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
Cal. Code Regs. Tit. 8, div. 1, ch. 4, subch. 7, grp. 16, art. 109, app B1 and B2