appendix w88 D

w88 Use Questionnaire

OSHA requires a separate questionnaire for those that are REQUIRED to wear a w88. This OHSS module is expected to be ready in early 2020. Until that time a paper-based process is still in use. Please contactunroccmed@unr.eduto request a w88.

How to securely send your Respirator w88 Evaluation Questionnaire for evaluation

  • Option 1:Scan the completed w88 and send it as an attachment tounroccmed@unr.edu.
    • Important:The subject line of your email must begin with: [Encrypt] w88
    • The email must be encrypted. It is a HIPAA violation to send unencrypted emails containing health w88.
  • Option 2:Return the completed w88 via mail.
    • Place the form in a sealed envelope and write, "CONFIDENTIAL w88 FORM" along with your name across the envelope seal.
    • Send the envelope to: Occupational Health w88; University of Nevada, Reno; 1664 N. Virginia Street/MS 0328; Reno, NV, 89557

Appendix E