All personnel working in animal facilities or in contact with animals in the course of their work are encouraged to participate in baseline and annual health screenings. All students working in animal facilities or in contact with animals in the course of their work are required to participate in baseline and annual health screenings. Health screenings are administered by the Lehigh University Health and Wellness Center. 

The month and year of your last tetanus inoculation must be listed on this Qualifications Form. Students and personnel working in animal facilities or in contact with animals are required to have a tetanus inoculation at least every ten years.

Please complete the Health Questionnaire Form and upload it to your Patient Portal. Report the date that you submitted the Health Questionnaire Form to the Health and Wellness Center on this Qualifications Form. Students are required to submit a Health Questionnaire Form annually.

Please read the General Zoonotic Training information and certify that you have read and understand it on this Qualifications Form.

I have read and understand the General Zoonotic Training information.
Have you completed the required CITI training modules?
Formal Lab Training
Laboratory Animal Work Experience
Do you have experience working with the following animals?
Do you have experience working with the following drug administration methods?
Do you have experience with the following methods for collecting biological specimens?
Do you have experience with the aseptic technique?
Does your work with laboratory animals involve contact with any of the following?
Have you been informed and instructed about biohazards in the workplace under the right to know laws?
Are you certified for radioisotope use?
Are you familiar with the regulations on methods of disposing of syringes and needles?
Health Screening
By submission of this form, I CERTIFY THAT ALL THE INFORMATION PROVIDED IN THIS FORM IS TRUE