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Figure: 25 TAC 289.202(GGG)(9) PAGE OF RC Form 2023 Texas Department of State Health Services/Radiation Control OCCUPATIONAL EXPOSURE RECORD FOR A MONITORING PERIOD 1. NAME (LAST, FIRST, MIDDLE INITIAL)

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How to fill out occupational exposure record for

01

Step 1: Obtain a copy of the occupational exposure record form.

02

Step 2: Start by providing basic information such as your name, job title, and contact details.

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Step 3: Specify the date and time of the exposure incident.

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Step 4: Describe the type of exposure that occurred (e.g., chemical, biological, physical).

05

Step 5: Provide details about the specific substances or agents involved in the exposure.

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Step 6: Document the duration and frequency of the exposure.

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Step 7: Include any protective measures or safety equipment used during the exposure.

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Step 8: Note down any symptoms or health effects experienced as a result of the exposure.

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Step 9: Sign and date the occupational exposure record form.

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Step 10: Keep a copy for your records and submit the form to the appropriate authority or department.

Who needs occupational exposure record for?

01

Employees working in occupations with potential exposure to hazardous substances or agents.

02

Medical professionals who may come into contact with infectious or contagious diseases.

03

Workers in industries such as construction, manufacturing, agriculture, and healthcare.

04

Employers who are responsible for ensuring the health and safety of their employees.

05

Regulatory agencies and government bodies that monitor occupational health and safety.

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