Welcome to Temple University
Dear Faculty:
This form has been created to familiarize you with Temple University’s policies and training requirements and to ensure the timely
approval of research applications. Please answer all relevant parts. If you have any questions as you complete the form, please contact
the Environmental Health and Radiation Safety Department at (215) 707-2520 or by visiting www.temple.edu/ehrs.
Name:_________________ Department_________________ Building: ____________________ Room number:________
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A. Are you going to have or work in a research laboratory?
Yes
No (if no please go to section B)
Please indicate what you are planning to use (check all that apply)
1.
Radioactive Materials. If yes, please complete the Authorization form (found at
http://www.temple.edu/ehrs/docs/NewRAMuseApplication.pdf) to apply for authorization to use radioactive materials. Please
note that if you used radioactive materials in another university and had been trained before, you still must attend a three hour
training session relating to Temple license’s conditions and procedures. Otherwise you must attend a six hour training course.
Please contact Ms. Kisha Grady, Training Program Coordinator at kgrady@temple.edu to schedule this training.
2.
Hazardous Chemicals. Please complete the Hazardous Materials/Operations Registration available at
http://www.temple.edu/ehrs/safety/biological-safety/documents/HazardousMaterialsRegistrationForm.pdf. You must also submit
a hazardous chemical inventory for upload into CEMS, Temple’s online chemical inventory database. For more information on
CEMS, contact Ryan Kohler at 2-9282 or by visiting http://www.temple.edu/ehrs/safety/chemical-safety.
3.
4.
5.
Biological Agents
a.
Recombinant DNA. Please note that use of this requires submitting an application to and getting approval of the Institutional Biosafety
Committee (IBC) prior to use. Please refer to http://www.temple.edu/research/regaffairs/ibc/index.html for additional information.
In addition you need the following training:
NIH Guidelines Training is available online through Temple University’s Blackboard system. For instructions on how to enroll in the course, please
go to http://www.temple.edu/ehrs/training/training-instructions.asp.
Biological waste training is available online on through Temple University’s Blackboard system. For instructions on how to enroll in the course,
please go to http://www.temple.edu/ehrs/training/training-instructions.asp.
The Chemical waste training module is available on line and be accessed through Temple University’s Blackboard system. For instructions on how
to enroll in the course, please go to http://www.temple.edu/ehrs/training/training-instructions.asp.
b.
CDC Select Agent. Please see http://www.selectagents.gov/Select Agents and Toxins List.html. You will need to
apply for authorization to use these agents. The application form is available here:
http://www.temple.edu/ehrs/safety/biological-safety/documents/SBA_registration.pdf.
Please take the Select Biological Agent Training available online through Temple University’s Blackboard system. For instructions on how to enroll
in the course, please go to http://www.temple.edu/ehrs/training/training-instructions.asp.
c.
Human (or other primate) Blood, Tissue, Fluids or Cell lines. You and your lab personnel will need Bloodborne
pathogen training. Please contact the Ms. Kisha Grady, Training Program Coordinator, via e-mail at
kgrady@temple.edu.
Controlled substances. Please complete the Hazardous Materials/Operations Registration at
http://www.temple.edu/ehrs/safety/biological-safety/documents/HazardousMaterialsRegistrationForm.pdf.
X-ray cabinet unit. Please notify EHRS to register and test your device and take the Analytical X-Ray online training
through Temple University’s Blackboard system. For instructions on how to enroll in the course, please go to
http://www.temple.edu/ehrs/training/training-instructions.asp.
6.
Electron microscope. Please notify EHRS to register and test your device and take the Analytical X-Ray online training
through Temple University’s Blackboard system. For instructions on how to enroll in the course, please go to
http://www.temple.edu/ehrs/training/training-instructions.asp.
7.
X-ray diffraction. Please notify EHRS to register and test your device and take the Analytical X-Ray Users online training
through Temple University’s Blackboard system. For instructions on how to enroll in the course, please go to
http://www.temple.edu/ehrs/training/training-instructions.asp.
8.
Fluoroscopy. Please notify EHRS to register and test your device and take the X-ray for Fluroscopy Users online training
through Temple University’s Blackboard system. For instructions on how to enroll in the course, please go to
http://www.temple.edu/ehrs/training/training-instructions.asp.
9.
Radiograph. Please notify EHRS to register and test your device and take the X-ray for Radiography Users online training
through Temple University’s Blackboard system. For instructions on how to enroll in the course, please go to
http://www.temple.edu/ehrs/training/training-instructions.asp.
10.
Irradiator. You must apply for security clearance for Unescorted Access and attend irradiator and security training. EHRS
will contact you with assistance if this box is checked.
11.
MRI. Please notify EHRS to register and test your device and take the MRI Safety Training online through Temple
University’s Blackboard system. For instructions on how to enroll in the course, please go to
http://www.temple.edu/ehrs/training/training-instructions.asp.
12.
