Welcome to the online medical respirator questionnaire. There will be 2 forms to fill out, the pre-questionnaire (below) and the medical questionnaire.

Once you have completed the pre-questionnaire we will set up your online medical questionnaire, this can take up to 24hrs not including weekends and holidays.

Once your medial pre-questionnaire is processed you will receive an email with a link to your secure medical questionnaire. After you complete the Medical Questionnaire you will be given an automatic response and if you pass, you can save and print your certificate immediately.

If you do not pass automatically you will receive a packet in the mail which you will take to a recommended clinic for further testing that is required in order to clear you for use of a respirator.

To process your questionnaire, there is a $57.00 investment due after completion of the prequestionniare. Payment is made via our secure site (Visa, MC, Amex, Discover, etc...)