DEPARTMENT OF HOMELAND SECURITY U.S. COAST GUARDACUTE EXPOSURE INFORMATION FORM EMPLIDLast Name, First Name, Middle InitialDateTimeOne form for each exposure Name of Chemical Exposed toChemical Abstract.

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How to fill out the DoD CG-6000-1 online

The DoD CG-6000-1 form is essential for documenting acute chemical exposure incidents. This guide will help you navigate the online version of the form, ensuring that you complete all required fields accurately and thoroughly.

Follow the steps to fill out the DoD CG-6000-1 form online.

  1. Press the ‘Get Form’ button to obtain the form and open it in your online editor.
  2. Begin by entering your EMPLID in the designated field.
  3. Fill in your last name, first name, and middle initial as prompted.
  4. Provide the current date and time of the exposure incident.
  5. Use a separate form for each exposure and specify the name of the chemical you were exposed to.
  6. If known, enter the Chemical Abstract Services (CAS) number related to the chemical.
  7. Indicate the physical form of the chemical by selecting one of the options: solid, liquid, gas/vapor, or aerosol.
  8. Select the chemical form from the following categories: acid, alkali, organic solvent, or heavy metals.
  9. Mark the modes or routes of exposure corresponding to your incident: solid, liquid, gas/vapor, or aerosol.
  10. Document the duration of the exposure incident.
  11. Provide a brief description of the incident, detailing what occurred.
  12. List any symptoms you observed following the exposure.
  13. Note any associated injuries resulting from the incident.
  14. Specify any personal protective equipment you used during the exposure.
  15. Make sure to notify the HSWL SC Safety & Environmental Health Officer.
  16. Indicate if you received any further guidance after the incident.
  17. Attach the Material Safety Data Sheet (MSDS) and shipping manifest to the form, if available.
  18. Ensure the reviewing authority signs the form.
  19. Finally, save changes, download, print, or share the completed form as needed.

Complete the DoD CG-6000-1 online today to ensure accurate documentation of your exposure.

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