Home
Forms Library
Medical respiratory evaluation questionnaire

OSHA Respiratory Medical Evaluation Questionnaire 2025

medical respiratory evaluation questionnaire Preview on Page 1

Show details

4.2 out of 5

38 votes

The OSHA Respiratory Medical Evaluation Questionnaire is a mandatory form for employees selected to use respirators. It collects personal and health information to assess the employee's fitness for respirator use, including questions about smoking, lung and heart conditions, and previous respirator experiences. The questionnaire ensures confidentiality and requires employers to facilitate its completion during work hours. Additionally, it includes sections for supplemental information that healthcare professionals need to evaluate the employee's suitability for using specific types of respirators.

Here's how it works

01. Edit your medical respiratory evaluation questionnaire online

Type text, add images, blackout confidential details, add comments, highlights and more.

02. Sign it in a few clicks

Draw your signature, type it, upload its image, or use your mobile device as a signature pad.

03. Share your form with others

Send it via email, link, or fax. You can also download it, export it or print it out.

How to edit OSHA Respiratory Medical Evaluation Questionnaire online

Ease of Setup

DocHub User Ratings on G2

Ease of Use

DocHub User Ratings on G2

With DocHub, making changes to your documentation requires only a few simple clicks. Follow these quick steps to edit the PDF OSHA Respiratory Medical Evaluation Questionnaire online free of charge:

Register and log in to your account. Sign in to the editor with your credentials or click on Create free account to examine the tool’s capabilities.
Add the OSHA Respiratory Medical Evaluation Questionnaire for editing. Click on the New Document button above, then drag and drop the sample to the upload area, import it from the cloud, or using a link.
Alter your file. Make any changes needed: insert text and photos to your OSHA Respiratory Medical Evaluation Questionnaire, highlight details that matter, remove parts of content and substitute them with new ones, and add symbols, checkmarks, and areas for filling out.
Complete redacting the template. Save the modified document on your device, export it to the cloud, print it right from the editor, or share it with all the people involved.

Our editor is very user-friendly and effective. Give it a try now!

See more OSHA Respiratory Medical Evaluation Questionnaire versions

We've got more versions of the OSHA Respiratory Medical Evaluation Questionnaire form. Select the right OSHA Respiratory Medical Evaluation Questionnaire version from the list and start editing it straight away!

Versions	Form popularity	Fillable & printable
2018	4.2 Satisfied (38 Votes)
2012	4 Satisfied (28 Votes)

be ready to get more

Complete this form in 5 minutes or less

Get form

Got questions?

We have answers to the most popular questions from our customers. If you can't find an answer to your question, please contact us.

How often does OSHA require a respirator medical evaluation?

There is not a specific annual requirement for medical evaluations in the standard. However, the physician or other licensed healthcare provider (PLHCP) may prescribe annual tests to ensure employees continued ability to wear a respirator.

What is the OSHA respirator questionnaire?

People with claustrophobia may not be able to wear a full facepiece or hooded respirator. People with vision problems may have trouble seeing while wearing a mask or hood (there are special masks for people who need glasses). Employees must be medically evaluated before assigned to use a respirator.

What is the OSHA respirator medical evaluation questionnaire?

This easy-to-use OSHA respirator medical evaluation questionnaire helps establish the workers clearance level for using a specific respirator in your work conditions. It can be completed in 15-20 minutes using any computer with internet access, and is available every day, any time, to fit your employees schedules.

What is the OSHA respiratory clearance?

The employer shall provide a medical evaluation to determine the employees ability to use a respirator, before the employee is fit tested or required to use the respirator in the workplace. The employer may discontinue an employees medical evaluations when the employee is no longer required to use a respirator.

Is a medical questionnaire required for a loose-fitting respirator?

However, medical evaluations are still required by 1910.134(e) for almost all respirator use. The only exception to the medical evaluation is for voluntary use of respirators as referenced in 1910.134(c)(2)(i) and 1910.134 Appendix D. This includes both tight and loose-fitting respirators.

What is a respiratory evaluation?

The evaluation of the respiratory system includes collecting subjective and objective data through a detailed interview and physical examination of the thorax and lungs.

Do employees have to be medically cleared to wear a respirator?

When respiratory protection is required employers must have a respirator protection program as specified in OSHAs Respiratory Protection standard (29 CFR 1910.134). Before wearing a respirator, workers must first be medically evaluated using the mandatory medical questionnaire or an equivalent method.

OSHA Respiratory Medical Evaluation Questionnaire 2025

Here's how it works

How to edit OSHA Respiratory Medical Evaluation Questionnaire online