Forms- Which form do i fill out

Question 1

-Forms- Which form do i fill out-

If you are in contact with a patient possibly having a communicable disease, eg HIV, Hep C, Tuberculosis, large amounts of blood

Answer 1

Medical Exposure Report

Question 2

-Forms- Which form do i fill out-

If you are in contact with a patient possibly having a communicable disease, if it is significant, eg. blood in eye, patient with TB coughs in your face,____

Answer 2

call the Designated Officer

Question 3

-Forms- Which form do i fill out-

If you are in contact with a patient possibly having a communicable disease, If you see a Doctor after a Medical Exposure,_______

Answer 3

fill out a workplace injury/illness report

Question 4

-Forms- Which form do i fill out-

Any time you are in contact with hazardous materials, eg house fire , pot on the stove, car fire, asbestos, unknown odour

Answer 4

Hazardous Materials Exposure Report

Question 5

-Forms- Which form do i fill out-

If you see a doctor after a Hazmat Exposure

Answer 5

fill out a Workplace injury/illness report

Question 6

-Forms- Which form do i fill out-

Every time you get hurt at work, eg cut finger doing dishes, hurt back lifting patient, or slip on ice getting out of your car

Answer 6

Workplace injury/illness report

Question 7

-Forms- Which form do i fill out-

The office of the fire marshal incident and casualty reporting manual requires a ______ ______ be completed for any injury sustained by a fire fighter in responding to and during any type of incident

Answer 7

Casualty Report

Question 8

-Forms- Which form do i fill out-

Off work 3 days or more and coming back to work. note: for the 24 hour shift this translates to 36 hours or more and coming back to work

Answer 8

Medical Assessment Form (non-occupational Injury)

Question 9

-Forms- Which form do i fill out-

Coming to modified duties after an off the job injury

Answer 9

Medical Assessment Form (non-occupational Injury)

Question 10

-Forms- Which form do i fill out-

Coming back to full duties after an off the job injury

Answer 10

Medical Assessment (non-occupational Injury)

Question 11

-Forms- Which form do i fill out-

Coming to full duties after being on modified due to off the job injury

Answer 11

Medical Assessment Form(non-occupational injury)

Question 12

-Forms- Which form do i fill out-

Coming back to full duties after chest pain

Answer 12

Medical Assessment Form (non- occupational injury)

Question 13

-Forms- Which form do i fill out-

Submitted monthly if off

Answer 13

Medical Assessment Form (non-occupational injury)

Question 14

-Forms- Which form do i fill out-

Submitted monthly if on modified duties

Answer 14

Medical Assessment Form (non-occupational injury)

Question 15

-Forms- Which form do i fill out-

Coming back to full duties after a work place injury

Answer 15

Functional Abilities From (Occupational Injury):

Question 16

-Forms- Which form do i fill out-

For every Workplace Injury resulting in lost time and/or medical care

Answer 16

Functional Abilities Form (Occupational Injury)

Question 17

-Forms- Which form do i fill out-

If returning or not returning to modified duties after a workplace injury and monthly after the 1rst Doctor’s visit (to be completed by doctor)

Answer 17

Functional Abilities Form (Occupational Injury)

Question 18

-Forms- Which form do i fill out-

May be brought to a member’s physician when when completing a Functional Ability form or medical Assessment Form. It is to assist the member in describing the demands of firefighting to the physician. Useful when the Doctor is deciding an appropriate return to work date or modified duties restrictions

Answer 18

Physical Demands Analysis (PDA) Document