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Respirator Medical Evaluation Questionnaire - OSHA

    https://www.osha.gov/sites/default/files/publications/OSHA3790.pdf
    to perform all medical evaluations using the medical questionnaire in Appendix C of the Respiratory Protection standard or a medical examination that obtains the same …

NOAA Form Repirator Medical Evaluation …

    https://www.corpscpc.noaa.gov/medical/Files/NOAA_Respirator_Questionaire.pdf
    RESPIRATOR MEDICAL EVALUATION QUESTIONNAIRE INSTRUCTIONS EMPLOYEE: Complete Part A and Part B, Section I. Submit this form directly to the Medical Provider. …

Appendix C to Sec. 1910.134: OSHA Respirator …

    https://www.osha.gov/sites/default/files/2022-01/1910.134%20Appendix%20C%20Medical%20Evaluation%20Questionnaire.pdf
    Check the type of respirator you will use (you can check more than one category): a. _____ N, R, or P disposable respirator (filter-mask, non-cartridge type only). b. _____ Other …

1910.134 App C - OSHA Respirator Medical Evaluation …

    https://www.osha.gov/laws-regs/regulations/standardnumber/1910/1910.134AppC
    8. If you've used a respirator, have you ever had any of the following problems? (If you've never used a respirator, check the following space and go to question 9:) a. Eye …

U.S. DEPARTMENT OF COMMERCE NOAA OSHA …

    https://www.corpscpc.noaa.gov/medical/Files/NOAA_Respirator_Questionaire_old_121112.pdf
    NOAA OSHA Respirator Medical Evaluation Questionnaire. Height (ft) (in) Weight (lbs) Phone Number: Home: Work: Male . FemaleYes. NO2. Have you worn a respirator: …

NOAA Corps Commissioned Personnel Center

    https://www.corpscpc.noaa.gov/forms/pdfforms/OSHA_Respirator.pdf
    NOAA Corps Commissioned Personnel Center

OSHA RESPIRATOR MEDICAL EVALUATION …

    https://www.carilionclinic.org/sites/default/files/2023-02/OSHA%20RESPIRATOR%20FORM%20%281%29.pdf
    Part A. Section 1. (MANDATORY) The following information must be provided by every employee who has been selected to use any type of respirator (please print). Part A. …

Major Requirements of OSHA's Respiratory Protection …

    https://www.osha.gov/training/library/respiratory-protection/major-requirements
    Must provide a medical evaluation to determine employee’s ability to use a respirator, before fit testing and use. Must identify a physician or other licensed health care …

Respirator Medical Evaluation Questionnaire | Office of …

    https://www.omao.noaa.gov/find/media/documents/respirator-medical-evaluation-questionnaire
    Respirator Medical Evaluation Questionnaire | Office of Marine and Aviation Operations Home Find Media Documents Respirator Medical Evaluation …

Respiratory protection medical evaluations: additional …

    https://www.osha.gov/laws-regs/standardinterpretations/2004-10-21
    Answer: The respiratory protection standard requires an initial medical evaluation to determine the employee's ability to use a respirator before the employee …



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