Get N95/respirator Mask Fit Testing Exemption Form

Completing the N95/Respirator Mask Fit Testing Exemption Form online is a straightforward process. This guide will walk you through each section of the form to ensure that it is filled out accurately and efficiently.

Follow the steps to complete your form successfully.

1. Press the ‘Get Form’ button to download the N95/Respirator Mask Fit Testing Exemption Form and open it in the online editor.
2. In the first section, enter your last name and first name in the designated fields. Make sure to fill in both names completely.
3. Next, specify your program and training level in the corresponding fields. This information is essential for correct identification within your training program.
4. Indicate the reason for your exemption by selecting one of the options: Religious/Cultural, Medical Condition, or Other. If you choose 'Other', please provide a brief explanation in the space provided.
5. Read the information regarding exposure to airborne infectious agents carefully. Acknowledge your understanding by signing your name in the 'Trainee Signature' field. Also, include the date of signing.
6. The Occupational Health Office must sign and date the form to acknowledge your inability to mask-fit. Ensure that these signatures are secured before finalizing the form.
7. Lastly, the Program Director must also sign and date the form. Make sure all signatures are present to validate your exemption request.
8. Once you have completed all sections of the form, save your changes. You may then download, print, or share the form as required.

Begin your process of completing the N95/Respirator Mask Fit Testing Exemption Form online now.