This questionnaire is used to determine whether or not you have a medical condition that may affect your ability to safely wear a respirator. We anticipate being able to approve most people for respirator use based on this questionnaire alone. Fit testing is also required and is done separately.
All medical information is considered confidential.
All information must be completed for respirator approval. Raymond B. Otero, Ph.D., All Rights Reserved. Web Page Hosting and Design by Computer Innovations, Inc.