Forms
Animal Exposure
Send completed forms to Occupational Medicine, 201 Plageman Building.
At the time of initial enrollment in the program, print and complete the following questionnaire:
On a yearly basis print and complete this questionnaire:
- Annual Health Surveillance Questionnaire (fillable PDF)
Fill this form out if you are a non-OSU employee, hold a courtesy or affiliate appointment, or are a volunteer, working on an OSU-approved research project:
- Non-OSU Employee Form (fillable PDF)
Asbestos Surveillance Program
- Asbestos Initial Medical Questionnaire (Word doc)
- Asbestos Periodic Medical Questionnaire (Word doc)
Noise Exposure
- Audiometry Questionnaire with Directions for Hearing Test (fillable PDF)
Respirator
- Respirator Questionnaire (fillable PDF)
- Dust Mask Approval (PDF)
Travel
- International Medical Questionnaire (PDF)
- MEDEX Travel Assist Program (PDF) - Part of PEBB Benefits
- PEBB Statewide Plan International Claim Form (PDF)