OHS ► Respirator Medical Online Questionnaire

Submit this online questionnaire ONLY IF this is your FIRST TIME getting fitted for a N95/PAPR respirator. This questionnaire is to be used by Department of Public Health (DPH) employees only. If you are from a different department, give us a call (628-206-6581).

► ZSFG/DPH Respirator Medical Evaluation Online Questionnaire

 (*Only fill out this questionnaire if this is your FIRST TIME getting a fit test)

Related

OHS ► Respirator Medical Paper Questionnaire

Submit this paper questionnaire only if this is your FIRST TIME getting fitted for a respirator. This questionnaire can be used by all employees of City & County of San Francisco departments.

OHS ► N95/Respiratory Protection Program

Learn about N95/Respiratory fit test and what you might want to know before your next fit test.

Last updated May 12, 2022

Department

Occupational Health Service (OHS) at Zuckerberg San Francisco General Hospital (ZSFG)