Get Cal Osha Respirator Medical Evaluation Questionnaire

The Cal Osha Respirator Medical Evaluation Questionnaire is a vital document required for employees selected to use respirators. Completing this form online ensures a streamlined process, facilitating the review by healthcare professionals.

Follow the steps to fill out the questionnaire accurately.

1. Press the ‘Get Form’ button to access the questionnaire online and open it in your preferred document editor.
2. Begin by entering today's date in the designated field.
3. Provide your name as it appears on official documents.
4. Input your age rounded to the nearest year.
5. Select your sex by checking the appropriate box for 'Male' or 'Female'.
6. Enter your height in feet and inches in the specified fields.
7. Fill in your weight in pounds.
8. Record your job title in the appropriate area.
9. Provide a contact phone number where you can be reached by the healthcare professional, including the area code.
10. Indicate the best time for the healthcare professional to reach you at this phone number.
11. Input your Social Security Number in the allocated space.
12. Respond to question 11 regarding employer communication about the healthcare professional.
13. Check the type of respirator you will be using and specify any additional types if applicable.
14. Answer the question about prior respirator usage, detailing the types used if applicable.
15. Move on to Part A, Section 2, and answer each mandatory question with a 'yes' or 'no' response.
16. Complete any optional additional comments, especially for medical conditions or symptoms related to respiratory or cardiovascular health.
17. Review your responses for accuracy before saving.
18. Once satisfied, save your changes, and choose to download, print, or share the completed form as needed.

Complete your health evaluation questionnaire online now to ensure respiratory safety.