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According with the OSHA Standard 1910.134 all employees that are required to wear a respirator as part of their job, need to receive questionnaires.

This questionnaire was developed and designed by health care professionals to give them all the information that is necessary about the ability to use a respirator.

Some questions will be asked about your medical history and current health.

These questionnaires will be review by a health care professional who is not affiliated with your employer.

The health care professional can medically clear an individual based on the information provided on the questionnaire.

NOTE: It is very important that you provide all additional information at the end of the questionnaire to the health care professional.

OSHA requires all questionnaires be reviewed by a health care professional.


OSHA Questionnaire

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