Get Needle Stick/exposure To Bodily Fluids Report Form

This guide provides a comprehensive overview of how to complete the Needle Stick/Exposure To Bodily Fluids REPORT FORM online. Following these steps will ensure that you accurately report any bodily fluid exposures or needle stick injuries in a timely manner.

Follow the steps to complete the form correctly.

1. Press the ‘Get Form’ button to access the Needle Stick/Exposure To Bodily Fluids REPORT FORM and open it in your preferred online platform.
2. Fill in the 'Name of person injured' section with your full name.
3. Enter your 'Student Identification Number (SID)' as required.
4. Provide your 'Contact Phone Number' for any follow-up communications.
5. Include your 'Email Address' to receive notifications related to your submission.
6. Record 'Today’s Date' to mark the date you are filling out the form.
7. Specify the 'Date of Exposure' in the relevant field.
8. Indicate the 'Time of Exposure' for accurate reporting.
9. Write a 'Brief Description of Exposure' that clearly outlines the nature of the incident.
10. Identify the 'LOCATION WHERE EXPOSURE OR INJURY OCCURRED' by selecting the appropriate option in the list provided.
11. Mark the 'TYPE(S) OF EXPOSURE OR INJURY' that occurred, selecting all that apply.
12. Specify 'THE EXPOSURE OCCURRED' by indicating the timing related to the use of a sharp object, if applicable.
13. Select the 'EXPOSED OR INJURED BODY PART(S)' from the options provided.
14. Provide details about your 'Faculty/Staff/Student’s Medical Provider'.
15. Enter the 'Date Provider Seen' to indicate when you consulted them.
16. Include the 'Patient/Source Name' relevant to the incident.
17. Provide 'Patient/Source Contact Information' for further details, if necessary.
18. Specify the 'Patient/Source Medical Provider' if applicable.
19. If you are College of Pharmacy faculty or staff, complete the 'Date of Source Testing' and any 'Additional Information or Follow-Up' that may be relevant.
20. Once all sections are completed, you may save your changes, download, print, or share the form as needed.

Ensure your safety and compliance by completing the Needle Stick/Exposure To Bodily Fluids REPORT FORM online today.