Template

Cumberland Group Face Fit Testing Checklist

by Gary Plume, from the Community

10+

This Face Fit Testing checklist by Cumberland Group helps assess the fit of respiratory protective equipment for workers on construction sites. Record employee and assessor details, mask make and model, hazards present, and the condition of the equipment. Conduct standard fit test exercises including normal and deep breathing, head movements, talking, bending, and seal checks. Capture sensitivity test levels, PPE worn during the test, and determine pass or fail outcomes. Includes space for site visit notes and required signatures.

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Digitize any process, procedure or policy

Eliminate mistakes made by paper-based processes

Create and share professional reports instantly

Confirm accountability and compliance with a digital log

About author

Community

This community page makes available free workplace checklists and templates created by other users within the SafetyCulture community. SafetyCulture has re-published this content and where possible, has credited the original author. SafetyCulture has not verified the accuracy, reliability or suitability of any community content. You agree that your use of any of this content is in accordance with SafetyCulture’s Terms and Conditions.

Template
Face Fit Testing Record Template
This Face Fit Testing Record template helps teams document respirator fit tests for workers. Record site details, test date, make and model of the mask, and mask condition. Log the type of fit test performed and the required exercises, including normal and deep breathing, turning and tilting the head, talking, bending, and final normal breathing. Capture whether assistance was required to place the mask, test results, and any need for re-testing. Include names, company details, and signatures of the person tested and the advisor. Designed to support respiratory protection programs and compliance requirements across high-risk environments.
by Scott Bundy, from the Community
Downloads: 30+
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Template
SDS Face Fit Test Record
This SDS Face Fit Test Record template helps teams document qualitative respirator fit tests in the field. Record client and site details, the make and model of the face piece, the test agent (sweet or bitter), and each exercise performed, including normal and deep breathing, head movements, talking, and bending. Capture pass or fail outcomes, retest requirements, and required signatures to demonstrate PPE compliance and worker protection on site.
by Alan Prodger, from the Community
Downloads: 0
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Template
Face Fit Certificate
This Face Fit Certificate template helps you document and certify respirator fit tests. Record mask details (type, make, model, size, condition), company and site, wearer and assessor names, sensitivity score, retest frequency, test date, and test exercises including normal and deep breathing, head movements, talking, bending, and final normal breathing. Capture number of repeat tests, assistance required, overall result, and obtain wearer and tester signatures for compliance records.
by Phillip Sparks, from the Community
Downloads: 0
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Template
Graham Roofing Face Fit Test Checklist GRH 007
Use this Graham Roofing GRH 007 face fit test checklist to document qualitative RPE fit testing for roofing teams. Capture worker details, employer and address, mask make and model, and hazards such as dust, mist, fumes, gas and vapour. Record training provided and PPE worn during the test including specs, goggles, hard hat and ear defenders. Complete test exercises covering normal and deep breathing, head movements, talking, bending and final normal breathing. Log pass or fail outcomes with signatures from the assessor and the person tested.
by Chris Blair, from the Community
Downloads: 10+
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Face Fit Testing Record Template

This Face Fit Testing Record template helps teams document respirator fit tests for workers. Record site details, test date, make and model of the mask, and mask condition. Log the type of fit test performed and the required exercises, including normal and deep breathing, turning and tilting the head, talking, bending, and final normal breathing. Capture whether assistance was required to place the mask, test results, and any need for re-testing. Include names, company details, and signatures of the person tested and the advisor. Designed to support respiratory protection programs and compliance requirements across high-risk environments.

by Scott Bundy, from the Community

30+

Get

Template

SDS Face Fit Test Record

This SDS Face Fit Test Record template helps teams document qualitative respirator fit tests in the field. Record client and site details, the make and model of the face piece, the test agent (sweet or bitter), and each exercise performed, including normal and deep breathing, head movements, talking, and bending. Capture pass or fail outcomes, retest requirements, and required signatures to demonstrate PPE compliance and worker protection on site.

by Alan Prodger, from the Community

Get

Template

Face Fit Certificate

This Face Fit Certificate template helps you document and certify respirator fit tests. Record mask details (type, make, model, size, condition), company and site, wearer and assessor names, sensitivity score, retest frequency, test date, and test exercises including normal and deep breathing, head movements, talking, bending, and final normal breathing. Capture number of repeat tests, assistance required, overall result, and obtain wearer and tester signatures for compliance records.

by Phillip Sparks, from the Community

Get

Template

Graham Roofing Face Fit Test Checklist GRH 007

Use this Graham Roofing GRH 007 face fit test checklist to document qualitative RPE fit testing for roofing teams. Capture worker details, employer and address, mask make and model, and hazards such as dust, mist, fumes, gas and vapour. Record training provided and PPE worn during the test including specs, goggles, hard hat and ear defenders. Complete test exercises covering normal and deep breathing, head movements, talking, bending and final normal breathing. Log pass or fail outcomes with signatures from the assessor and the person tested.

by Chris Blair, from the Community

10+

Get

Cumberland Group Face Fit Testing Checklist

About author

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Face Fit Testing Record Template

SDS Face Fit Test Record

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Graham Roofing Face Fit Test Checklist GRH 007

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Face Fit Testing Record Template

SDS Face Fit Test Record

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