A written access order from WISHA will contain at least the following information:

1. (1) The identity of employees whose medical information is being requested. This may be either by name, job classification, time clock number, department, or similar identifier.
2. (2) A description of the medical information that will be examined.
3. (3) The purpose for seeking access to this medical information, and any additional evidence supporting access to the medical information.

4. (4) A step-by-step description of how the records will be obtained, copied, reviewed, and stored, specifying the following:

   1. (a) Who will be in charge of on-site review of the records, or who will take possession of the records for off-site review.
   2. (b) Where the records will be reviewed.
   3. (c) When review or receipt of the records is to take place.
   4. (d) If the records are to be reviewed on-site, what type of information will be copied and removed off-site.
5. (5) How personal identifiers will be separated from the medical information and how long this information will be kept.
6. (6) The principal WISHA investigator's full name, business address and telephone number.
7. (7) The full names and titles of all individuals that will review the records.

8. (8) The WISHA industrial hygiene program manager's full name, business address and telephone number.

   Note:	WISHA does not need a written access order for the following types of employee medical records:
   	• Medical records and analyses that do not contain personal identification information.
   	• Examination of records to verify compliance with the medical surveillance requirements of another occupational health and safety rule.
   	• The following records when required by another occupational health and safety rule:
   	– Medical opinions.
   	– Biological monitoring results.
   	– Results of medical examinations and laboratory tests.

[Statutory Authority: RCW 49.17.010, 49.17.040, 49.17.050, and 49.17.060. WSR 18-22-116, § 296-802-50010, filed 11/6/18, effective 12/7/18; WSR 04-10-026, § 296-802-50010, filed 4/27/04, effective 8/1/04.]