List of Attachments.docx

LIST OF ATTACHMENTS

Attachment 1 – Security, Safety and Fire Provisions Attachment 2 – Clinic Government Property Inventory (DSCC and DFAS) Attachment 3 – Radio & Television Stations Attachment 4 – Potential Exposure to Bloodborne Pathogens Attachment 5 – Refusal of Medical Services Attachment 6 - Job Injury Report Package DFAS-CO and Serviced Activities Attachment 7 - Job Injury Report Package DLA Organizations Attachment 8 - Job Injury Report Package DISA Defense Enterprise Computing Center – Columbus Attachment 9 - Medical Officer’s Report of Injury or Illness--DSCC FM 1157 Attachment 10 – Attending Physician’s Report--DOL Form CA-20 Attachment 11 – Federal Employee’s Notice of Traumatic Injury and Claim for Continuation of Pay/Compensation--DOL Form CA-1 Attachment 12 – CA-16 Referral Instructions Attachment 13 – Documentation of services received – CLIN Sheet Attachment 14 – Authorization for Examination and/or Treatment--DOL Form CA-16 Attachment 15 – Handicap Parking Requests Attachment 16 – Ergonomic Equipment Medical Supplement Attachment 17 – Physical & Medical Qualifications for Police—Policy Document #10-009 Attachment 18 – Control & Recording Procedures for Exposure to Ionizing Radiation & Radioactive Materials—DLAR 1000.28 Attachment 19 – Modification 10 to USCENTCOM Individual Protection & Individual/Unit Deployment Policy Attachment 20 – PPG-Tab A: Amplification of the Min. Stds. Of Fitness for Deployment to the CENTCOM AOR; To Accompany Mod 10 Attachment 21 – Deployment Forms

Attachment 22 – CENTCOM Medical Waiver Request Documentation Attachment 23 – DoDI 6200.03 - Public Health Emergency Management Within the DoD Attachment 24 – Authorization for Release of Medical Information to the DSCC/OSU Occupational Health Physician Attachment 25 – DA Form 5006-R – Authorization for Disclosure of Information Attachment 26 – Health Promotions/Screenings Attachment 27 – DSCC 2278 – AED Class Registration Form Attachment 28 – Privacy Act Statement – Health Care Records Attachment 29 – Occupational Medical Services Invoice Attachment 30 – Services Performed by Individual Attachment 31 – Department of Labor Wage Determination 2005-2417 Attachment 32—Mission Essential Services