An Administrative Officer or Supervisor must send OMS a Medical Qualification Determination Questionnaire (NIH Form 750-3) and a Request for Medical Determination and Report of Findings (NIH Form 750-2), if at least one of the following applies to the prospective worker:
Works with infectious agents
Works with highly toxic agents
Works with human or nonhuman primate body fluids
Works in areas that patients may visit
Works in areas housing or visited by animals used in research
Works in Building 10
Works as a firefighter or police officer
Works in areas with potential exposure to noises above 85dB or louder during an eight-hour work day, or
Works in areas with potential exposure to significant concentrations of airborne asbestos.
An OMS provider will contact the employee to schedule an appointment once paperwork has been received and processed. Potential employees should bring the following forms filled out to the appointment, or arrive 15 minutes before your scheduled appointment time:
OMS Clinical Record/Face Sheet (NIH Form 2110)
Report of Medical History (GSA Form SF 93)
A copy of your immunization records (can be obtained from your physician or school)
If the employee will be working in an area that has patient or non-human primate contact, he/she must also fill out a TB Questionnaire and Quiz.
If an employee is only working with animals and none of the above apply, only an Animal Exposure Program appointment is necessary.