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RESPIRATOR FIT TEST PROCEDURE:

1. GIVE CONCENTRA THE AUTHORIZATION FORM with PHYSICIAN STATEMENT AND OSHA
QUESTIONNAIRE
- MAKE SURE THEY ARE ONLY DOING FIT TEST FORM AND NO PHYSICAL
- THEY WILL CHECK YOUR BP THOUGH, SO MAKE SURE WHEN YOU ARE SCHEDULED TO DO
EXAM THAT YOUR BP IS NORMAL
- IF THEY ASK IF YOU HAVE DONE OSHA QUESTIONNAIRE, TELL THEM YOU HAVE AND REFER
THEM TO ME 561-496-7993 OR 561-221-4524

2. DURING RESPIRATOR FIT TESTING


- MAKE SURE YOU ARE USING THE CORRECT SIZE, WE ONLY HAVE REGULAR SIZE AND SMALL
- YOU WILL BE ASK TO SMELL SOME THINGS AND JUMP AROUND, MAKE SURE YOU SAY NO,
THAT YOU DO NOT SMELL ANYTHING; OTHERWISE YOU WILL HAVE TO REPEAT RESPIRATOR
FIT TESTING FOR ANOTHER DAY.
3. RETURN MASK AND RESULT WILL BE FAXED TO US. THIS WILL BE PAID FOR BY ULTIMATE CARE.

LET ME KNOW IF YOU HAVE QUESTIONS.

THANKS,

JEN

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