Forms
Research and Clinical
Haz Waste
Working Safely
Environmental
Construction
Living Safely
Planning Safe Research
- Door Sign Request Form
- Pre-Commissioning Consultation Form
- Laboratory Space Modification
- Request for a Laboratory Decommissioning Inspection
- Laboratory Equipment Owner Decontamination Form
- Work Activity Form for Minors Performing Research Activities (PDF)
- U-M Informed Consent and Authorization Form (PDF)
- Lab Use Assumption of Risk and Release of Liability for Volunteers and Visitors (PDF)
Chemical
- Chemical Inventory System User Request Form
- MI Safety Portal Log-In Request
- SOP Template Prior LD Approval (Word document)
- SOP Template (Word document)
- Restricted Hazardous Gases Authorization form
- EHS Nanomaterials Survey
Biological
- EHS BL2 Recombinant/Infectious Agent Inspection Form (PDF)
- Toxin Declaration Form (PDF)
- UN Certified Biological Shipping Systems Available
Radiation
- RSS-101 Application for Authorization to Use Radioactive Material (Word document)
- RSS 101 Section 9
- RSS-101A Statement of Training and Experience (Word document)
- RSS-105 (Radioactive Contamination Survey Record) (Word document)
- Dosimeter Request Form
- Dosimeter Modification/Deletion Form
- Spare Dosimeter Form
- Declaration of Pregnancy Form (RSS-105A)
- Pregnancy Declaration Revocation Form (RSS-105B)
- Pregnancy Declaration Expiration Form (RSS-105C)
- New Series Request Form
- UMHHC New Series Dosimetry Assessment Form (PDF)
- Annual Refresher Training Acknowledgment Form (Word document)
- Radionuclide Receipt, Utilization and Disposal Record (Word document)
- Laboratory Equipment Radioactive User Decommissioning Form (PDF)
Laser Safety
Diving Safety
Risk Factors: Physical
- Department Confined Space Form (PDF)
- Entry Permit (PDF)
- U-M Contractor Confined Space Entry Notification (PDF)
Risk Factors: Equipment
- Shop/Studio Door Sign Request Form
- Machine Shop Usage Agreement and Training Documentation Form (Word document)
- Self Inspection Checklist Survey
- Project Review Form (Word document)
Safety Equipment
- Prescription Eyeglass Request Form
- U-M Personal Protective Equipment Guideline Certification Of Hazard Assessment (PDF)
Medical Surveillance
Ergonomics
Air: Refrigerant Management Program Forms
- Change – Add – Delete Equipment Request Form (PDF)
- U-M HVAC RCM Contractor Input Form (PDF)
- U-M HVAC Refrigerant Equipment Input Form 1A (PDF)
- RCMS Service Order Form 2C (PDF)
- Contractor Refrigerant Acquisition and Disposal Form 2C (PDF)
Spill Prevention
Lab Modifications
Environmental Impacts
- Project Notification Form – Soil Erosion & Sedimentation Control (PDF)
- Minor Project Form – Soil Erosion & Sedimentation Control (PDF)
- Design & Review Requirements (Checklist for SESC Plans) (PDF)
- Field Inspection Report – Soil Erosion & Sedimentation Control (PDF)
Contractor Safety
- Safety Plan Certification
- Project Safety Scope Checklist
- Contractor Incident Report Form (PDF)
- Monthly Safety Report (PDF)
Hot Work Permits