Reproductive Hazard Identification Checklist

This checklist is to be completed by the employer for each job assignment in the workplace. In the case of temporary workers, the checklist should be completed by the host employer, or collaboratively with the staffing agency, and included in the agency contract prior to placement of employees in the position. The completed checklist should also be shared with employees assigned to the job as part of their health and safety training. Employees should share the checklist with their healthcare provider, who can use the information to evaluate the need for any work restrictions or accommodations