From: Neil Edwards <Neil.Edwards**At_Symbol_Here**LIU.EDU>
Subject: Re: [DCHAS-L] Waiver Form Example
Date: Thu, 27 Aug 2015 20:43:18 +0000
Reply-To: DCHAS-L <DCHAS-L**At_Symbol_Here**MED.CORNELL.EDU>
Message-ID: D204EE74.3C902%neil.edwards**At_Symbol_Here**
In-Reply-To <691617fdb1b9455f9d62588f9904a9cd**At_Symbol_Here**>

Regarding a waiver form for pregnancy and for health conditions that might preclude someone from participating in a chemistry lab course, we take a slightly different approach. We have EVERY student sign a form (and also give them a copy to take home) on the first day of lab, in which they acknowledge that if they are (or might be) pregnant, OR if they have a medical condition that might subject them to potential risks in a laboratory setting, they have been advised to consider consulting with a physician in connection with those risks.

In this form, they are also told that upon request they will be given a complete list of chemicals used in the course they are taking, so that they may share the list with their own physician; and that we will also provide a copy of the SDS for any chemical that the physician considers questionable or particularly risky. We keep these signed forms on file for at least five years.

It is of course not up to us to prohibit a student from taking a course based on our own subjective assessment of the student's health or based on our views as to whether an expectant mother might be risking her own or her baby's health by exposure to certain chemicals. We can provide the relevant information; but the student is in charge of making such decisions.

Stephanie, I am sending you a copy of our form. If anyone else wants a copy, please send me a private email message, and I will send you one.

Neil Edwards
Laboratory Manager
Adjunct Professor
Department of Chemistry
LIU Post
Brookville, NY 11548-1300
Email: neil.edwards**At_Symbol_Here**

From: Stephanie McClouds >
Reply-To: DCHAS-L >
Date: Thu, 27 Aug 2015 19:27:14 +0000
To: >
Subject: [DCHAS-L] Waiver Form Example

Good Afternoon,

We have recently been tasked with creating a waiver form for students with health conditions such as pregnancy, allergies, etc. This waiver will be signed prior to them beginning work in the research lab. I was wondering if anyone is willing to share a similar waiver form.

Thank you,

Stephanie L. McClouds, MHS
Senior Laboratory Safety Specialist
Office: 443-334-2775

Stevenson University
School of the Sciences
1525 Greenspring Valley Road
Stevenson, Maryland 21153

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