Complete Your Respirator Medical Questionnaire Online
15-Minute OSHA-Approved Questionnaire • Mobile-Friendly • Instant PLHCP Review
15 Minutes
Average completion
Any Device
Mobile optimized
HIPAA Secure
Bank-level encryption
98% Instant
Immediate results
✓ 2 Free Credits • ✓ No Clinic Visit Required
OSHA 1910.134 Compliant
PLHCP Reviewed
98% Instant Results
85% Cheaper Than Clinics
What Questions Are On The Respirator Medical Questionnaire?
The OSHA-approved questionnaire covers health conditions that may affect respirator use. All questions are confidential and reviewed by licensed PLHCPs.
Personal Information
- Age, weight, height
- Current job title and duties
- Type of respirator required
- Duration of respirator use per shift
- Physical activity level while wearing respirator
Cardiovascular Health
- History of heart disease or heart attack
- Chest pain or pressure
- High blood pressure (controlled/uncontrolled)
- Heart surgery or cardiac procedures
- Pacemaker or implanted cardiac device
Respiratory Health
- Asthma, bronchitis, or COPD
- Shortness of breath during exertion
- Chronic cough or wheezing
- History of pneumonia or lung infections
- Smoking history (current or past)
Medications & Other Conditions
- Medications affecting breathing or heart rate
- Claustrophobia or panic attacks
- Vision or hearing problems
- Epilepsy or seizure disorders
- Previous respirator-related medical problems
📋 All Responses Are Confidential
Your questionnaire responses are protected by HIPAA regulations. Only licensed PLHCPs can access your medical information. Your employer receives only clearance status (approved/restricted/denied) - never specific health details. Learn more about our medical evaluation process.
How The Online Questionnaire Works
Complete your OSHA respirator medical questionnaire in 4 simple steps
Start Questionnaire
Access secure online form via email link or employer portal
⏱ 1 minuteAnswer Questions
Complete 15 main questions about health history and work environment
⏱ 10-15 minutesPLHCP Review
Licensed healthcare professional reviews responses immediately
⏱ Instant (98%)Receive Certificate
Digital certificate emailed to you and your employer
⏱ 1-2 minutesTotal Time: 15-20 Minutes From Start to Certificate
Start Your Questionnaire NowWhy Complete Your Questionnaire Online?
Online questionnaires save time, reduce friction, and maintain full OSHA compliance
15-Minute Completion
Complete the entire questionnaire in 15 minutes vs 2-4 hours at a clinic. No travel, no waiting rooms, no lost productivity.
Mobile-Friendly
Works perfectly on smartphones, tablets, and computers. Responsive design adapts to any screen size. Complete it anywhere.
Auto-Save Progress
Your answers are saved automatically after each question. Close browser and return anytime - your progress is secure.
HIPAA Secure
Bank-level encryption (AES-256) protects your medical information. Only authorized PLHCPs can access responses. Full audit trails.
Instant Results
98% of questionnaires receive instant PLHCP approval. Certificate delivered via email within minutes. Same-day clearance guaranteed.
OSHA Compliant
Uses exact OSHA Appendix C questionnaire format. PLHCP reviewed per 1910.134 requirements. Accepted by all OSHA inspectors.
Online vs Clinic Questionnaire Costs
Complete the same OSHA questionnaire online for 85% less cost
| Method | Cost | Time Required | Device Options |
|---|---|---|---|
| RespiratorTest.com Online | $22 | 15 minutes | Phone, tablet, computer |
| Occupational Health Clinic | $150-300 | 2-4 hours (+ travel) | Paper form at clinic |
| Your Savings | $128-278 | 1.75-3.75 hours | Complete anywhere |
Same OSHA questionnaire. Same PLHCP review. 85% lower cost.
Complete Questionnaire Online - $22Respirator Questionnaire FAQs
Common questions about the online OSHA respirator medical questionnaire
What is the OSHA respirator medical questionnaire?
The OSHA respirator medical questionnaire is a mandatory health screening form required by OSHA 1910.134. It evaluates whether employees can safely wear respirators by assessing cardiovascular, respiratory, and psychological conditions. The questionnaire must be reviewed by a PLHCP before employees can use respirators.
How long does the online respirator questionnaire take?
Most employees complete the OSHA respirator medical questionnaire in 10-15 minutes. The questionnaire contains 15 main questions with follow-up questions based on your answers. Our mobile-optimized interface saves your progress automatically, so you can complete it at your own pace.
Can I complete the respirator questionnaire on my phone?
Yes. Our respirator medical questionnaire is fully mobile-optimized and works on smartphones, tablets, and computers. The responsive design adapts to your screen size, and your progress is saved automatically if you need to switch devices.
Is the online questionnaire HIPAA compliant?
Yes. All medical information submitted through our online respirator questionnaire is HIPAA compliant with bank-level encryption (AES-256). Only authorized PLHCPs can access your responses, and we maintain comprehensive audit trails for compliance documentation.
What questions are on the respirator medical questionnaire?
The OSHA-approved questionnaire covers: personal information (age, weight, height), cardiovascular conditions (heart disease, chest pain), respiratory conditions (asthma, COPD, breathing difficulties), medications affecting breathing, claustrophobia or anxiety, and work environment details (respirator type, duration of use, physical activity level).
Who reviews my respirator questionnaire answers?
A licensed PLHCP (Physician or Licensed Healthcare Professional) reviews every respirator medical questionnaire. Our PLHCPs are occupational health specialists experienced in respirator medical evaluations and OSHA 1910.134 compliance. 98% of questionnaires receive instant approval; complex cases are reviewed within 24 hours.
What happens after I submit the questionnaire?
After submission, a PLHCP reviews your responses immediately (98% instant approval). If cleared, you receive a digital certificate via email within minutes. If the PLHCP needs more information, you will be contacted within 24 hours. Your employer receives notification of your clearance status automatically.
Can I save my progress and finish later?
Yes. The online questionnaire automatically saves your progress after each question. You can close the browser and return later using the same link. Your responses are encrypted and stored securely until you complete and submit the questionnaire.
How much does the online respirator questionnaire cost?
The complete respirator medical evaluation (including questionnaire, PLHCP review, and certificate) costs $22 per employee. This is 85% cheaper than traditional clinic visits ($150-300). Volume pricing of $17 per evaluation is available for 100+ employees.
Is the online questionnaire accepted by OSHA?
Yes. OSHA 1910.134 explicitly allows medical evaluations via questionnaire without physical examination. Our questionnaire uses the exact format from OSHA Appendix C, reviewed by licensed PLHCPs, making it fully compliant for all OSHA inspections and audits.
Complete Your Respirator Medical Questionnaire Today
15-minute OSHA-approved questionnaire. Mobile-friendly with auto-save. Instant PLHCP review. Digital certificate delivered in minutes. Get medical clearance before your fit test.
Start Questionnaire - $22✓ 2 Free Credits • ✓ No Clinic Visit • ✓ 98% Instant Results
Questions? Read our OSHA compliance guide or contact us