Respirator fit test report checklist
What does this form include?
This form contains 10 sections:
Name
Department / Team
Make / Model / Size or Respirator
Own face piece/Pool or Test Model used?
- Own face piece/Pool or Test Model used?
Fit Test Kit Used
Re-test Required
Test Conducted by
Pass Achieved On Date
Signature of Tester
Signature of Employee
Use this template