Occupational Health

Hours & Contact Info

  • Office Hours
  • M - F: 8:30am - 4:00pm
  • Phone
  • 301-314-8199
  • Fax
  • 301-405-9755

  • Information


  • Emergency


Located on the ground floor of the Health Center, the Occupational Health Service provides a number of work-related services to employees. Occupational Health works closely with the Department of Environmental Safety, Sustainability, and Risk to create and maintain a safe and healthy work environment.


  • Pre-placement physical examinations are required for certain jobs on campus prior to starting work. Examinations may require further evaluation which may include pulmonary function testing, x-ray, lab work, or referral to a specialist.
  • Pre-placement forms are required for the Animal Handler Program and the Respirator Program. These forms must be completed prior to enrolling in either of these programs.
  • Work-related immunizations such as Hepatitis B; Tetanus, Diphtheria, Pertussis (Tdap), Influenza, and Rabies.
  • Tuberculosis screening
  • Medical surveillance for employees exposed to hazardous materials; working with asbestos, silica, noise, and pesticides; and employees with certain laboratory exposures.
  • Initial and periodic health assessment for employees in need of Department of Transportation (DOT) certificates.
  • Consultation and education on occupational health concerns.



DOT Physicals

Please call 301-405-3153 or 301-314-8184 to schedule your DOT appointment.

You will also need to schedule a separate appointment with the lab for a urine test. If this is your first DOT physical for Shuttle-UM, then you will also need to schedule an additional appointment for drug testing.

Prior to your appointment with the provider, you will need to review or complete your “Health History” in the Patient Portal. In addition, you will also need to complete the appropriate sections of the DOT Medical Examination Report Form:


Driver Information

  • Personal Information (page 1)
  • Driver Health History (pages 1-2)
  • CMV Driver's Signature (page 2)

When you arrive for your appointment, please bring the following items:

  • Completed DOT Medical Examination Report Form (pages 1-2)
  • Driver’s License
  • Drivers with vision problems must bring their eyeglasses or contacts
  • Drivers with hearing problems must bring their hearing aids

Drivers with psychological disorders (i.e. ADHD, depression, bipolar disorder, etc.) must bring a completed CMV Driver Medication Form from their mental health professional (psychiatrist or psychologist)

Drivers with diabetes must bring the following:

  • A copy of their most recent blood test results that includes their Hemoglobin A1C (HgA1C) level (within the last 3 months).
  • Drivers that require insulin to treat their diabetes must also bring The Insulin-Treated Diabetes Mellitus Assessment Form that has been completed by their treating clinician within forty-five (45) days of your DOT appointment. In addition, these drivers must also bring records of their preceding three (3) months of ongoing blood sugar logs.

Insulin-Treated Diabetes Mellitus Assessment Form

Occupational Health Forms

Animal Handler

Initial Asbestos

Please complete each form included in this section and bring to your appointment

Initial Asbestos Form

Periodic Asbestos

Please complete each form included in this section and bring to your appointment.

Periodic Asbestos Form

Respirator Physical

Complete each form included in this section and bring to your appointment. 

Respirator Evaluation

Occupational Health (OH) History

Please complete each form included in this section and bring to your appointment.

Occupational Health (OH) History Form

Vaccinia (Small pox)

Please complete each form included in this section and bring to your appointment

Vaccine Request Form History and Consent Form Important Information About Vaccinia (Smallpox) Vaccine

Hepatitis B

Your position has been identified as one in which there is exposure to blood and body fluids.  We recommend that you receive Hepatitis B vaccine (three doses at time 0, 1 month and 6 months) to protect you from this blood-borne infection. 

Please complete the form below and upload it into myuhc.umd.edu with a message to Rebekah Giannakos with your preference about receiving the vaccine and dates of vaccination.  Alternatively, send the completed form via interoffice mail to Rebekah Giannakos, University Health Center. 

We will contact you to schedule the vaccine administration, if necessary.

Hepatitis B Vaccine Form