Cal. Code Regs. Tit. 8, 5197 app B1

Current through Register 2022 Notice Reg. No. 16, April 25, 2022

Appendices B1 and B2: Respiratory Health Questionnaires (Mandatory)

Adapted from forms prepared for the CDPH Guidelines by the Hazard Evaluation System and Information Service (HESIS), Occupational Health Branch, California Department of Public Health, with assistance from the Division of Respiratory Disease Studies, National Institute for Occupational Safety and Health

NOTE: The following additional respiratory health questionnaires contained in the CDPH Guidelines may be utilized as appropriate:

1.Initial Questionnaire in Spanish

2.Follow-Up Questionnaire in Spanish

Flavor Worker Initial Questionnaire

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Notes

Cal. Code Regs. Tit. 8, 5197 app B1

Note: Authority cited: Section 142.3, Labor Code. Reference: Section 142.3, Labor Code.