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Please complete this OSHA questionnaire and return it Fermilab Occupational Medical Office Mail Stop 204 ASBESTOS QUESTIONNAIRE used for Asbestos and Grit Blasters Standard 1926. 1101 App D PERIODIC MEDICAL QUESTIONNAIRE Part 2 Name ID Present Occupation DOB Telephone Ext. Date Occupational History In the past year did you work full time 30 hours per week or more for 6 months or more Yes No Does not apply Was dust exposure Mild Moderate Severe Job/Occupation Position/job title Recent Medical...
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Start by reading the OSHA form carefully to understand the required information.
02
Provide the requested personal details such as your name, address, and contact information.
03
Fill out the sections related to your current employment, including the company name, address, and contact information.
04
Answer all the questions accurately and truthfully to ensure compliance with OSHA regulations.
05
Include any additional information or details that are specifically requested on the form.
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Review the completed form for any errors or missing information before submitting it.
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Submit the completed OSHA form according to the provided instructions or guidelines.

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Please complete this OSHA form is needed by employees or employers who are required to provide information related to workplace safety.
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Specifically, individuals or companies that fall under the jurisdiction of the Occupational Safety and Health Administration (OSHA) in the United States may need to fill out this form.
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This includes businesses that engage in activities covered by OSHA regulations, such as construction, manufacturing, healthcare, and more.
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Employers may also require their employees to complete this form as part of their safety protocols and compliance measures.
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The OSHA form must be completed to report workplace injuries and illnesses.
Employers are required to file the OSHA form.
The OSHA form can be filled out online or submitted by mail.
The purpose of the OSHA form is to track and record workplace injuries and illnesses.
Employers must report information such as the nature of the injury or illness, the date it occurred, and the treatment provided.
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