ANR Environmental Health & Safety
University of California
ANR Environmental Health & Safety



How can I get my medical medical evaluation?


Locations can use a local occupational health clinic (i.e. Job Care) or the UC Davis Occupational Health office, which will not charge, to obtain a respirator medical evaluation.

To use the UCD Occupational Health office to obtain a medical evaluation please do the following.

First go to this website link: 

There you will find 3 documents that need to be downloaded and fill in:

  • Respirator Questionnaire
  • Medical History Form
  • Request & Authorization Form (leave the recharge # blank,  boxes blank, and write in “ANR Respirator Medical Clearance” at the bottom of the form)

Then fax the completed documents to (530) 752-5277 with your return contact information. It should only take a few days to get the clearance back from Occupational Health. If possible please note on the fax cover page to have a copy of the medical clearance sent to ANR EH&S (

Last Updated

December 17, 2014

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