Workplace Services Booking Enquiry

1

The candidate must be clean shaven where the mask makes contact with the face to complete the test.
Anyone requiring a fit test must show some form of photographic id to the tester.
They must not have smoked for at least one hour prior to the test.
They must be fit enough to perform the face fit test exercises for 15 minutes.
You must inform the tester of the required certificate expiry date, or we will adopt the one-year default certificate setting.
If other head mounted ppe is normally worn, e.G. Eye wear, hard hat, ear defenders these items must be brought along and worn throughout the duration of the fit test.
Please inform us if a combination filter (abek, gasnvapour etc) is normally used, as this must be worn in addition to the p3 (particle) filter used during the fit test.
All masks supplied by a customer for testing purposes must be clean with new filters.
Please remember any candidates on the booking form who fail to attend the test or meet this criteria will still be included in your charge.
Eurox workplace services provides and recommends masks from our own mistralle and universal range of rpe alongside those of our selected partners JSP and UVEX
Please let us know in advance of the fitting session if you have an alternative brand preference.

2

Terms and Conditions* This field is required.

3

Are you an existing Eurox Customer?* This field is required.

Yes

No

4

What is the name of your organisation?* This field is required.

5

What is the nature of your organisation?* This field is required.Please provide basic detail of the nature of your business and sector

6

If you know the name of your Account manager / Sales representative please enter it here.

7

Please enter your Name. * This field is required.

First Name

Last Name

8

and your Email Address* This field is required.

example@example.com

9

Telephone Number

Area Code

Phone Number

10

Service or Session Required* This field is required.You can select more than one item.

11

How Many People for the half day Face Fit Session?* This field is required.Maximum allowed is 8

12

How Many People for the full day Face Fit Session?* This field is required.Maximum allowed 16

13

You have entered 'Other Service' as a response. What is the service you require or nature of your enquiry?

14

Would you still like to select dates for a proposed visit?

Yes

No

15

Would you still like to give details of your current RPE

Yes

No

16

Please tell us a little more about your organisation, nothing too detailed number of employees nature of business etc.

17

On the next pages, you will be asked to provide a few details about the current RPE in use by the individuals, that will be taking part in the fitting. If you are booking a train the tester course, we also ask that you complete this section, detailing the masks that the trainees will be fitting once they have completed the course. If you have any queries ,please don't worry, give us a call or send a message. If it helps you, you can click below to send us a picture of the RPE, if you do send a picture, please try and capture the stamps or markings on the products detailing its conformance etc. This is normally all that is needed .

18

If you would like to send a picture please click TAKE PHOTO or click NEXT to enter the details.

19

Current Mask Details (Make/Model/Size)

If yiu have multiople masks in use don't worry, you can add a second entry after this one

20

Would you like to enter another?* This field is required.

Yes

NO

21

Current Mask Details (Make/Model/Size)

22

Would you like to enter another?* This field is required.

Yes

NO

23

Current Mask Details (Make/Model/Size)

24

Would you like to enter another?* This field is required.

Yes

NO

25

Current Mask Details (Make/Model/Size)

26

Are you happy for us to make proposals for alternative products of equal or higher efficacy if we believe that it will either improve the experience of the wearer or save you money.

27

Please note our assessor may still make proposals if they do not think that the current product is compliant or fit for purpose.

28

Location of Training, Course, Survey or Assessments Venue (Post Code)

29

First Date Option* This field is required.

Date

30

Second Date OptionLeave blank if not possible

Date

31

Third Date optionLeave blank if not possible

Date

32

If you require a half day service would you prefer AM or PM

AM

PM

Either

33

Please submit this form and a member of the team will contact you as soon as possible to confirm availability and cost.

34

Type a question