Forms

Employees & Student Employees

All injuries need to be reported to your supervisor by the end of your shift. Supervisors, please send paperwork to HR within 24 hours of injury notification.

• Employee’s Work Injury and Illness Report & Supervisor’s Accident Analysis and Prevention Report forms
  Forms are completed online and forwarded to Human Resources

Students & Visitors

• General Incident Report 300A2 (PDF)
  For student injuries or incidents

• Tool Safety Rules Template (DOC)

All forms related to IBC protocol registration, including annual renewal, can be found on the Institutional Biosafety Committee site.

• Biological Risk Assessment Template (DOCX)
• Biological Inventory Template (XLSX)
• Autoclave Log (PDF)
• Laboratory-Specific Biosafety Level 2 Biosafety Manual Template (PDF)
• Biological Safety Cabinet SOP (PDF)
• Laboratory Signs & Postings:
  • Animal Biosafety Level 1 Door Sign (DOCX)
  • Animal Biosafety Level 2 Door Sign (DOCX)
  • Autoclave Poster – Complete (PDF)
  • Autoclave Poster – Waste Disposal Quick Guide (PDF)
  • Biosafety Level 2 Door Sign (DOCX)
• UWM Biological Exposure Control Plan Template (DOCX)
• Biosafety Inspection Checklist (PDF)

You are welcome to use our Standard Operating Procedures forms below for your convenience. You will need to modify your lab specific information and use in each form but the common safety information is filled in for you.

• Standard Operating Procedure for Highly Hazardous Chemicals Use Blank. rev. December 2020 (DOCX)
• Directions for Highly Hazardous Chemical Standard Operating Procedure (SOP) revision October (DOCX)

• Confined Space Entry Permit (PDF)
  Print form and post at confined space location

• Fire Drill Response (PDF)
• Fire and Life Safety Inspection Form (PDF)
• Grilling or Other Outdoor Fires Approval
• Tornado Drill Evaluation Form (PDF)

• Hot Work Fillable Form (PDF)
  After opening form, select Download (at the top of the page) to complete and submit

• Laboratory-Specific Chemical Hygiene Plan Template (DOC)
• Standard Operating Procedure (SOP) Blank for Highly Hazardous Chemicals Use (DOCX)
• Chemical Abbreviation form – Key posting (PDF)
• Chemical Identification Key (XLSX)
• Emergency Action Plan Posting (DOCX)
• Eyewash Weekly Inspection Form (DOCX)
• Lab Design or Renovation Plans Interview/Review (DOCX)
• Lab Hibernation Shutdown Checklist (DOCX)
• Lab Closeout Checklist (PDF)
• Laser Registration Form Blank (XLSX)
• Laboratory-Specific Safety Orientation Checklist (DOCX)
• Laser SOP (DOCX)
• Minors in Labs:
  • Checklist Volunteer Minors in Labs (DOCX)
  • Volunteer Letter (sample) (DOCX)
  • Letter to Parent of Volunteer Minors (PDF)
  • Confirmation of Assumption of Risk, Indemnification and Release (DOCX)
  • Consent and Release form – Minor (PDF)
  • Cover Letter for Faculty with Minor Students (DOC)
  • Photo Release (PDF)
• New Laboratory Setup Safety Checklist (PDF)
• Respiratory Protection Voluntary Use – Appendix D (PDF)
• Service Animal Inquiry Form (PDF)
• Volunteers in Labs:
  • Confirmation of Assumption of Risk, Indemnification and Release (DOCX)

• Working in Isolation (BPLogix Form)
• Working in Isolation User Dashboard

• RS Form 100 Application (PDF): Application for Possession and Use of Radionuclides
• RS Form 120 Animal Use (PDF): Application for Animal Use of Radionuclides
• RS Form 200 Control Sheet (PDF): Radionuclide Inventory Form
• RS Form 250 Disposal (PDF): Radioactive Waste Disposal Form
• RS Form 310 Badge Application (PDF): Application for a Personal Dosimeter
• RS Form 320 Lost Dosimeter (DOCX): Lost Dosimeter Form
• RS Form 350 Training Checklist (PDF): Training checklist for Authorized User to complete with Radiation/Lab workers
• RS Form 410 (DOCX): Authorization to Use Radioactive Materials Aboard UWM Research Vessels
• RS Form 500 Lab Audit (PDF): Radionuclide Lab Audit Form
• RS Form 510-Notice of Violation (DOCX)

• Outside Contractor Notification, Risk, and Safety Checklist (DOCX)
• Facility Environmental Health and Safety for Contractors-Vendors (DOCX)