Animal Research Safety Program

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Medical History Questionnaire FAQs

  • What is the Medical History Questionnaire (MHQ)?
  • The MHQ is an annual requirement for all personnel that are involved in animal research activities including animal care, access to vivarium spaces, handling animal tissues, sponsors of animal research and those that support animal research. The Medical History Questionnaire covers medical history and immunization requirements for working with specific animal research species to protect both human and animal health.
  • Why do I need to fill out the MHQ?
  • The MHQ is a medical surveillance program to protect both your health and animal health.

    There is additional policy requiring a medical surveillance program.

    1. The MHQ is required if you are working with research animals, animal tissues, need access to the vivarium (animal housing) or are in contact with quarantine animals or insects per the ARC policy.

    2. There are further requirements for a medical surveillance program from the accrediting non-profit group American Association for the Accreditation of Laboratory Animal Care (AAALAC International), which UCLA has proudly been accredited by.

    3. UCLA Policy 990: Use of Animals in Research, Teaching, and Testing, states that the Guide is required to be followed along with federal, state and local acts and regulations.
  • Who needs to fill out the MHQ?
  • Please complete the MHQ annually as enrollment is required for all that visit animal spaces including study areas, vivariums and/or laboratories that use research animals. Enrollment in the MHQ program is required for all personnel involved in the care and use of research animals regardless of whether they handle animals. This requirement includes EH&S, facilities, investigator staff/students, volunteers, personnel that handles animal tissues, and all PIs and faculty sponsors of Animal Research Committee protocols.
  • Who reviews the Medical History Questionnaire?
  • The Occupational Health Services (OHS) reviews submissions for UCLA staff and faculty. The Arthur Ashe Student Health & Wellness Center (Ashe) reviews MHQs for UCLA students. These medical professionals will ensure proper medical surveillance and care based on risk and medical history.
  • What is the status of my MHQ?
  • Please be patient with medical staff reviewing your MHQ application. Please allow for at least 30 days of your submission as some further documents might be requested.

    You can also view the status of your MHQ by logging back on to the MHQ site. Look under the “actions” column. If you have a “revision request” please go through your application correcting the information. It is important to go through the entire application for it to be resubmitted with the updated information.
  • I have a specific question about my MHQ submission; who can I contact?
  •  

    Student Questions: please e-mail asheimmune@ashe.ucla.edu 

    Faculty & Staff Questions: please e-mail occupationalhealth@mednet.ucla.edu 

    Technical Questions: please e-mail mhqsupport@mednet.ucla.edu

    Not sure who to contact? Please e-mail AnimalResearchSafety@ucla.ehs.edu

  • What vaccines/ titers are required and recommended for the species I am working with?

  • While all immunizations are highly recommended there are some that are required to protect both human health and animal health. You can find this information here.

  • Where can I find the declination forms for vaccines?

  • You can find the current declination forms herePlease upload the declination forms on the MHQ site in the section that asks for uploads of the specific vaccines and titers.

  • I need a vaccine, who pays for it?

  • UCLA staff and facility are able to get vaccines for free from Occupational Health Services (OHS). UCLA students under UCSHIP are also able to receive vaccines free of charge from the Arthur Ashe Student Health & Wellness Center (Ashe). Students that are not enrolled in UCSHIP will need pay for vaccines out of pocket or from their medical insurance provider. Visiting researchers need to obtain their vaccines and titers from their home university or personal medical provider.

  • How is my medical information protected?

  • The MHQ is reviewed by medical professionals from The Occupational Health Services (OHS) and the Arthur Ashe Student Health & Wellness Center (Ashe). The online system uses the UCLA multi-factor authenticator sign in system and is a HIPAA-compliant software.

Questions?

Contact UCLA Animal Research Safety at AnimalResearchSafety@ehs.ucla.edu 
or email Animal Research Safety Specialist 
Kaitlyn M. Hanley.