N95 Respiratory Fit Test Questionnaire

An annual fit test is required for all employees with the same model, style, and size respirator that the employee will be required to wear for protection. The N95 respirator is to be used when entering the room of a patient on airborne precautions. 

After completing this form electronically, please email to Employee Health Services. 

If printed, please send the completed form:

• Via interoffice mail to the Saratoga Hospital Employee Health Office, or
• Fax to Attention: Employee Health Office (518-583-8403), or
• Scan and email the form to Employee Health Services