- Review the HHQ Form A within 30 days of receipt, prior to initiation of an individual’s active work.
- If HP has questions about the individual’s HHQ, contact the individual to have them come in for an in-person medical evaluation. If necessary, the HP may refer individuals to their Primary Care Physician (PCP) for further medical evaluation, immunizations, diagnostic testing and/or referral and/or recommend further modifications such as additional PPE, based on information provided on Form A.
- Complete Form B
- Noting whether or not an individual is physically fit to be exposed to animals or animal by-products, OR
- Noting any recommendations to the individual for further medical evaluations, immunizations, diagnostic tests, and/or PPE. Receiving written proof of completion from the individual when these recommendations are completed, OR
- Noting on Form B if the individual declines to follow the HPʻs recommendations made on Form B, after receiving a signed copy of Declination Form C from the individual.
- Mail a copy of Form B to the enrollee’s academic unit listed on HHQ Form A.
- Maintain all employee health records in accordance with applicable standards for privacy and confidentiality.
- Straub will bill either UH JABSOM, UHCC, or AVS for reviews of Health History Questionnaires and medical clearances for respirators. Straub will reference on the bill the PIʻs name to whom the individual enrollee reports.