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About the OHP

UCSF OCCUPATIONAL HEALTH PROGRAM (OHP)

FORMS

 
 

Request for Service

CMO Message and Flu Shot Declination On-Line Tool
Use is limited to UCSF personnel working in UCSF Medical Center locations

Seasonal flu Declination Form
Use only if you cannot access the on-line tool or work location is outside the Medical Center

H1N1 flu Declination Form
Use only if you cannot access the on-line tool or work location is outside the Medical Center.

Hepatitis B Consent and Declination

Laboratory Animal Allergy Questionnaire

Laboratory Animal Asthma Questionnaire

Respirator Fit Testing Medical Clearance On-Line Tool for staff, faculty, housestaff, students, and other trainees.

Respirator Fit Testing Medical Clearance
Use the hard copy form only if you have difficulty accessing the on-line tool.

Supervisor's Report of Injury - Campus

Supervisor's Report of Injury - Medical Center

Combined Tuberculosis Placement/Symptom Review