Exhibit 2, 242 FW 7
Instructions for Pesticide User Medical Examination


Date: December 4, 2009

Series: Occupational Safety and Health

Part 242: Industrial Hygiene

Originating Office: Division of Safety and Health



PDF Version


If using a Federal Occupational Health Clinic (FOH) or FOH contracted clinic:


1. Before scheduling an examination, an employee must complete FWS Form 3-2395, Recommended Exams & Tests for Pesticides Users Form and provide it to the FOH clinic. This form will help the clinic to prepare for your visit by letting them know what exams and testing will be needed.


2. FOH’s contract scheduler or FOH nurse will contact the employee’s administrative officer to schedule employee medical exams with FOH or FOH-contracted clinics.


3. The employee must fill out his or her portions of all the medical examination forms (see section 242 FW 7, Table 7-2) before going to see the physician.



If using local medical clinics or personal physicians:


1. The employee must schedule his or her medical examinations.


2. The employee must notify the clinic or physician of what exams he or she will need to receive (i.e., Pesticide Applicator/Wildland Fire Arduous Duty/Commercial Drivers License (CDL)/Respirator, etc.).


3. The employee must provide the clinic or physician with the completed forms prior to scheduling an appointment so that all required physical exams and laboratory tests will be scheduled.


4. After the employee’s examination and laboratory testing are completed, send all documents to the U.S. Fish and Wildlife Service’s Reviewing Medical Officer for Pesticide Users at the following address:


Federal Occupational Health

Attn: Fish and Wildlife Service’s Reviewing Medical Officer

2201 6th Avenue

MS RX-21

                                                Seattle, Washington  98121-2500




For information on the content of this exhibit, contact the Division of Safety and Health. For information about this Web site, contact Krista Bibb in the Division of Policy and Directives Management.  

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