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The information requested in this questionnaire about your health status will be used only to detect diseases or bodily dysfunction due to your work with wildlife in the field or your work with animals in the UM Laboratory Animal Resources facility before you would normally seek medical care. Your responses to this questionnaire are considered confidential; they will be reviewed by an occupational medicine physician and stored in an off-campus medical office to ensure the security of your confidential information.
There are two separate Risk Assessment questionnaires: one is designed for people working with or around wildlife and one is designed for people working with or around laboratory animals. Please download the correct form and return it to the appropriate physician.
This questionnaire is mandatory.
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