Date

Receiver Title
Address
Suburb
State/Postcode

Dear Recipient Name

EXPOSURE LETTER FOR USE OF CARCINOGEN

Name of Carcinogen:
Supervisor:
Division/College/Directorate:
Date commenced working with Carcinogen:	Completion Date of working with Carcinogen:
Was the Work Identified to Have Potential for Exposure?	If Yes, was Health Monitoring Recommended?
If Health Monitoring was required, details of schedule and testing undertaken:

Records of the possible exposure are maintained within the JCU Records Management System. Requests to obtain information can be sent to the WHS Unit.

Sincerely

Sender Name

Sender Title

JCU Work Health and Safety Unit

Email: safety@jcu.edu.au