Division Title
Health and Wellness

Preplacement Evaluations

These evaluations explore the physical demands and environmental hazards of an applicant’s proposed position. The OMS healthcare provider reviews the individual’s personal medical and immunization history to determine whether the worker can assume the duties of the position. The OMS staff provides work-related health and safety advice, administers appropriate vaccines, and enrolls the individual in applicable OMS surveillance programs. 

How to Prepare for a Preplacement Evaluation  

An Administrative Officer or Supervisor must send OMS a Medical Qualification Determination Questionnaire (NIH Form 750-3) and a Request for Medical Determination and Report of Findings (NIH Form 750-2), if at least one of the following applies to the prospective worker: 
  • Works with infectious agents 
  • Works with highly toxic agents 
  • Works with human or nonhuman primate body fluids 
  • Works in areas that patients may visit Works in areas housing or visited by animals used in research 
  • Works in Building 10 Works as a firefighter or police officer 
  • Works in areas with potential exposure to noises above 85dB or louder during an eight-hour work day, or 
  • Works in areas with potential exposure to significant concentrations of airborne asbestos.

An OMS provider will contact the employee to schedule an appointment once paperwork has been received and processed. 

Potential employees should bring the following forms filled out to the appointment, or arrive 15 minutes before your scheduled appointment time: OMS Clinical Record/Face Sheet (NIH Form 2110) and  Report of Medical History (GSA Form SF 93)  

The Short Stay Form is for NIH trainees and fellows with an anticipated stay of up to one year. The responsible Administrative Officer or IC representative completes the top portion and return it to OMS for processing. A copy of your immunization records can be obtained from your physician or school.

If the employee will be working in an area that has patient or non-human primate contact, he/she must also fill out a TB Questionnaire and Quiz.  

If an employee is only working with animals and none of the above apply, only an Animal Exposure Program appointment is necessary.

Please contact OMS by email or by phone at (301) 496-4411 if you have any questions.