Document Code:
P1-F1
Laboratory Safety Training Questionnaire
Contact Information
Responsible Faculty or Staff Name
*
First Name
Last Name
Academic Title
*
Employee ID
*
Responsible Faculty or Staff Email
*
example@fit.com
Phone Number
Please enter a valid phone number.
Building
*
Room
*
Questions about your Research
Is there a fume hood in your lab?
*
Yes
No
Is there or will there be an autoclave in your lab?
*
Yes
No
Is there or will there be a biosafety cabinet in your lab?
*
Yes
No
Will your work generate hazardous waste?
*
Yes
No
Will your work generate biological waste?
*
Yes
No
Will your work require a respirator?
*
Yes
No
Will your work require use of an overhead and/or gantry crane?
*
Yes
No
Will you be working with rocketry?
*
Yes
No
Do you work with sharps? (i.e., needles)
*
Yes
No
Do you work with animals?
*
Yes
No
Do you work with blood-borne pathogens?
*
Yes
No
Do you work with compressed gasses?
*
Yes
No
Do you work with chemicals?
*
Yes
No
Do you work with Flammable Liquids?
*
Yes
No
Do you work with Hydrogen Sulfide?
*
Yes
No
Do you work with Formaldehyde?
*
Yes
No
Do you work with Benzene?
*
Yes
No
Do you work with silica?
*
Yes
No
Do you work with Liquid Nitrogen?
*
Yes
No
Do you work with radioactive material?
*
Yes
No
Do you work with x-rays?
*
Yes
No
Do you work with lasers?
*
Yes
No
Submit
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