Large red hawk statue behind red flowers on campus

Patient Forms

For questions about completing or submitting a form, please contact the Occupational Health Department at 973-655-5014 or ohd@montclair.edu.

1. a. Animal Exposure Baseline Assessment Questionnaire
Animal Handlers must complete and submit this form prior to obtaining clearance to work in Vivarium facilities.

1. b. Animal Exposure Periodic Assessment Questionnaire
Animal Handlers must complete and submit this form annually for clearance to work in Vivarium facilities.

2. Hepatitis B Vaccine Participation/Declination Form
This form must be completed by all employees subject to the Hepatitis B vaccine program.

3. Medical Questionnaire for Respirator Users
Respirator Users must complete and submit this form prior to obtaining clearance to use a respirator on-the-job.

4. Animal Handler Injury Report Form
This form must be completed after an incident (injury or illness) has occurred while handling animals.