The forms and checklists have been assembled from many different parts of the RMEHS Campus Programs. Where forms come from procedures, the procedure title and appendix are given. The Procedures are found in the RMEHS Procedures Manual. Most Emergency Preparedness checklists and forms are found in Emergency Preparedness.
- Employee Report of Occupational Injury or Illness (IIPP App. 8.4)
- Hazard Incident Report Form (IIPP App. 8.2)
- Report a Safety Concern
- Supervisor Report of Occupational Injury or Illness (IIPP App. 8.3)
Note: The following components must be fulfilled in order to be respirator qualified.
- Training – Compliance Brief: Filtering Facepiece Respirators and Masks – 16 min. (Online @ CSU Learn)
- N95 Respirator Request Form (Online) – Attach a copy of the N95 online training “Certificate of Completion” when submitting the N95 Respirator Request form.
Forms and Checklists
Risk Management Forms
- Emergency Information Guidelines Form
- State Vehicle Driver Program Enrollment Form
- Authorization to Use Privately Owned Vehicles on State Business- Form STD 261
- Vehicle Accident Report Form for State Drivers
- CSULA Site Visit Checklist
- Individual General Release
- Class General Release
- Class General Release for Athletics
- Photo Release
- Photo Release (Spanish)