Request for Service

Request for Service (Note: Due to security and sensitive information, this form can only be accessed from a UCSF computer or through a VPN.)

Consents and Declinations

On-Line Tdap Declination

On-Line Flu Declination

Paper Flu Shot Declination - This should only be used if you are a UCSF campus employee and do not have access to a UCSF medical center computer

Hepatitis B Consent and Declination

Clearance, Questionnaires, & Self-Monitoring Tools

Infectious Disease Symptom Self Monitoring

Laboratory Animal Allergy Questionnaire

Laboratory Animal Asthma Questionnaire

Respirator Fit Testing Medical Clearance

Tuberculosis Placement/TB Symptom Review

Working-Training Abroad - Returning to UCSF Clearance

Report of Injury

Supervisor's Report of Injury - Campus

Supervisor's Report of Injury - Medical Center