How to Use

Complete this quiz if you have to wear a N95 respirator. Submit it to your supervisor in a sealed envelope, along with the Respirator Medical Evaluation Questionnaire. Stanford University Occupational Health Center (SUOHC) reviews forms submitted by supervisors, and informs employees and their supervisor of the medical evaluation results.

N95 respirators use approval

The following instructions apply to University employees who have to wear a N95 respirator. If you do not need to wear one but would like to for comfort­ purposes, see the Voluntary Respirator Use Agreement.

Step 1 – N95 respirator training

Review the material covered in the N95 Respirator Training document.

Step 2 – Quiz and medical evaluation questionnaire

1. Complete the following forms and submit them to your supervisor

• This N95 Respirator Training Quiz
• The Respirator Medical Evaluation Questionnaire (delivered in a sealed envelope. Note: Complete this form for first-time and annual N95 clearance.)

2. Supervisors submit the completed form(s) to SUOHC:

480 Oak Rd.
Stanford, CA 94305-8007
MC 8007 for Internal Mail
Telephone: (650) 725-5308
Fax: (650) 725-9218

3. The SUOHC reviews the forms, and notifies employees and their supervisors of the medical evaluation results.

Step 3 – Fit testing

1. Once the SUOHC has given medical clearance, contact us at (650) 723-0448 to schedule a respirator fit test.
2. We will assign the correct respirator model/size based on fit-testing results.

After finishing the above steps, we provide N95 approval documentation for one year.