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  • Va Sentara Medical Questionnaire For Respirator Use 2006

Get Va Sentara Medical Questionnaire For Respirator Use 2006-2025

Hospital: SBH SCH SLH SNGH SVBGH SWCH Other Sentara Location: Department: TO BE COMPLETED BY OCCUPATIONAL HEALTH NURSE: Date: Interviewed by: Nurse Yes Reviewed with Medical Advisor: N/A Cleared for fit test:: N-95 Respirator Yes No N/A Full or Half Face Respirator Yes No N/A Please print your answers. 1. Today's date: 2. Your name: 3. Your Employee ID Number: SSN: 4. Your age (to nearest year): Date of Birth: 5. Sex: Male 6.

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Loose-fitting PAPRs, in which the hood or helmet is designed to form only a partial seal with the wearer's face or hoods which seal loosely around the wearer's neck or shoulders, do not require fit testing.

A medical evaluation determines your ability to wear a respirator. You must complete a medical evaluation before you are fit tested and before using a respirator in a workplace.

A respirator medical evaluation is a health assessment that determines if an employee is medically fit to wear a respirator on the job.

Before wearing a respirator, workers must first be medically evaluated using the mandatory medical questionnaire or an equivalent method.

When respiratory protection is required employers must have a respirator protection program as specified in OSHA's Respiratory Protection standard (29 CFR 1910.134). Before wearing a respirator, workers must first be medically evaluated using the mandatory medical questionnaire or an equivalent method.

Voluntary use of a filtering facepiece respirator does not require medical evaluation.

Medical Evaluations for Respirator Usage So the Occupational Safety and Health Administration (OSHA) requires medical evaluation before any employee can even be fit-tested for — let alone wear — a respirator.

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. Symptomatic coronary artery disease, significant arrhythmias, or history of recent myocardial infarction; 5.

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© Copyright 1997-2025
airSlate Legal Forms, Inc.
3720 Flowood Dr, Flowood, Mississippi 39232
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