Forms

Search forms either by alphabetical order or by topic. Some forms are in PDF format and require Adobe Acrobat Reader.

Alphabetical

[A]   [B]   [C]   [D]   [E]   [F]   [G]   [H]   [I]   [L]   [M]   [N]   [O]   [P]   [R]   [S]   [T]   [V]   [W]   [X]   [Y]  

A

• AAUS Request for Diving Reciprocity Form (pdf)
• Accident/Incident Report (pdf)
• Additional Requirements for Food Events in Booths (pdf)
• AED Request (pdf)
• Amendment to use Additional Radionuclide(s) (pdf)
  RSO Form 14 - 10/95
  Fill in on-line then fax or mail.
• Animal Use Medical Screening Form (AUMS) (Smart Form)
• Annual Equipment and Maintenance Summary (pdf)
• Annual Renewal Information (pdf)
• Appendix A - SOP for the use of Hazardous Materials in Animal Studies (Word 2000)
• Application for Approval to Use Radiation with Human Research Subjects (word 2003)
  HSRAC Form 1 - 5/10
  Fill in on-line then mail or email.
• Application for Registration/Certification of Laboratory/Room for Use of Radioactive Materials (RSO Form 50) 03/08
  Fill in on-line then fax or mail.
• Authorized Investigator's Laboratory Survey Record (pdf)
  RSO Form 412a - 09/03
  Print form, fill out and fax or mail.
• Authorized Investigator's Laboratory Survey Record Survey Results (pdf)
  RSO Form 412b - 02/08
  Print form, fill out and fax or mail.
• Autoclave Quality Control Checklist (Word 2000)

B

• Battery Bin Collection Site Pick Up Request (online)
• Battery Collection Request Form (pdf)
• Biohazard Warning Sign (pdf)
• Biological Use Authorization Application (Word)
• Biological Use Authorization, Request for Change to (Word)
• Bloodborne Pathogens Site-Specific Exposure Control Plan (Word)

C

• Certificate of Environmental Compliance (CEC) Signature Request Form (Word)

Fill in on-line then fax or mail.

• Chemical Treatment Log (pdf)
• Online Chemical Waste Collection request
• Chemical Waste Collection Request (pdf)
  
• Chemical Waste Collection Request, Sample (pdf)
• Chemical Waste Collection Request, Set Up New Routine (pdf)
• Chemical Waste Collection Request, Set Up Routine, Sample (pdf)
• Chemical Waste, Routine Collection Request
  (online request for previous established routine pickups)
• Consent and Understanding of Risk Form (pdf)

D

• Decayed Waste Disposal Record (pdf)
  RSO Form 159 - 09/03
  Print form, fill out and fax or mail.
• Decontamination, Notice of Laboratory Equipment (pdf)
• Dive Plan (pdf)
• Diving Emergency Plan (pdf)
• Diving Registration Form (pdf)
• Dosimetry Change, Deletion, or Addition (online)

E

• Emergency Plan, Diving (pdf)
• Equipment Decontamination, Notice of Laboratory (pdf)
• Evaluation Request, Waste (pdf)
• Example Standard Operating Procedures (pdf)
• Exposure Response Poster (pdf)

F

• Fall Protection Work Plan (pdf)
• Fire Drill Report (pdf)
• Food: Temporary Food Event Application (pdf)
• Foreign Object Report (pdf)

G

H

• Hazardous Waste Labels (pdf, Word 2003, and where to pick up free ones)
• Hepatitis B Vaccine Form (pdf)
• Sample UW Hot Work Permit (For use outside of welding booths) (pdf)

I

J

K

L

• Labels: Hazardous Waste (pdf, Word 2003, and where to pick up free ones)
• Laboratory Safety Training Matrix (pdf, EH&S draft class matrix 5/2013)
• Laboratory Safety Manual Binder Art and Tabs order form (online)
• Laser Registration Form (pdf)
  RSO Form 600 - 12/98
  Print form, fill out and fax or mail.
• Lockout Procedure (pdf)
• Lockout/Tagout, Supervisor Annual Evaluation (pdf)

M

• Mercury Thermometer Swap Request
• Missing/Damaged Dosimeter Report (pdf)
  RSO Form 15 - 05/04
  Fill in on-line then fax or mail.
• Monthly Dive Summary (pdf)
• Moveout, Notice of Laboratory (pdf)

