Purpose: The Occupational Risk Assessment Form and Health History Form for Personnel with Research Related Animal Contact are used in conjunction to evaluate appropriate medical surveillance.
When working with research animals the following general considerations should be taken into account:
Please complete the following forms for enrollment in the Rice University Occupational Health Program:
Part 1. Submit the Occupational Risk Assessment Form online.
Part 2. After completing the Occupational Risk Assessment Form, individuals who will have exposure to live animals, animal housing areas, or unfixed animal tissues will need to complete the Health History Form for Personnel with Research Related Animal Contact. Personnel not listed in those categories may also voluntarily submit the Health History Form for assessment. This form is a fillable PDF and should be saved to your personal computer or device. It may then be submitted to US Healthworks via fax or email.
Your personal health history information is private information protected under the Health Insurance Portability and Accountability Act (HIPAA). DO NOT SEND your health history form to anyone other than US Healthworks medical professionals!
For more information regarding safety at Rice University, including the First Report of Accident or Injury, please visit Rice Environmental Health and Safety.