Request for Fetal Radiation Monitoring (Form 9)
Use this form to confidentially request a fetal dosimeter.
UW LOTO Field Procedure
For equipment and systems that are not routinely repaired or serviced, or require partial shutdowns, and where change management of practices are not robust, then the UW LOTO Field Procedure…
Human Subjects Radiation Approval Committee (HSRAC) Application
Instructions:
1) Click on the link below to download the application.
2) Save the application in a file folder on your computer.
3) From the folder, open the file with Adobe Reader or Acrobat.
Ergonomics Evaluation
Office Ergonomics Evaluation Form
Instructions: Complete this form to request an ergonomics evaluation of an office workstation. For other types of ergonomics evaluations, please contact ehsergo@uw.…
Confined Space Evaluation Form
If you suspect a space meets the definition of a permit-required confined space, but you do not have a permit to enter, do not enter the space. Complete the Confined Space Evaluation form…
UW LOTO Procedure
For equipment that is routinely maintained and serviced, requires a full shutdown for servicing, and has good change management practices in place, the UW LOTO Procedure form can be used.…
LOTO Lock Removal Form
The LOTO Lock Removal Form (Word) includes directions and specific information a department or unit must document when an Authorized Person (lock owner) is unable or unavailable to remove…
Lockout/Tagout Authorized Person(s) Periodic Review
The Lockout/Tagout Authorized Person(s) Periodic Review is used to inspect the Authorized Person’s role and responsibility established in the hazardous energy control program and…
Lead Work Plan Template
Use the Lead Work Plan Template (Word) when lead exposure is assumed or known to be at or above 10 micrograms of airborne lead per cubed meter during an eight-hour TWAe.
Metallic Lead Use Area-Storage Area Inspection Template
Use the Metallic Lead Use Area-Storage Area Inspection Template (Word) when conducting inspections of metallic lead use areas and metallic lead storage areas.
Accident/Incident Report Form
An Accident/Incident Reporting form for use when in the field to document an incident when internet access is unavailable.
UW Select Toxin Transfer Due Diligence Form
Complete this form for any transfer of select toxins in any amount to any intra- or extramural entity or individual requires documentation of due diligence. Submit the completed form to uwsa@uw.…
Clinical Trial Biological Use Authorization (BUA) Application
Complete the Clinical Trial Biological Use Authorization (BUA) Application for new and renewal projects to obtain approval for research involving recombinant DNA in human subjects. Submit Clinical…
Biological Use Authorization (BUA) application (new and renewal)
Complete the Biological Use Authorization (BUA) application for new and renewal projects to obtain approval for research involving biohazards. Submit BUA applications at least four weeks prior to the…
Capital Safety Project Request Form
Complete the Capital Safety Project Request Form to request assistance with implementing a project to improve safety-related building elements and safety systems in a University-owned…
Food Illness Report/Complaint
If you believe you have become sick from eating at a food service establishment on the University of Washington campus, please answer the questions below. Answering all questions helps us…
Radiation Waste Collection Request
Complete the form below to request a radiation waste collection.
Please contact Radiation Safety team at radsaf@uw.edu or call 206.543.0463 with questions.
The University of Washington is…
Respirator Request Form
University supervisors submit a Respirator Request Form to EH&S, when respiratory hazards are first identified, when processes change that may impact respiratory hazards, and annually…