Clinic RPP Template
- Clinic RPP Template Home
- Scope and Application
- Identifying Work Hazards
- Respirator Selection
- Medical Evaluations
- Fit Testing
- Proper Respirator Use
- Cleaning and Disinfecting
- Inspecting, Maintenance and Repairs
- Respirator Training
- Evaluating/Updating Program
- Roles and Responsibilities
- Documentation and Record-keeping
Clinic Respiratory Protection Program Template
- __________ (example: Clinic Supervisor, employer’s name, human resources person) will be responsible for the administration of the respiratory protection program and thus is called the Respiratory Program Administrator (RPA).
- _________ (example: Clinic Supervisor, employer’s name, human resources person) will be responsible for monitoring the ongoing and changing needs for respiratory protection.
Download a print version of this template:
Clinic Respiratory Protection Program Template (PDF: 39KB/6 pages)
Download an editable version of this template:
Clinic Respiratory Protection Program Template (Word: 73KB/6 pages)
If you have questions or comments about this page, use our IDEPC Comment Form or call 651-201-5414 for the MDH Infectious Disease Epidemiology, Prevention and Control Division.