Safety Services
Forms
Education and Training
- Armed Robbery Description Checklist
- Bomb Threat Checklist
- Emergency Paging Codes - All Regions
- Injury-Related Forms
- NESOP Level 2 - Site Specific Information
- Notice to Employees - Texas Hazard Communication Act (English)
- Notice to Employees - Texas Hazard Communication Act (Spanish)
Environmental
- Certificate of Decontamination
- Chem-Exchange Redistribution Program
- Indoor Air Quality Complaint Form
- Occupant Diary
- Pest Control Request Form
- Records & Requirements for Autoclave
- Request for Transfer of Chemicals
- Stericycle Pick Up Locations
- TUB/DRUM List For Disposal by UMC Commercial Vendor
- Waste Streams
Fire and Life
Laboratory
- Biohazardous Agents Requiring IBC Protocol Registration
- Chemical Hygiene Plan (CHP)
- Exposure Control Plan (ECP)
- Hazard Communication Plan (HCP)
- Hazardous Toxicants and Toxics Requiring IBC Protocol Registration
- IBC Amendment
- IBC Registration Application
- IBC Registration - Addendum A (use to register biological materials)
- IBC Registration - Addendum B (use to register chemical materials)
- Laboratory Specific Standards Operating Procedure - submitted by PI or Laboratory Supervisor
Occupational
- Ergonomic Consultation Request - Online
- Health and Safety Review Form
- Injury-Related
- Supervisor's Investigation of Employee's Accident/Incident
- Unusual Occurrence Report - event occurred inside a clinic
Radiation
- A-01 Application for Temporary Approval for Supervised Work with Radioactive Materials
- A-03 Application for Radioactive Material Sublicense (Non-Human Use)
- A-04 Radioactive Material Sublicense Amendment/Renewal Request
- A-05 Radioactive Material Receipt and Accountability Record
- A-05a Radioactive Material Receipt and Accountability Record Continuation Sheet
- A-06 Radioactive Waste Disposal Record
- A-07 Radioactive Material Incident Report
- A-08 Application for Dosimetry Service
- A-10 Radiation Dose Assessment
- A-12 Laboratory Radioactive Contamination Survey Calculation Sheet
- A-14 Radiation Laboratory Close-Out Survey Checklist
- A-15 Declaration of Pregnancy
- L-02 Laser Safety Inventory and Evaluation
- L-05 Medical Laser Incident Investigation Report
Texas Tech University Health Sciences Center, Department of Safety Services, 3601 4th Street MS 9020, Lubbock, TX 79430
806.743.2597