N

• Notice of Laboratory Equipment Decontamination (pdf)
• Notice of Laboratory Moveout (pdf)
• New Employee Health and Safety Orientation Checklist (Word)
• New Employee Health and Safety Orientation Checklist (pdf)

O

• Open Water Checkout (pdf)

P

• Peroxide Management and Assessment Guidelines (pdf)
• Pest Sighting Report (online)
• Principal Investigator Assurance Form (Word)

Q

• Quarterly Sink Disposal Record for Radioactive Material (pdf)
  RSO Form 170 - 10/99
  Print form, fill out and fax or mail.

R

• Radiation-Detection Instrument Registration (pdf)
  RSO Form 51 - 11/04
  Fill in on-line then fax or mail.
• Radioactive Material and Usage Record (pdf)
  RSO Form 160 - 12/09
  Fill in on-line then fax or mail.
• Radioactive Material Transfer and Usage Record (pdf)
  RSO Form 160t - 12/09
  Fill in on-line then fax or mail.
• Radioactive Material Waste Collection Record (pdf)
  RSO Form 150 - 10/99
  Print form, fill out and fax or mail.
• Radioactive Waste Collection
  Email Request (collected weekly)
• Radioactive Material (RAM) Lab Personnel Change Form
  (Email Request)
• Renewal Application for Continued Approval to Use Radiation with Human Research Subjects (word 2003)
  HSRAC Form 1 - 6/10
  Fill in on-line then mail or email.
• Request to Purchase or Relocate Biological Safety Cabinets
• Research MRI Medical Safety Screening Form (Word)
• Research MRI Medical Safety Screening Form (pdf)
• Respirator Request Form (pdf)
• Respirator Request Form (Word)
• Register for the Radiation Safety Class
• Routine Chemical Collection Request
  Online request for previous established routines
• Rush Form for Purchases of Radioactive Material
  (RUSH ORDER) - 12/03
  Fill in online then fax or mail.

S

• SCUBA Health History Form (pdf)
• SCUBA Medical Examination Report (pdf)
• SCUBA Medical Overview (pdf)
• Short-Lived Radioactive Waste Certification (pdf)
  RSO Form 176 - 9/04
  Fill in on-line then fax or mail.
• Standard Operating Procedure for Chemicals, Template (Word)
• Standard Operating Procedures, Sample (Word)

T

• Template Standard Operating Procedure for Chemicals (Word)
• Temporary Food Event Application (pdf)
• Thermometer, Mercury Swap Request
• Training and Experience in use of Radiation (pdf)
  RSO Form 20 - 10/07
  Fill in on-line then fax or mail.

V

• Variance Request (pdf)
• Voluntary Respirator Use Form (pdf)
  EHS Form 405

W

• Waste Collection Request, Chemical (pdf)
  
• Waste Collection Request, Chemical, Sample (pdf)
• Waste Collection Request, Set Up New Routine, Chemical (pdf)
• Waste Collection Request, Set Up New Routine, Chemical, Sample (pdf)
• Waste, Routine Collection Request, Chemical (online request for previous established routine pickups)
• Waste Evaluation Request (pdf)

X

Y

Z

By Topic

Below are some frequently used forms organized by topic:

• Chemical Waste Disposal
• Diving Safety
• Fire Safety
• Occupational Health & Safety
• Public Health/Biosafety
• Radiation Safety

Chemical Waste Disposal

• Chemical Treatment Log (pdf)
• Chemical Waste Collection Request (pdf)
• Chemical Waste Collection Request, Sample (pdf)
• Chemical Waste Collection Request, Set Up Routine (pdf)
• Chemical Waste Collection Request, Set Up New Routine, Sample (pdf)
• Chemical Waste, Routine Collection Request
  (online request for previous established routine pickups)
• Chemical Waste Generator Registration (online)
• Peroxide Management & Assessment Guidelines (pdf)
• Mercury Thermometer Swap Request
• Waste Evaluation Request (pdf)

