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Respirator Medical Evaluation Questionnaire. Respirators must be used in workplaces in which employees are exposed to hazardous airborne contaminants. When respiratory protection is required employers must have a respirator protection program as specifed in OSHA’s Respiratory Protection standard (29 CFR 1910.134).
2023 OSHA Respiratory Fit Testing Medical Evaluation Questionnaire. Your employer must allow you to answer this respiratory (i.e. N95 or PAPR) questionnaire during normal working hours, or at a time and place that is convenient to you.
Questions 10 to 15 below must be answered by every employee who has been selected to use either a full- face piece respirator or a self-contained breathing apparatus (SCBA). For employees who have been selected to use other types of respirators, answering these questions is voluntary.
Appendix C to § 1910.134: OSHA Respirator Medical Evaluation Questionnaire (Mandatory) To the employer: Answers to questions in Section 1, and to question 9 in Section 2 of part A, do not require a medical examination.
This easy-to-use OSHA respirator medical evaluation questionnaire helps establish the worker's clearance level for using a specific respirator in your work conditions. It can be completed in 15-20 minutes using any computer with internet access, and is available every day, any time, to fit your employees' schedules.
3M facilitates a convenient method for employers to obtain medical evaluation of respirator wearers as required by the OSHA Respiratory Protection Standard, 29 CFR 1910.134. It is an easy-to-use questionnaire that helps establish the worker's clearance level for using a specific respirator in your work conditions.
Answers to questions in Section 1, and to question 9 in section 2 of part A, do not require a medical examination. However, it does require that a Physician or Licensed Health Care Professional (PLHCP) review this questionnaire and
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