• Respirator Fit Testing Appointment Form

    LEONGATHA
  • Synposis

    The focus of respirator fit testing is to ensure there is an adequate seal between the face of the HCW and the chosen P2/N95 respirator.

    Respirator fit testing is not recommended in the presence of facial hair between the sealing edge of the respirator and the face of an individual.  A pass in this circumstance cannot be relied upon.

    Purpose

    The purpose of fit testing is to verify which selected makes, models and sizes of close fitting respiratory protective equipment (RPE) adequately fits the individual.  Future use of P2/N95 respirator(s) worn by the individual shall take this into consideration.

    Release of Information

    The Gippsland Respiratory Program Coordinator/Administrator may be requred to discuss any medical condition(s) with your line manager if this impacts on your ability to obtain an adequate fit.

    Data Collection

    The information collected during this assessment will be sent to your line manager and the Department of Health and Human Services (DHHS).  This data will be de-identified prior to submission.  You will be advised of the result at the time of the fit test.

  • Appointments will be held in the Education Centre, Leongatha Hospital. Please be 5 minutes early for your appointment and bring your previous fit test card with you.

    To change/cancel your appointment please contact:

    debra.moloney@gshs.com.au

    Infection Prevention & Control Coordinator

  • Consent

  • By signing below, you confirm:

    • I have read the above information / I have had the above information explained to me.
    • I understand the conditions of this testing program.
    • I acknowledge that I am medically and physically able to wear a respirator.
    • I consent to participate in testing.
    • I consent for the Gippsland Respiratory Protection Program Coordinator/Administrator to release information collected in this assessment to my line manager and the DHHS.
  • Clear
  • Respiratory Fit Testing Results

  • BYD DE2322 - Front Fold Mask

  • Image-40
  • Halyard 46727 - Regular

  • Image-46
  • 3M 1860 - Cup Mask

  • Image-51
  • BSN Medical Proshield - 72509-10 Medium

  • Image-61
  • BSN Medical Proshield - 72509-09 Small

  • Image-64
  • 3M Aura 9320A+
    (No longer available)

  • Image-70
  • 3M Aura 1870+

  • Image-99
  • 3M 1860S

  • Image-80
  • Trident RTCFFP2

  • Image-87
  • Halyard N95 46827 Sml

  • Image-93
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  • Should be Empty: