Laboratory Relocation Notification Form

Please fill out the form below and click the Submit Button.  If you require assistance or have questions about this form please contact Occupational Safety and Health Programs or call 843-792-3604 .

Fields marked with * are required. Investigator Name:* Email Address* Telephone Number: * Department: Building/Rooms:(List all building/room numbers corresponding to your current location if at MUSC) Destination* MUSC Another campus If relocating to another MUSC location, please provide the building/room numbers. Proposed Date of lab relocation (mm/dd/yyyy)* Types of laboratory hazards being relocated (check all that apply) Biological Chemical Radioactive Lab Manager/Contact: (Please provide the name and contact information of the individual who will coordinate the laboratory relocation.)*