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How to download and save your Lab Safety Contract

1. To begin you will need to download this fillable PDF to your desktop by selecting the
download button in the upper right-hand corner of your browser screen.

2. Next, open the PDF in a PDF reader (ex: Adobe acrobat, Foxit, etc.) to fill out the
contract.
*** Note: If your PDF is opening in a browser page, right-click on the file to open it with a
PDF reader. If you do not have a PDF reader installed on your computer, you can download
one for free online.

3. Once you have finished filling out your Lab Safety Contract, save it and submit it
to your instructor.
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Lab Safety Contract

eScience Labs feels confident that with the knowledge of our Safety Procedures, you will be
able to create and maintain a safe laboratory experience. With your cooperation, you will be
able to eliminate, prevent, and correct possible hazards.

Please complete the questions below and, if you comply with the safety rules, sign this contract.
If you do not comply, please note this within your contract. Note that if you do not choose to
comply, you will not be included in eScience Labs’ safety and liability coverage.

Return this safety contract to your Instructor.

Questions

1. Do you wear contact lenses?

□ YES □ NO
2. Are you colorblind?
□ YES □ NO
3. Do you have any allergies?
□ YES □ NO

If YES, list specific allergies: _________________________________

4. Do the contents of your kit match the packing list?
□ YES □ NO

If NO, contact eScience labs customer support immediately to request the missing
components.
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Student Agreement

Destre Tashjian
I, _____________________ (your name) have read and choose to comply with all of the safety
rules set forth in the Safety Procedures. By signing this contract, I realize that I must obey these
rules to ensure my own safety. I will cooperate to the fullest extent with my instructor and the
protocols in my lab kit to maintain a safe lab environment. I will also closely follow any oral
and/or written instructions additionally provided by my instructor as part of a specific activity. I
am aware that any violation of this safety contract that results in unsafe conduct in the
laboratory, or misbehaviour on my part, may result in consequences as specified by my
instructor.

Destre A. Tashjian
____________________________________
Student Signature
02/06/2020
____________________________________
Date
The Physical World SPRING 2020 20628
____________________________________
Course Name