Get Uab Hospital Employee Follow-up N95 Respirator Use Form - Uab

Completing the UAB Hospital Employee Follow-Up N95 Respirator Use Form is a critical step in maintaining a safe workplace. This guide provides clear, step-by-step instructions to help users efficiently fill out the form online.

Follow the steps to accurately complete the form.

1. Click ‘Get Form’ button to obtain the form and open it in your editor.
2. Select the workplace location from the provided options: UAB Hospital, UAB Highlands, or The Kirklin Clinic. Mark the appropriate box.
3. Enter the current date in the specified field.
4. Fill in your full name (first and last) in the designated area.
5. Provide your date of birth in the DOB field.
6. Input your Blazer ID and the last four digits of your Social Security Number in the respective fields.
7. Enter your UAB e-mail address. Note that communication regarding this form will be sent to this address.
8. Fill in your job title and work phone number in the provided fields.
9. Complete the department and supervisor's name fields accurately.
10. Answer the three medical questions by selecting 'YES' or 'NO'. Make sure to provide honest responses, as they are critical for your safety.
11. Acknowledge your responsibility regarding changes in your status that may affect your ability to use the respirator by signing in the designated area.
12. Add the date next to your signature to confirm when the form was completed.
13. After completing the form, ensure to save changes, download, print, or share the form as needed.

Complete your UAB Hospital Employee Follow-Up N95 Respirator Use Form online today to ensure your safety and compliance.