Students and/or workers must complete this form and attached fact sheet confirmation, and mail or scan and email to URCO at email@example.com to ENROLL in the OHSP. Despite enrollment, you are not cleared until the Occupational Health Professional at Via Christi sends your clearance form to URCO.
Students and/or workers must complete this form, then scan and email to Via Christi Occupational Health at Francis.Koopman@ascension.org as the second step in the OHSP enrollment process.
Every year, or if animal work or personal health status changes, personnel enrolled in the OHSP need to fill out form 4 and return to firstname.lastname@example.org. If you have changes in your health status or animal activities, also complete Form 5 (below).
If you indicated a change in health or animal activity status on an annual reassessment (Form 4), complete and email this form to Via Christi Occupational health at Francis.Koopman@ascension.org.