WSIB Exposure Form

This form is filled out voluntarily by the worker and kept on file at the WSIB.  Fill this out if:

1. You have had an exchange of bodily fluids, either a bite, scratching/breaking the skin, spit on the face (eyes, mouth, nasal passage) or any sputum, feces, urine contacting an open sore AND:
2. You have not submitted an Employee’s Report of Injury OR:
3. You have submitted an Employee’s Report of injury and there was no lost time OR:
4. You have submitted an Employee’s Report of Injury and have not sought medical attention

This form is filled out in case you have come into contact with a contaminant, and later get sick, this is your proof you were infected at work.  Mail it in yourself, then copy to your Principal

For a copy of the form click here.