Get N95 Fit Test Form

The N95 fit test form is an essential document for ensuring that individuals are properly fitted for respirators. This guide provides you with clear instructions on how to complete the form online, ensuring that you submit all necessary information accurately and efficiently.

Follow the steps to complete the N95 fit test form online.

1. Click the ‘Get Form’ button to access the N95 fit test form and open it in your chosen editor.
2. Begin by filling out your personal information in the designated fields. This includes your name, department, home address, social security number, job title, date of birth, and work phone number.
3. In the medical clearance section, indicate your fitness for respirator use by selecting the appropriate option. You may choose from: fit for respirator use with no restrictions, fit for respirator use with mild restrictions, additional testing needed, or not fit for respirator use. If necessary, provide comments to elaborate on your selection.
4. Next, ensure that your medical practitioner reviews and signs the medical clearance section, providing their signature and the date.
5. Move on to the training section. Here, the instructor must confirm that you have been trained in the appropriate use, limitations, and maintenance of the issued respirator. Fill out the type of respirator by including the manufacturer, model, and size. The instructor will need to sign and date this section.
6. In the fit testing section, indicate the method used for the fit test and record the sensitivity levels by circling the appropriate values for Bitrex and Saccharin, or selecting the option for smoke or other methods as applicable.
7. The instructor will then certify whether you successfully completed the medical clearance, training, and fit testing. They must sign and date this certification.
8. Finally, in the acknowledgment section, the employee must confirm receipt of the respirator and agree to adhere to all guidelines. Ensure to complete the signature and date fields.
9. Once all fields are completed, review the document for accuracy. You may then save the changes, download, print, or share the completed form as necessary.

Complete your N95 fit test form online today for a streamlined process.