Portland State University Pregnancy Declaration Form free printable template

PREGNANCY DECLARATION FORM First and Last Name When completed Environmental Health Safety Submit by E-mail Print Form I voluntarily declare my pregnancy so any work related radiation exposure to the embryo/fetus can be monitored by the Radiation Safety Officer RSO. I will be issued a dosimeter for abdominal fetal monitoring if I continue working where I may expect exposures greater than 20 mrem 0. 2 mSv per month. If I do not meet the above requirements I will only receive a fetal dosimeter...

How to fill out psu declaration get form

How to fill out Portland State University Pregnancy Declaration Form

1. Obtain the Portland State University Pregnancy Declaration Form from the official website or student services.
2. Fill in your personal information including your name, student ID, and contact information.
3. Indicate the estimated date of the pregnancy by entering the date in the specified section.
4. Provide details about any accommodations or assistance you may require during your pregnancy.
5. Sign and date the form to certify the information provided is accurate.
6. Submit the completed form to the designated office, such as the Office of the Registrar or Student Health Services.

Who needs Portland State University Pregnancy Declaration Form?

1. Pregnant students attending Portland State University who seek to declare their pregnancy status.
2. Students requiring accommodations due to pregnancy during their academic studies.
3. Students who want to inform the university for health and support resources related to their pregnancy.

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What is Portland State University Pregnancy Declaration Form?

The Portland State University Pregnancy Declaration Form is a document that students must complete to officially declare their pregnancy status to the university.

Who is required to file Portland State University Pregnancy Declaration Form?

Students who are pregnant and wish to access specific accommodations or services related to their pregnancy are required to file the form.

How to fill out Portland State University Pregnancy Declaration Form?

To fill out the form, students must provide personal information, details about their pregnancy, and any special accommodations they may need.

What is the purpose of Portland State University Pregnancy Declaration Form?

The purpose of the form is to inform the university of a student's pregnancy in order to facilitate necessary support and accommodations during their educational experience.

What information must be reported on Portland State University Pregnancy Declaration Form?

The information that must be reported includes the student's name, student ID, expected due date, and any specific requests for accommodations related to their pregnancy.