General Chemistry Laboratory Safety Training Verification Form

This statement serves as a verification that the student identified on the signature line below has received instruction in the basic principles of laboratory safety.

  1. I have read the laboratory regulations to be followed in the Chemistry 105/106/109/110/113/221 laboratory at the University of Nebraska–Lincoln.
  2. I have been informed on the location and/or use of the fire extinguishers, fire pull alarm, emergency phone, eyewash, safety shower, and emergency exits. I know the location of first aid supplies, accident report forms, and Material SafetyData Sheets.
  3. I have watched the Safety Video presented during the first week of Chemistry 105/106/109/110/113/221 laboratory.
  4. Lab Safety Code and Student Safety Agreement

Safety glasses or goggles must be worn by everyone in the lab, including wearers of prescription glasses.

Do you wear contact lenses?