MEDICAL FORM
Upon arrival at the Station you will be asked to complete a Medical Disclosure and Emergency Contact form.  To expedite check-in we ask that you download the PDF and arrive with a completed form.  

The Medical Disclosure and Emergency Contact form provides medical information that may be necessary in the event of serious illness or accident.  The facts you disclose will be kept confidential and will be kept on file with the station safety coordinator.  The information provided will be given to others (medical personnel, staff, etc.) only in an emergency situation.  This form is for your protection, the more complete the form, the better the medical treatment you may receive, if needed. Failure to disclose accurate and complete information could compound the seriousness of an accident or illness, particularly if you are unable to respond clearly to the medical responders inquiries.

Because of confidentiality issues the  Medical Disclosure and Emergency Contact can not be Web Based at this time.

MEDICAL INSURANCE
Each Toolik Field Station project member must have medical/accident insurance that will cover the expenses of serious illness or accident, as well as accidental death and dismemberment coverage, and emergency evacuation.  You must check with your health plan to verify that coverage applies. Project members are responsible for all expenses in the event that they become ill, injured, or require emergency evacuation. 
Air Medevac Insurance ApolloMT

RESEARCH PERMITS

1. Project permits from applicable Borough, State and Federal agencies are required and must be obtained by the project leader prior to conducting research at the Station. The Institute of Arctic Biology cannot jeopardize the authorization for the Station site by allowing research to proceed in the absence of the required permits. All principal investigators must submit copies of permits to the Logistics Office before they or their co-workers conduct research at the Station.
   
   
2. Does your project intend to work on lands owned by the Bureau of Land Management? Does your project intend to use a snowmachine to support your work. Contact the United States Department of the Interior, Bureau of Land Management. Request Form 2920-1, Land Use Application and Permit.
   B.L.M. Dalton Management Unit
   1150 University Ave.
   Fairbanks, AK 99709-3844
   Phone: (907) 474-2334
   Contact: Boyce Bush
   
   
3. Does your project involve collection, tagging or holding of wild animals or fish? Contact the State of Alaska, Dept. of Fish and Game and request an application for Scientific or Educational Permits.
   Alaska Department of Fish And Game
   Division of Wildlife Conservation
   PO Box 115526
   Juneau, AK 99811-5526
   Phone: (907) 456-4190 Wildlife Division
   http://www.wildlife.alaska.gov/index.cfm?adfg=info.contact
   
   Alaska Department of Fish And Game
   Division of Sport Fish
   PO Box 115525
   Juneau, AK 99811-5526
   Phone: (907) 456-4180 Sport Fish Division
   http://www.sf.adfg.state.ak.us/statewide/index.cfm
   
   
   
4. Will your project involve vertebrates? All activities involving live vertebrates must be reviewed and approved
   by the Institutional Animal Care and Use Committee from the institution awarded the research grant. You must provide a copy of the approved IACUC protocol and the approval letter. If you need to use the Toolik Field Station Animal Facility you also need approval from the University of Alaska Fairbanks IACUC. Please contact the UAF IACUC Administrator for assistance:
   
   IACUC Administrator
   Office of Research Integrity
   PO Box 757270; 909N Koyukuk Drive
   WRRB suite 212
   University of Alaska Fairbanks
   Fairbanks, AK 99775-7270
   
   Phone (907) 474-7800
   Fax (907) 474-5444
   e-mail: fyiacuc@uaf.edu
   web page: http://www.uaf.edu/iacuc
   
   
5. Does your project involve significant manipulations on the environment or development? Contact the North Slope Borough. Request a Permit Application.
   North Slope Borough Planning Dept.
   P.O. Box 69
   Barrow, AK 99723
   Phone: (907) 852-2611
   FAX: (907) 852-5406
   
   
6. Does your project involve work on lands administered by Gates of the Arctic National Park and Preserve?   Contact the park and preserve research coordinator and request a research permit packet.
   Research Coordinator
   Gates of the Arctic National Park & Preserve
   4175 Geist Road
   Fairbanks, Alaska 99709-3420
   907-457-5752
   http://www.nps.gov/gaar/naturescience/reasearch.htm
   
   
7. Does your project plan to use or store radioactive material at the Station? Contact theUAF Departmetn of Environmental Health, Safety, and Risk Managment and and request an Application for Supervised User of Radioactive Materials.
   Main Office: 907-474-5413
   http://www.uaf.edu/safety/
   
   Industrial Hygienist &
   UAF Radiation Safety Officer
   Tracey Martinson
   (w) 474-6771
   fntam@uaf.edu
   
   
   
   
8. Submit copies of permits to the Institute of Arctic Biology, Logistics Office.

Updated 7/22/09