Get Ehs 701 8

Filling out the Ehs 701 8 medical assessment form for respirator use is an essential task for employees whose job duties require respirator use. This guide provides comprehensive instructions to help you navigate each section of the form with clarity.

Follow the steps to complete the Ehs 701 8 form accurately.

1. Click ‘Get Form’ button to obtain the form and open it for completion.
2. Provide the agency requesting the medical assessment, including the agency name, address, contact name, agency code, voice, and fax telephone numbers.
3. Fill in the personal privacy protection law notification section. Understand that the information provided is for conducting a medical assessment and will be maintained confidentially by the Employee Health Service.
4. In Part A, Section 1, enter mandatory employee information such as today's date, name, social security number, weight, height, job title, and contact information. Ensure a supervisor does not review your answers.
5. Answer the questions regarding past respirator use and check the type of respirator that you will use. Provide details about your previous experiences with respirators if applicable.
6. In Section 2, respond to the mandatory questions regarding your health history related to lung and cardiovascular issues. Indicate any health conditions by checking YES or NO and provide explanations where required.
7. Continue through Section 2 by detailing current symptoms and answering questions about medication use relevant to your respiratory and cardiovascular health.
8. Complete Section 3 by answering additional questions specifically for users of full-facepiece respirators or self-contained breathing apparatus.
9. Proceed to Part B, focusing on questions for employees using cartridge, PAPR, supplied air respirators, or SCBA. Answer accurately and include details where applicable.
10. After addressing all questions, affirm that the information provided is accurate to the best of your knowledge by signing and dating the document.
11. Save your changes, then download a copy of the completed form. You may also print or share the form as required by your employer.

Complete the Ehs 701 8 form online to ensure a smooth medical assessment process.