Respirator Medical Evaluation Form

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This form is for OU Health Sciences Center Faculty/Staff/Students. OU-Tulsa Faculty/Staff/Students, please contact your supervisor for instructions.

Please only complete this medical evaluation if your intent is to be fit for a respirator that will be used for protection against airborne particulates/diseases. If you are unsure if you will be required to wear a respirator, please contact your supervisor. Departments will not be charged for the actual fit test, however departments will be charged for the review and approval/denial of the medical evaluation form.

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Contact the OUHSC Service Desk at 405-271-2203 if you have authentication errors.