Search

Employee Health Services Forms

HEALTH CLEARANCE REQUIREMENTS

Employee Health Services Forms

Information Sheet

Non County – For use by non-County workforce members to obtain employment within Health Services.

Pre-placement or Pre-assignment Health Clearance Packet

Non-County – Non-County- For use by contractor staff, affiliate students, volunteers and vendors who are not Health Services – county employees. In addition, to be used for other county employees working in Health Services facilities such as DPH, DMH, Sheriff and Coroner.

<span data-mce-type="bookmark" style="width: 0px;overflow: hidden;line-height: 0" class="mce_SELRES_start"></span><span data-mce-type="bookmark" style="width: 0px;overflow: hidden;line-height: 0" class="mce_SELRES_start"></span>

Annual Health Screening Packet

Non-County – For use by non-County workforce members to obtain annual health screening clearance. Health screening clearance must be obtained each year on the same month of assignment date with Health Services.

EHS Forms

O-NC – Respirator Medical Evaluation Questionnaire – Questionnaire for fit test respirator greater than a N95 (such as a full-face respirator)

EHS Policies

Health Screening – NonCounty WFM Policy No. 705.001

Frequently Asked Questions

FAQ

Health Clearance Requirements

EHS Requirements