Download Questionnaire Forms

The following forms are in PDF format
and can be viewed using the Adobe Acrobat Reader.

The following forms allow you to capture data in the EPINet™ format created by Janine Jagger of the University of Virginia.

Note: The downloadable forms on this page are in Adobe Acrobat format. In order for you to view them, please download the latest version of Adobe Acrobat Reader by clicking on the Get Acrobat Reader Button. This will take you to the Adobe Acrobat Reader's homepage. There will be instructions available there.

• Form 1 - Uniform Needlestick and Sharp Object Injury Report
• Form 2 - Uniform Blood and Body Fluid Exposure Report
• Form 3 - Postexposure Follow Up Form

EPINet™ is a trademark of the University of Virginia.