N95 Fit Testing Request
Please complete this form to request fit testing services from York County HAZMAT Team.
PAgency Name *
Physical Address *
Point of Contact *
Telephone *
Email Address *
How many employees require fit testing? *
Do you have a Respiratory Protection Plan in place?
Clear selection
Have your employees being fit tested, been medically cleared for respiratory use? *
Do you have N95 masks? Enough for all your employees who require fit testing?
Clear selection
Is anyone in your facility (Resident or Staff) COVID-19 positive?
Clear selection
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