Respiratory Medical Questionnaire

Respirator Medical Evaluation Questionnaire

https://www.osha.gov/sites/default/files/publications/OSHA3790.pdf

OSHA Respirator Medical Evaluation Questionnaire

https://www.3m.com/3M/en_US/respiratory-protection-us/support/center-for-respiratory-protection/medical-evaluation/osha-respirator-questionnaire/

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 …

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 …

Medical Evaluation | Center for Respiratory Proction

https://www.3m.com/3M/en_US/respiratory-protection-us/support/center-for-respiratory-protection/medical-evaluation/

You can print the OSHA Respirator Medical Evaluation Questionnaire (link below) directly from OSHA’s website to be completed, reviewed and mailed to a PLHCP for …

MRC questionnaire (MRCQ) on respiratory symptoms

https://academic.oup.com/occmed/article/57/5/388/1407076

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. …

Respiratory Symptoms Questionnaire …

https://www.pulmonologyadvisor.com/home/topics/asthma/respiratory-symptoms-questionnaire-validated-tool-for-asthma-and-or-copd/

The Respiratory Symptoms Questionnaire (RSQ), a simple 4-item tool designed to assess symptoms and severity of respiratory symptoms independent of diagnosis, is a valid and …

OSHA Respirator Medical Evaluation Questionnaire …

https://www.pace.edu/sites/default/files/2021-05/OSHA-respirator-medical-evaluation-questionnaire.pdf

a. Seizures (fits): b. Diabetes (sugar disease): c. Allergic reactions that interfere with your breathing: d. Claustrophobia (fear of closed-in places): e. Trouble smelling …

OSHA RESPIRATOR MEDICAL EVALUATION …

https://hvfd.com/wp-content/uploads/2016/09/OSHA-RESPIRATOR-QUESTIONNAIRE-English-1.pdf

Have you worn a respirator (circle one): Yes No If “Yes”, what type(s):___________________________________________________________ PART …

RESPIRATOR MEDICAL QUESTIONNAIRE

https://www.usf.edu/administrative-services/environmental-health-safety/documents/respirator-medical-questionnaire.pdf

11. How often are you expected to use the respirator(s) (circle "yes" or "no" for all answers that apply to you)?: Escape only (no rescue): Yes/No Emergency rescue only: Yes/No …