Get Ukap-ohr Initial Registration Form. Ukap-ohr

Filling out the UKAP-OHR Initial Registration Form is a critical step for registering healthcare workers who are infected with blood-borne viruses. This guide provides a clear, step-by-step approach to ensure that users can complete the form accurately and efficiently.

Follow the steps to complete the UKAP-OHR Initial Registration Form.

1. Click ‘Get Form’ button to obtain the UKAP-OHR Initial Registration Form and open it for editing.
2. Provide registrant details in Section 1. Fill out the forename(s), surname, and professional registration number(s) in block capitals. If applicable, include the NHS/CHI number for students and state the date of birth and specialty. Confirm if the registrant performs exposure prone procedures (EPPs) and list which EPPs they perform. Indicate if the registrant works as a locum and if they have previously been registered onto the UKAP-OHR.
3. In Section 2a, input the designated occupational health consultant physician's details, including their name, title, GMC number, and whether they are MFOM accredited. Provide the occupational health department's address, telephone, and email.
4. If you wish to nominate an additional member of occupational health staff in Section 2b, include their name, title, professional registration number(s), address, telephone, and email.
5. In Section 3, fill out registrant clinical details. Indicate whether the registrant is currently on cART, if they are an elite controller, and whether they have a record of sustained viral load results. Provide the viral load for both IVS samples – ensuring the dates are recorded accurately.
6. Complete Section 4 by detailing the current cART regimen. Mark the appropriate NRTI, multiclass combinations, NNRTI, and PI medications as applicable, using the provided checkboxes.
7. In Section 5, finalize by adding the sender details. Include the name of the person completing the form, contact details which encompass the place of work, telephone, and email. Sign and date the form, and add any relevant comments.
8. Once you have completed all sections, save changes, and then you can download, print, or share the form as needed. Follow the secure transfer methods outlined to return the completed form.

Complete the UKAP-OHR Initial Registration Form online today to ensure effective registration and monitoring.