| Form Name: | House Officer OSHA Respirator Medical Evaluation Questionnaire |
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| Also Known As: | Mask Fit Test Medical Form |
| Completed By: | House Officer |
| Used When: | Required for Mask Fit Testing |
| Purpose: | Provides medical clearance for residents undergoing mask fit testing. Required by OSHA. |
| Direct Questions To: | Ashley Walker |
| Form Link: | Included with new hire documents for new hires: Newhire Documents |
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Instructions for Completing Form
This form is provided automatically as part of the online Newhire Documents process. It is included in the Newhire Packet that is submitted to the GME Office.
Continuing House Officers undergoing mask fit testing should manually complete the form.
Other Info
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