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  • Respirator Medical Clearance Approval Form

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MEDICAL CLEARANCE FOR RESPIRATOR USE Part I: To be completed by the supervisor EMPLOYER Employees Name Date of Birth Social Security Number Supervisor's Name Department Circle Type or Types of Respirator(s).

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DA 5888-1 2006 DA 5897 1999 DA 5913 2002 DA 7000 1993

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A: Before employees can be fit-tested for a respirator and use it on the job, they must get medical clearance indicating that they're able to wear respiratory protection.

Individuals must be medically cleared to wear an N95 respirator before fit testing can occur. A medical clearance involves completing a respiratory questionnaire, and having that questionnaire reviewed by a licensed medical practitioner. The medical clearance must be completed prior to initial use of a respirator.

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.

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 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.

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.

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.

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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
All Forms
Search all Forms
Industries
Forms in Spanish
Localized Forms
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