UC San Diego PPE Office Online Fitting Form
Name
Name
First
Last
UCSD Email Address *
(If no UCSD email, then personal email)
Principal Investigator
Principal Investigator
First
Last
What is the reason for your visit to the PPE Office?
Please check all that apply
What is the reason for your visit to the PPE Office?
Please check all that apply
Lab Coat Fitting
Safety Glasses
Faceshield/Goggles/Aprons
Loaner lab coat (pick-up/return)
Laundry
Question/Other
Do you need to be fitted for embroidered lab coats? * *
Eligible lab members include: Any researcher employed by UC San Diego (i.e. graduate students, post-docs, staff, and PAID undergraduates) that will be working in the lab for AT LEAST ONE CALENDAR YEAR. Volunteers are NOT ELIGIBLE for embroidered lab coats and will receive a loaner lab coat, which is a temporary use coat they will return to the PPE Office when are finished working in the lab.
Yes
No
ELIGIBILITY REQUIREMENTS FOR EMBROIDERED LAB COATS
1. You are employed by a UC San Diego lab (i.e. paid undergraduates, graduate students, post-docs, and staff) and will be working in the lab AT LEAST ONE CALENDAR YEAR.
2. You have been placed on the lab roster in the LHAT (Laboratory Hazard Assessment Tool) application.
This is the description of your section break.
Embroidery: Professional Name *
The following should be written EXACTLY as you want it to appear on your lab coat. Embroidery cannot be in all caps. NOTE: All abbreviations and titles need a period. (e.g. M.D. not MD). 25 character maximum. PLEASE ENSURE THAT THE SPELLING IS CORRECT BEFORE SUBMITTING THIS FORM.
By typing your first and last name in the box below you are verifying you meet the eligibility requirements: *