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  • Osha Respirator Medical Evaluation Form

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OSHA RESPIRATOR MEDICAL EVALUATION QUESTIONNAIRE (MANDATORY) Do not return completed questionnaire to the Department of Environmental Health & Safety. Take completed from with you to your scheduled.

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Related content

Respirator Medical Evaluation Questionnaire...
The requirements of the medical evaluation and for using the questionnaire are provided...
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Immediately dangerous to life or health...
The term immediately dangerous to life or health (IDLH) is defined by the US National...
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PRAIRIE VIEW A&M UNIVERSITY MEMBERSHIP ROSTER Portland State University Family Newsletter LANDLORD TENANT HANDBOOK - Portland State University GRADUATE PROGRAM DEPARTMENT OF CHEMISTRY PORTLAND STATE UNIVERSITY - Pdx

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The employer must identify a physician or other licensed health care professional (PLHCP) to perform all medical evaluations using the medical questionnaire in Appendix C of the Respiratory Protection standard or a medical examination that obtains the same information.

Section 2. (Mandatory) Questions 1 through 9 below must be answered by every employee who has been selected to use any type of respirator (please circle “yes” or “no”). 1. Do you currently smoke tobacco, or have you smoked tobacco in the last month?

Answer: The respiratory protection standard requires an initial medical evaluation to determine the employee's ability to use a respirator before the employee is fit tested or required to use the respirator in the workplace.

The following may disqualify an employee from wearing a respirator: 1. Facial deformities and facial hair, where the respirator forms a seal to the face; 2. Perforated tympanic membranes; 3. Respiratory diseases affecting pulmonary function; 4.

Medical Evaluations for Respirator Usage People with underlying medical conditions may put themselves at risk if they work while wearing one. So the Occupational Safety and Health Administration (OSHA) requires medical evaluation before any employee can even be fit-tested for — let alone wear — a respirator.

Answer: The respiratory protection standard requires an initial medical evaluation to determine the employee's ability to use a respirator before the employee is fit tested or required to use the respirator in the workplace.

To meet OSHA standards for respirator medical evaluation, an employer must complete an Employer Authorization and Information for Respiratory Evaluation Form and include the following information: Respirator type and weight. Respirator use duration and frequency.

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© Copyright 1997-2025
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Form Packages
Adoption
Bankruptcy
Contractors
Divorce
Home Sales
Employment
Identity Theft
Incorporation
Landlord Tenant
Living Trust
Name Change
Personal Planning
Small Business
Wills & Estates
Packages A-Z
Form Categories
Affidavits
Bankruptcy
Bill of Sale
Corporate - LLC
Divorce
Employment
Identity Theft
Internet Technology
Landlord Tenant
Living Wills
Name Change
Power of Attorney
Real Estate
Small Estates
Wills
All Forms
Forms A-Z
Form Library
Customer Service
Terms of Service
DMCA Policy
About Us
Blog
Affiliates
Contact Us
Privacy Notice
Delete My Account
Site Map
Industries
Forms in Spanish
Localized Forms
State-specific Forms
Forms Kit
Legal Guides
Real Estate Handbook
All Guides
Prepared for You
Notarize
Incorporation services
Our Customers
For Consumers
For Small Business
For Attorneys
Our Sites
US Legal Forms
USLegal
FormsPass
pdfFiller
signNow
airSlate workflows
DocHub
Instapage
Social Media
Call us now toll free:
1-877-389-0141
As seen in:
  • USA Today logo picture
  • CBC News logo picture
  • LA Times logo picture
  • The Washington Post logo picture
  • AP logo picture
  • Forbes logo picture
© Copyright 1997-2025
airSlate Legal Forms, Inc.
3720 Flowood Dr, Flowood, Mississippi 39232