MODIFICATION
Q -- Occupational Health Examinations
- Notice Date
- 11/8/2006
- Notice Type
- Modification
- NAICS
- 621399
— Offices of All Other Miscellaneous Health Practitioners
- Contracting Office
- Department of the Air Force, Air Force Reserve Command, 94 CONF/LGC, 1538 Atlantic Ave, Dobbins ARB, GA, 30069-4824, UNITED STATES
- ZIP Code
- 00000
- Solicitation Number
- Reference-Number-F5B2206212A200
- Response Due
- 11/22/2006
- Archive Date
- 12/7/2006
- Description
- Performance Work Statement continued (Part 5) 5.0 DELIVERABLE 5.1 The contractor shall provide to the 94th ASTS a copy of any standard or guidelines used to interpret laboratory test results. 5.1 Contract physicians shall complete required forms and documentation in accordance with the corresponding attached Air Force regulations, directives and policies. 5.2 NOTIFICATION: The contractor shall follow the notification requirements listed below: EXAMINATION RESULTS TO METHOD NLT: Pre-placement 94 ASTS/SGA *Mail Within 5 work (678-655-4259) days after exam completion Annual 94 ASTS/SGA *Mail Within 5 work days after exam Fitness for Duty 94 ASTS/SGA *Mail Within 5 work (678-655-4259) days after exam completion. Termination 94 ASTS/SGA *Mail Within 5 work days after exam completion * All physical examination results that medically disqualify employees and/or abnormal laboratory results must be telephoned to the responsible office immediately after receipt. Telephone notification is not normally necessary for normal examination results; however, it must be provided if requested by ASTS/POC and or the Dobbins Civilian Personnel Office. ** All examination results will be reported on AF Form 2770 (with attachments as necessary) and distributed. Exception- Fitness for Duty physicals results will be reported on SF 513) ORIGINAL: File in the employee's medical folder (Mail to 94 ASTS/SGA if the examination is not completed during the employees' appointment.) Copy 1: 94 ASTS, 1175 4th St, Bldg 550, Ste 201, Dobbins ARB, GA. 30069-4506. Copy 2: GIVE TO THE EMPLOYEE (Must mail to employee if examinations are not completed during the appointment). Must not be sent to employee's supervisor. Must be sent to employee in sealed envelope marked "TO BE OPENED BY ADDRESSEE ONLY ." Copy 3: Mail to employee's supervisor. 5.5 The contractor shall provide the 94th ASTS office with a monthly list of all personnel tested. Included in the list shall be the identification of the tests administered and date and cost of each test. The list shall be compiled on a monthly basis and shall be received by the 94th ASTS not later than the fifth calendar day after the end of the month. 5.6 The contractor shall annotate the monthly examination roster as follows: "Completed" and the date completed, if the individual meets their exam appointment; "NO-show" and date and reason, if any, if the individual fails to meet or schedule their appointment. 5.7 The contractor shall send or fax (678-655-4255) the annotated monthly examination roster to 94 ASTS by the 25th day of the action month. 5.8 All required forms (except employee, SGPB) and supervisory copy of AF Form 2770) and transcription of examination results completed during the occupational health examination shall be filed in the employee's medical folder. The folder shall be sealed and returned to the employee to return to the Civilian Personnel Office/DCPS. All required forms and transcription not completed during the employee's appointment shall be completed within two working days after results are known by the contractor and forwarded by the contractor in a sealed envelope to 94th ASTS 5.9 The contractor medical personnel shall provide technical review of all examination data to ensure the highest level of quality control and accuracy of the completed occupational health examination data. In addition, the contractors' physician, nurse or technician shall sign the AF Form 2770 as having provided medical review. The copies of completed forms shall be sent to 94 ASTS/SGA. 5.10 The government will provide revisions to forms on an as required basis. Referenced Documents 1. Privacy Act Statement 2. Air Force Instruction (AFI) 48-123, 3. Air Force Occupational Safety and Health (AFOSH) Standard 161-20, Hearing Conservation Program 4. DoD Occupational Hearing 5. FPM 292-31, S6-1/7, Employee Medical File System 6. 29 Code of Federal Regulations (CFR), Part 1910, Section 1001 7. Standard Form (SF) 88, Report of Medical Examination, Dobbins ARB (overprint) 8. SF 93, Report of Medical History 9. SF 513, Medical Consultation Sheet 10. Dept. of Defense (DD) Form 2493-1, Asbestos Exposure, Part 2- Initial Medical Questionnaire 11. DD Form 2493-2, Asbestos Exposure, Part 2 -Periodic Medical Questionnaire 12. Air Force (AF) 895, Annual Medical Certification 13. AF Form 1753, Hearing Conservation Examination 14. AF Form 2770, Assessment and Disposition Record 16. AF Form 2766, Clinical Occupational Health Requirements
- Place of Performance
- Address: 94 CONF/LGC, 1538 Atlantic Avenue, Dobbins ARB, GA
- Zip Code: 30069
- Country: UNITED STATES
- Zip Code: 30069
- Record
- SN01178291-W 20061110/061108220732 (fbodaily.com)
- Source
-
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