NMDOH Logo
RSS Feed Icon

Forms


Photo of the publication cover. Occupational Health Case Reporting Occupational Health Surveillance - Form March 15, 2018

This confidential case reporting form allows health care providers and lab directors to meet the requirements of the law by reporting occupational and/or injuries to the New Mexico Occupational Health Surveillance Program (OHSP) within 24 hours. Additional instructions for reporting a case are contain within the document.



Photo of the publication cover. Pesticide Illness Reporting Occupational Health Surveillance - Form April 2, 2014

This form should be used by all healthcare professionals to report pesticide related illness and injury of workers in New Mexico to the Occupational Health Surveillance Program. It includes a list of questions you can ask your patients and the symptoms of pesticide exposure are also listed in both English and Spanish.