The UAB EH&S Occupational Medicine Enrollment Form is the start of this process for the eligible employee. The Occupational Medicine Professional reviews the work exposures and medical history in order to determine what services to provide the employee to ensure a safe and healthy work environment.

Every two years the Enrollment Renewal Form is due unless the employee’s job changes or work exposures change, then an updated enrollment renewal form is required.

Annual updates for certain forms may be required.

Email reminders will be sent to the employee’s UAB email account due to confidentiality requirements.

Initial Enrollment:

Update Enrollment:

  • Download the Enrollment Renewal Form or applicable form (Allergy Form, Annual TB Form, Latex Allergy Form) from the list at the right-hand side of this page.
  • Print and complete the form.

Form Submittal:

  • You may submit completed forms electronically to This is preferred. 
  • You may place the completed forms in a confidential envelope and send it to:
    UAB EH&S Occupational Medicine
    CH19, Suite 445, -2041
  • You may fax the completed forms to (205) 934-7487.
    flag red Please be aware that the fax machine is located in the main EH&S office and confidentiality cannot be assured.
  • You may deliver your completed forms to CH19 Suite 412 and place the forms in the secured lock box at the receptionist’s desk.

After the forms are received in Occupational Medicine, please allow 2 weeks for processing. Incomplete forms can prolong the process. Occupational Medicine professionals review the forms and an email will be sent to the employee for being compliant with Occupational Medicine.