Respiratory Medical Clearance

Simply fill out the questionnaire and mail


OSHA requires the employer to provide a medical evaluation to determine the employee's ability to use a respirator before the employee is fit tested or required to use the respirator in the workplace. If an employer chooses to implement the use of a respirator, OSHA requires that the employer has a written program in place. E&SSG will request a copy of your company's written program. The medical evaluation shall obtain the information requested by the questionnaire in Sections 1 and 2, Part A of Appendix C of OSHA regulation 29 CFR 1910.134. E&SSG will provide the medical questionnaire to you to distribute to the participating employees. The employees will complete the questionnaires confidentially. The employee will be provided an envelope to seal the medical clearance form. This envelope will be returned to the company contact. The company contact will deliver all sealed envelopes to E&SSG for review by our consulting physician. The employer will receive back from E&SSG's consulting physician a written recommendation concerning the employee’s ability to use a respirator.
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