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RMU Home » Forms » Occupational Health

• Forms
• Claims and Incident Reporting
• Employee Safety
• Insurance Requirements in Contracts
• Occupational Health
• Wellness
• Worker’s Compensation

Occupational Health

DOT Random Testing for Driving Classifications

• Employee Clinic Passport (PDF - 174kb)*.

Pre-employment Medical Screenings

Referral Forms:

• Sedentary positions (PDF - 19kb)*.
• Sedentary positions with special requirements (PDF - 24kb)*.
• Non-sedentary positions (PDF - 30kb)*.

Health History Questionnaires:

• Health History Questionnaire (PDF - 72kb)* - all positions except POST and ACFD badge positions.
• Health History Questionnaire (PDF - 355kb)* - Public Safety Dispatchers only.
• Health History Questionnaire (PDF - 401kb)* - Peace Officers only.
• Health History Questionnaire (PDF - 279kb)* - ACFD badge positions only.
• Respirator Medical Evaluation Questionnaire (PDF - 56kb)* - if applicable.

Health Screening During Employment

• Referral for Medical Services (PDF - 125kb)* - All tests and services other than for pre-employment.

* Portable Document Format (PDF) file requires the free Adobe Reader.