Initial Report of Biological Exposure or Release Event AND Near Misses

This report, when submitted, provides the University Safety and Assurances Department, Biological Safety Program, and the Institutional Biosafety Committee (IBC) with information to ensure that proper actions have been taken, including appropriate medical care, and helps the University meet NIH reporting requirements.

INSTRUCTIONS:

  • If you have an approved biosafety protocol, please go to IManager and submit the xForm in your protocol. Just log in, select the protocol number, and when viewing that protocol, select “Start xForm in the left column” and select the Biosafety Initial Report of Biological Exposure or Release Event AND Near Misses xForm to complete. 
  • Use this form to report any and all potential exposures or releases of organisms or biological toxins on UWM main campus and its extension facilities, including the School of Freshwater Science, Global Water Accelerator, and the Innovation Accelerator.
  • Reporting should be completed within 24 hours of the event, and is the responsibility of the Principal Investigator.
  • Potential exposures include needle sticks, animal bites, aerosol exposures, and other incidents potentially resulting in disease.
  • Potential releases include spills outside of primary containment as well as potential releases to the environment.
  • Unauthorized releases of transgenic animals or plants should also be reported on this form.
  • After completing this form, select “Submit” at the bottom of this form. The information on this form will be sent to the UWM Biological Safety Officer.
  • Information on this form is used to determine how our offices may help you and your laboratory and for mandatory federal reporting purposes.
  • The submitter will be contacted for incident follow-up.
  • If you need assistance completing this form or reporting an incident, please call the Biological Safety Officer at uwm-biosafety@uwm.edu.
  • If anyone was injured in the incident, please complete:

  • Please fill in ALL *Required fields before submitting the form.

 

First Report of Biological Exposure or Release Event

  • Date Format: MM slash DD slash YYYY
  • :