Diving Safety

• Diving Registration Form (pdf)
• AAUS Request for Diving Reciprocity Form (pdf)
• Annual Equipment and Maintenance Summary (pdf)
• Annual Renewal Information (pdf)
• Consent and Understanding of Risk Form (pdf)
• Dive log form (Requires Log-in)(Fill-in online)
• Dive Plan (pdf)
• Emergency Plan (pdf)
• Monthly Dive Summary (pdf)
• Open Water Checkout (pdf)
• SCUBA Health History Form (pdf)
• SCUBA Medical Examination Report (pdf)
• SCUBA Medical Overview (pdf)
• Variance Request (pdf)

Fire Safety

• Fire Drill Report (pdf)

Laboratory Safety

• Hepatitis B Vaccine Form (pdf)
• Laboratory Safety Training Matrix (pdf)
• Notice of Laboratory Equipment Decontamination (pdf)
• Standard Operating Procedure for Chemicals, Template (Word)
• Standard Operating Procedures, Samples (Word)
• Mercury Thermometer Swap Request

Occupational Health & Safety

• Accident/Incident Report (pdf)
• AED Request Form UoW1051 (pdf)
• Animal Use Medical Screening Form (AUMS) (Smart Form)
• Bloodborne Pathogens Site-Specific Exposure Control Plan (Word)
• Fall Protection Work Plan (pdf)
• EHS Form 405: Voluntary Respirator Use Form (pdf)
• Sample UW Hot Work Permit (For use outside of welding booths) (pdf)
• Lockout/Tagout, Supervisor Annual Evaluation (pdf)
• Research MRI Medical Safety Screening Form (Word)
• Research MRI Medical Safety Screening Form (pdf)
• Respirator Request Form (Word)
• Respirator Request Form (pdf)
• New Employee Health and Safety Orientation Checklist (Word)
• New Employee Health and Safety Orientation Checklist (pdf)

Public Health/Biosafety

• Autoclave Quality Control Checklist (Word)
• Biological Use Authorization Application
• Foreign Object Report (pdf)
• Request for Change to Biological Use Authorization (Word)
• Appendix A - SOP for the use of Hazardous Materials in Animal Studies (Word)
• Temporary Food Event Application (pdf)
• Additional Requirements for Food Events in Booths (pdf)
• Pest Sighting Report (Fill in online)

Radiation Safety

• Dosimetry Change, Deletion, or Addition (Email Request)
• Register for the Radiation Safety Class
• Radioactive Waste Collection Email Request (collected weekly)
• Radioactive Material (RAM) Lab Personnel Change Form (Email Request)

Fill in online then fax or mail. If you have PDF Writer or Professional you can save form & e-mail it to Radiation Safety.

• Amendment to use Additional Radionuclide(s) RSO Form 14 (pdf) 10/95
• Missing/Damaged Dosimeter Report RSO Form 15 (pdf) 05/04
• Training and Experience in use of Radiation RSO Form 20 (pdf) 10/07
• Application for Approval to Use Radiation with Human Research Subjects
  HSRAC Form 1 (word 2003) 5/10
  Fill in on-line then mail or email.
• Renewal Application for Continued Approval to Use Radiation with Human Research Subjects
  HSRAC Form 2 (word 2003) 6/10
  Fill in on-line then mail or email.
• Application for Registration/Certification of Laboratory/Room for Use of Radioactive Materials (RSO Form 50) 03/08
• Radiation-Detection Instrument Registration RSO Form 51 (pdf) 11/04
• Radioactive Material and Usage Record RSO Form 160 (pdf) 3/04
• Radioactive Material Transfer and Usage Record RSO Form 160t (pdf) 3/04
• Short-Lived Radioactive Waste Certification RSO Form 176 (pdf) 9/04
• Rush Form for Purchases of Radioactive Material RUSH ORDER (pdf) 12/03

Print form, fill out and fax or mail.

• Radioactive Material Waste Collection Record (RSO Form 150) (pdf) 10/99
• Decayed Waste Disposal Record (RSO Form 159) (pdf) 09/03
• Quarterly Sink Disposal Record for Radioactive Material (RSO Form 170) (pdf) 10/99
• Authorized Investigator's Laboratory Survey Record (RSO Form 412a) (pdf) 09/03
• Authorized Investigator's Laboratory Survey Record - Survey Results (RSO Form 412b) (pdf) 02/08
• Laser Registration Form (RSO Form 600) (pdf) 12/98