Completely fill out the medical questionnaire and cover sheet - Appendix A found below. Email us the form. Do not send this to EHS or your supervisor, as the documents will contain personal health information. EHS will email your form to Occupational Medicine at DHMC. Occ Med will send the cover sheet back to EHS, which lets us know if the user is medically able to wear a respirator. EHS will email the user after receiving their clearance to set up training and/or fit testing.

Before the fit test for an N95, watch the training video. We will review and complete a training checklist at the fit test.

Fit tests generally take place at 37 Dewey Field Rd., Rm 115 and take 15-20 minutes. Call 603-646-1762 with access issues. You must be clean shaven to get fit tested and to wear a respirator. Bring the respirator you will be using. We must fit test on the exact make, model, and size you'll be using. If you do not yet have a respirator and do not know where to find one please let us know. Once you pass the fit test, the certification lasts a year, so if you plan to continue using a respirator, we'll have to complete this process again the following year.

• Appendix A: Medical Questionnaire and Cover Sheet
• Appendix B: Filter Face Piece Training Checklist
• Appendix C: Tight Fitting Respirator Training Checklist
• Appendix D: Respirator Issuance Form
• Appendix E: Voluntary Signature Page