Occupational Health provides care to all eligible Federal Civilian employees and active duty military personnel working in industrial hazardous positions. Services are directed toward prevention of occupational illness and/or injury, health maintenance and prevention/monitoring of occupational hazards. Programs include medical examinations, reproductive hazard surveillance, hearing and vision conservation, work-site visits, illness/absence monitoring, respiratory protection, employee modified duty, patient education and employee in/out processing.
Forms for Occupational Health Needs:
Individual Reliability Screening and Evaluation Form
DD5557.pdf
Fort Lee Record of Injury
FtLeeForm-1051-E-RecordofInjury.pdf
Forms for TB Testing:
Initial Entry TB Risk Assessment Tool
MEDCOM FORM 829.pdf
Periodic TB Risk Assessment Tool
MEDCOM FORM 830.pdf
Health Care Worker TB Risk Assessment Tool
MEDCOM FORM 831.pdf
Other Forms:
Respirator Questionnaire
Respirator Questionnaire (OSHA 3789) (3).pdf
Screening Form Adult
SCREENING FORM ADULT 2016-2017.docx
Authorization for Disclosure of Medical or Dental Information
DD2870.pdf
Influenza Vaccine Information Statement
VIS2016.pdf