The University of Texas at Dallas

The University of Texas at Dallas

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The University of Texas at Dallas

Occupational Health Verification Form

Individuals in the Occupational Health Program can certify their enrollment and complete their required training in Safety Skills each year.

For "Location", please indicate the workspace (class, laboratory, or area) where the work is performed.

If you want to upload any documentation (pictures, etc.), please do so in the "Add Supporting Documents" section.

This Occupational Health Verification form is classified as an "incident report" type in CampusOptics, however, it is primarily used to certify your continued participation in the program after completing the intake form with UTSW.

If you have questions about this form or the Occupational Health Program, you can reach us at OHSafety@utdallas.edu.

Reporter Info

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Location

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    Exact Location

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    Basic Information

    Add Supporting Documents

    Add files to upload as supporting documentation along with your incident.