Forms

In the event of a needlestick injury, the steps in the "Needlestick / cut injury" information sheet should be followed.
It is recommended that the questionnaire (due to required information on the 'donor') be completed at the workplace.
Further information

Forms for "Information / notification of the department about the employment of an expectant mother to the responsible personnel administration" can be found in the Maternity Protection section. Please note that there are different forms for notifications at the University Hospital and for notifications at Heidelberg University.

Prior to employment at Heidelberg University Hospital, the required immunisation protection / immune status must be verified using the following forms. As a rule, any missing proof must be provided as a prerequisite for employment by the time of employment / commencement of work.
Missing or incomplete vaccinations must be carried out or supplemented at the expense of the SHI in accordance with the Stiko recommendations and also, if they are occupationally indicated vaccinations (against measles, mumps, rubella and varicella). [see: Vaccination guideline of the B-GA (amended 05/03/2020/valid from 15/05/2020)].

Form on employment requirements for all employees (including PJ students, school pupils, trainees, temporary workers)

• Information on necessary proof of immunity according to IfSG FSJ/BFD, honorary/guest doctors (for submission to the company medical service)
• Conditions of Submission for foreign health care workers
• Personnel data

Form on the existence of hiring requirements for short-term employees

• Short-term employees: short-term employees, trainees, interns (to be completed by the family doctor)

Immune protection against measles
Since 1 March 2020, proof of immune protection against measles must be provided to the University Hospital and its subsidiaries in accordance with Section 20 (9) IfSG and Hospital Board Resolution 72/2020.

Before each examination in accordance with the Radiation Protection Ordinance, the application form (only available via the UKHD intranet) must be completed in full by the radiation protection officer of your institution / department (stating the SSR number and dose details).
The completed application form must be brought to the examination. Registration under 06221 56-8966.

If you have any questions about radiation protection at the UKHD, please contact the radiation protection officer (only available via the UKHD intranet).

1. Please take note of the information sheet and bring any current glasses, visual aids and your spectacle pass with you to the examination.
   Information sheet: Display screen workstation glasses
2. To prepare for the examination, please bring the completed
   VDU workstation description with you to the appointment:
   1. Upper part: Please enter the necessary information here in preparation for the examination/consultation (if necessary, ask employees to take the necessary measurements). This information must then be confirmed by the supervisor.
   2. Lower part: The determination of the reaction by an optician will only take place after your appointment with the company doctor. Should the company doctor's consultation/examination reveal this, an additional ophthalmological examination may be necessary in individual cases (the costs for this are not covered by the employer).

UKHD - internal form: Administrative request for "Determination of suitability in the existing employment relationship"

• Fillable PDF form [the field function for filling in only exists when viewing the file in Acrobat Reader]

Form - external: for"Determination of suitability in the existing employment relationship"

• Immunitäts-Voraussetzungen für Studierende der Humanmedizin und Zahnmedizin an der Universität Heidelberg