facilitate communication.
3. Proceed to Section B: Medical History. Here, provide the name and lab phone number of your primary care physician, your date of last eye exam, and list any previous major injuries, surgeries, or illnesses. Indicate if you have worked with or near lasers at locations other than the University of Chicago, specifying those locations if applicable.
4. Continue to Section C: Visual History. In this section, you will check all applicable conditions you currently experience or have experienced in the past. Options include wearing prescription lenses, dryness, eye infections, and various other visual conditions. Be thorough to ensure safe assessment.
5. Once all sections are completed, review your entries for accuracy and clarity. Make any necessary adjustments before finalizing.
6. Finally, save your changes. You can choose to download, print, or share the completed form as required for submission along with the Initial Laser Training Certification Form to the Laser Safety Officer.

Get started on your document today and ensure your laser training is compliant.