Forms

Environmental

• Asbestos and Lead Clearance Form

Miscellaneous

• Job Site Safety Analysis (PDF)
• Sharps Injury Log (PDF)
• IIPP CSULB General Facility Inspection Checklist (PDF)
• Training Attendance Roster
• Prescription Safety Glasses Request Form
• BBS - Hot Work Permit (PDF)
• BBS - Hot Work Permit for Contractors (PDF)

• Document

  Supervisors Accident Review Form.pdf
• Accident Investigation Report Form Non-Workers Compensation
• Workers Compensation Packet (PDF)
• Document

  Authorization for medical treatment - Los Alamitos ER.pdf
• Document

  Authorization for medical treatment - Memorial Occupational Medical Services.pdf
• Document

  Kaiser Antelope Valley Area or Lancaster Treatment Referral Form.pdf

• Bloodborne Pathogens - Post Exposure Declination Form (PDF)
• Occupational Questionnaire for Personnel Assigned to Laboratory Animal Facilities (PDF)
• Medical Examination Appointment Letter (PDF)(SRMIS 001) 
• Authorization to Release Medical Information (PDF) (SRMIS 002)
• Authorization to Release Previous Medical Information (PDF) (SRMIS 003)
• Health Status Medical Report (PDF) (SRMIS 004) 
• Employee Medical Examination Findings (PDF) (SRMIS 005) 
• Provider Examination Requests (PDF) (SRMIS 006) 
• Exit Examination Employee Declination (PDF) (SRMIS 007) 

• Form 269 - Accident Identification
• Form 274 - Supervisor's Review - Review of State Driver Accident
• From 270 - Vehicle Accident Report

• BBS New Employee EHS Check-In (PDF)