Instructions: Complete the form below to update your Injury & Illness Prevention Plan (IIPP). An updated IIPP document will be sent to you within 7 days. This information must be updated annually.
About this department
Department:
Location:(Building(s))
Name of Department Head:(Director, Dept. Chair, Unit Head, Laboratory Manager / Director)
Name of Department Safety Coordinator:
Will you have a department safety committee?(If "Yes" please indicate name of the Chair in the "Comments" section below)
Comments:
Certification
Your Name: ✻
Your Email: ✻
By submitting this form I verify that the IIPP has been updated (with the above information), and a Department Safety Coordinator has been assigned. ✻