Laser. If using Class 3B or Class 4 lasers please notify EHRS to register and test your device by using the following form
http://www.temple.edu/ehrs/safety/laser-safety/documents/LaserRegistrationForm.pdf and take the Laser Safety Training online
through Temple University’s Blackboard system. For instructions on how to enroll in the course, please go to
http://www.temple.edu/ehrs/training/training-instructions.asp.
13.
Working with animals. Please note that all works with animal(s) required submitting application and getting approval of
Institutional Animal Care & Use Committee (IACUC) prior to use. Please refer to
http://www.temple.edu/research/regaffairs/iacuc/index.asp for additional information and training requirements.
14.
Working with human subjects. Please note that all work involving human subjects, such as testing and/or gathering
information, requires submitting an application to and getting approval from the Institutional Review Board (IRB) prior to performing
any research. Please refer to http://www.temple.edu/research/regaffairs/irb/irb_what_is.html for additional information and training
requirements.
15.
Nano Particles. Please complete the Hazardous Materials/Operations Registration at
http://www.temple.edu/ehrs/safety/biological-safety/documents/HazardousMaterialsRegistrationForm.pdf.
16.
Hazardous machinery. Please complete the Hazardous Materials/Operations Registration at
http://www.temple.edu/ehrs/safety/biological-safety/documents/HazardousMaterialsRegistrationForm.pdf.
17.
Bioaerosol substances such as tuberculosis (TB) or entering bioaerosol isolation areas. Please register for Airborne
Pathogen training and respirator fit testing. Please contact EHRS at 215 707-2520 (2-2520) to schedule a respiratory fit test.
18.
Aerosol producing hazardous substance such as lead, silicon, formaldehyde, xylene, etc. Please complete the Hazardous
Materials/Operations Registration at http://www.temple.edu/ehrs/safety/biologicalsafety/documents/HazardousMaterialsRegistrationForm.pdf. EHRS may need to perform exposure evaluation for your work areas.
19.
Do you package/prepare and ship (Fed Ex, UPS, DHL, etc.), transfer or transport (in person or by car, plan boat, etc.)
Hazardous Materials? You will need to attend Department of Transportation (DOT) required Dangerous Goods Training. Please
contact EHRS at 215 707-2520 (2-2520) to schedule this training
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B. Are you going to work in a clinical setting?
Yes
No(if no please go to section C)
1.
You are required to have Bloodborne pathogen training. Please contact EHRS at 215 707-2520 (2-2520).
2.
Contact with TB patients. Please register for Airborne Pathogen training and for respirator fit testing. Please contact
EHRS at 215 707-2520 (2-2520) to schedule respiratory fit test.
3.
Working with Hazardous drugs (e.g. chemotherapeutic agents). Please take the online Hazardous Drugs Safety
Training through Temple University’s Blackboard system. For instructions on how to enroll in the course, please go to
http://www.temple.edu/ehrs/training/training-instructions.asp.
4.
Working with infectious agents. Please take the online Biological Safety and Airborne Pathogens training modules.
These modules are located under Initial Safety Training, which can be accessed through Temple University’s Blackboard
system. For instructions on how to enroll in the courses, please go to this website
http://www.temple.edu/ehrs/training/training-instructions.asp.
5.
Working with radioactive materials. Please complete the Authorization form (found at
http://www.temple.edu/ehrs/safety/radiation-safety/documents/NewRAMuseApplication.pdf) to apply for authorization to
use radioactive materials.
6.
Working with x-ray producing equipment. Please complete the Radiation Worker Registration Form(found at
http://www.temple.edu/ehrs/safety/radiation-safety/documents/RadWorkerReg.pdf) and take the appropriate online X-ray
training (e.g., analytical, fluoroscopy, and/or radiography) through Temple University’s Blackboard system. For instructions
on how to enroll in the course(s), please go to this website http://www.temple.edu/ehrs/training/training-instructions.asp.
C.
7.
Working with MRI. Please take the MRI Safety Training through Temple University’s Blackboard system. For
instructions on how to enroll in the course(s), please go to this website http://www.temple.edu/ehrs/training/traininginstructions.asp.
8.
Working with lasers. If using Class 3B or Class 4 lasers please notify EHRS to register and test your device by using the
following form http://www.temple.edu/ehrs/safety/laser-safety/documents/LaserRegistrationForm.pdf and take the Laser
Safety Training online through through Temple University’s Blackboard system. For instructions on how to enroll in the
course(s), please go to this website http://www.temple.edu/ehrs/training/training-instructions.asp.
9.
Do you package/prepare and ship (Fed Ex, UPS, DHL, etc.), transfer or transport (in person or by car, plan boat,
etc.) Hazardous Materials? You will need to attend Department of Transportation (DOT) required Dangerous Goods
Training. Please contact EHRS to schedule this training
My work does not involve any of the items listed above.
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Please fax (2-1600) or e-mail (ehrs@temple.edu) completed form to EHRS.