Online Forms

Job Assessment Form (JAF) - Completion of the Job Assessment Form is required before an examination at the Occupational Medicine Clinic (OMC).  This provides the examining physician with information needed to conduct an occupational health examination and determines what medical surveillance may be required.  OMC professionals also use information on the JAF to determine fitness for duty and evaluate possible work-related health effects. (more)

Additional Medical Surveillance Form (AMS) - is used to request surveillance for those items not on the JAF. These evaluations can be done at the time of the scheduled examination or on request or at any time.

Laser History and Eye Exam Form - The purpose of this two-part form is to provide BNL-OMC with information necessary to determine that an individual to be cleared as a laser user at BNL has met the medical requirements of ANSI Standard Z136.1-2000 (Appendix E) governing the safe use of lasers.

Employees with questions about Laboratory policies should contact Human Resources on extension 2882.

Last Modified: March 5, 2008
Please forward all questions about this site to: Joseph Falco

One of ten national laboratories overseen and primarily funded by the Office of Science of the U.S. Department of Energy (DOE), Brookhaven National Laboratory conducts research in the physical, biomedical, and environmental sciences, as well as in energy technologies and national security. Brookhaven Lab also builds and operates major scientific facilities available to university, industry and government researchers. Brookhaven is operated and managed for DOE’s Office of Science by Brookhaven Science Associates, a limited-liability company founded by Stony Brook University, the largest academic user of Laboratory facilities, and Battelle, a nonprofit, applied science and technology organization.

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