Forms safety

Bloodborne Pathogen Exposure Report

OSHA 29 CFR 1910.1030 BBP exposure report — needlestick / body fluid exposure documentation.

Built for: Healthcare Lab Dental

What's inside this template

Date and time of exposure (required)
Location (unit / room) (required)
Type of exposure (required)
Needlestick / Other sharps / Mucosal splash / Non-intact skin contact
Body site exposed (required)
Source of exposure (device / activity) (required)

Time to reach occupational health (must be ≤2 hr for HIV PEP eligibility) (required)
PEP recommendation made
Reporter signature (required)

Needlestick / sharps exposure

Mucosal splash exposure

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