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Please type responses here: |
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First name:
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Last name:
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Email Address:
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Retype Email Address:
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Phone number:
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Institution:
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Title:
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Address:
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City:
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State:
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Country:
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Zip/Postal Code:
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At what type of laboratory are you currently employed?
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Hospital
Reference
Academic
Physician Office
Other
I do not work in a laboratory
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If you chose 'Other' above, please describe the type of laboratory at which you are currently employed:
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My credentials (i.e., MD, RN, PHD, etc.): Please fill in the blank:
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I practice/work in: (select all that apply)
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Laboratory
Emergency
Hospital
Urgent Care
Primary Care
Pharmacy
Specialized clinic
Long-term Care/Nursing home
Other clinical setting
Medical Distributor/Manufacturer/Supplier (If selected, please skip to the following question)
Non-clinical setting
Other
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I specialize in: (select all that apply)
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Pediatrics
Family Medicine/Internal Medicine
Emergency Medicine
Urgent Care
Student/Resident
Administration
Pharmacy
Clinical Acute Laboratory
Clinical Non-acute Laboratory
Operations/Practice Management
Other Business Professionals
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How familiar are you with OSHA's Hazard Communication Standard (HCS) and its requirements for workplace safety?
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Very Familiar
Somewhat Familiar
Neutral
Slightly Familiar
Not Familiar
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What is your current level of understanding regarding NFPA ratings and labels, Safety Data Sheet (SDS) sections, and the procedures for cleaning up a chemical spill?
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Excellent
Good
Fair
Poor
Very Poor
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