New Jersey Department of Health

PEOSH Unit

Emergency Medical Services

Respiratory Protection Program Evaluation Questionnaire

Training Program Evaluation Questions	Strongly Agree	Agree	No Position	Disagree	Strongly Disagree
The EMS Respiratory Protection training was well organized and well structured.
The educational materials were easily understood.
The trainer was knowledgeable about the material, kept the training on target and was sensitive to group dynamics.
Participation in this program is appropriate for someone in my position.
The environment in which the training was held was conducive to learning.
Overall Respiratory Protection

Program Evaluation	Strongly Agree	Agree	No Position	Disagree	Strongly Disagree
The respirator assigned to me is an appropriate selection for the hazards to which I am exposed.
I am able to don and doff my respirator correctly.
I am able to adequately store my respirator as appropriate.
The Program Administrator is accessible for my questions and needs regarding the program.
I feel that I have been adequately trained to use the respirator appropriately and understand the conditions when a respirator may need to be used as outlined in the written program or standard operating procedures.

What changes would you make to improve the EMS Respiratory Protection Program?

OCC-16

JAN 13

OCC-16, EMS Respiratory Protection Program Evaluation Questionnaire

EMS, PEOSH, OCC-16, OCC, emergency medical services, respiratory protection program, respirator, evaluation, questionnaire, occupational health

ewhite

2010-01-27

NJDOH