Loading...
Item C06BOARD OF COUNTY COMMISSIONERS AGENDA ITEM SUMMARY Meeting Date:_S)KI)i�115 1015 Division: E ---EW]oyce Services Bulk Item: Yes X No Department: Human Resources Staff Contact Person/Phone #: Pam Pumar X4459 AGENDA ITS WORDING: Approval of contract with Richard L. Dolsey, PHC, Inc. dba Physician's Health Center, Inc. to provide employment physical services. ITS BACKGROUND- The County advertised a Request for Proposals for employee physical services (which also included drug screening) in December, 2010. The County received two bids from the lower keys and one bid from the Middle Keys and contracted with these physicians in April, 2011. No bids were received from the Upper Keys. On July, 2011, the County entered into an agreement with Dr. Deacyle to perform the screenings in the upper keys. Dr. Deagle retired November 30, 2012. It has been extremely difficult to rind a doctor in the upper keys to enter into an agreement with the County to perform the required services. This contract will allow for employees and applicants to go for the required screenings in the upper keys instead of traveling to the middle or lower keys to obtain these services, PREVIOUS RELEVANT BOCC ACTION: CONTRACT/AGREERIENT CHANGES: STAFF RECOMME, NDATIONS: Approval TOTAL COST:_gnpM& $750.00yr INDIRECT COST: BUDGETED- Yes DIFFERENTIAL OF LOCAL PREFERENCE: COST TO COUNTY: -Approx.-j79.-0r SOURCOF FUNDS: Ad Valorem REVENUE PRODUCING: Yes N) A AMOUNT PER MONTH Year APPROVED BY: County Arty � MB/Purchasinl Risk Management DOCUMENTATION- Included X Not Required — DISPOSITION: AGENDA ITEM # MONROE COUNTY BOARD OF COUNTY COMMISSIONERS CONTRACT SUMMARY Contract with: Richard L. Dolsey, PUC, Contract # ......... Effective Date: June 10, 015 ........................................ ......... Expiration Date: Contract Purpose/Description: To enter into a contract with Richard L. Dolsey, PHC, Inca dba Physician's Health Center, Inc. to provide employment physical services. Contract Manager: Pram Purnar 445 Human Resources ........... (Name) (Ext.), (Depart ment/Stop ) for BOCC mectinn on June 10, 2015 Agenda Deadline: May , ` 015 CONTRACT COSTS Total Dollar Value of Contract: Apron Current Year Portion: 750.00 °, r. . Budgeted? YesZ No Account Codes: 001-0 5 0-510- 1 .............. .. Grant: $ ---------------- - County Match: � f -------u k-------- ADDITIONAL, COSTS Estimated Ongoing Costs: _/yr For: (Not included in dollar value above) (cg, maintenance, utilities, janitorial, salaries, etc.) CONTRACT REVIEW Changes Date Out at I Needed Jeviewer Division Director `�- Yes[] No r � Risk Management r Yes❑ NoE'] i II SI S O.M.B./Purchasing 5 a�I !� Yes❑ No[ 1� � < County Attorney 5'22•10tSYes❑ No[w S• Zz• Zc� I Comments: PHYSICALAGREEMENT EMPLOYMENT 1 TABLE OF CONTENTS SECTION ONE - Scope of Services SECTION - County Forms and Insurance Forms ATTACHMENTS: A. Post -offer and Fit for Duty Physical Forms (4 pages) t CBOT Physical (9 pages) C. Respirator Physical "Part 1" (6 pages) Respirator Physical "Part It" (3 pages) MONROE COUNTY CONTRACT FOR EMPLOYMENT PHYSICAL SERVICES THIS AGREEMENT ("Agreement") is made and entered into this — day of , by MONROE COUNTY ("COUNTY"), a political subdivision of the State of Florida, whose address is 1100 Simonton Street, Key West, Florida 33040 and Richard L. Dols r PRO Inca ribs ("CONTRACTOR"), whose address is at 1448 N. Krome Ave, Suite 101, Florida City, FIL 33034. Section 1. SCOPE OF SERVICES CONTRACTOR shall do, perform and carry out in a professional and proper manner certain duties as described in the Scope of Services — Section One — which is attached hereto and made a part of this agreement. CONTRACTOR shall provide the scope of services in Section One for COUNTY. CONTRACTOR warrants that it is authorized by law to engage in the performance of the activities herein described, subject to the terms and conditions set forth in these Agreement documents. The CONTRACTOR shall at all times exercise independent, professional judgment and shall assume professional responsibility for the services to be provided, Contractor shall provide services using the following standards, as a minimum requirement: A. The CONTRACTOR shall maintain adequate staffing levels to provide the services required under the Agreement. B. The contractor is responsible for obtaining proper releases from the employee or prospective employee in order to discuss the results with Monroe County BOCC. C. The contractor will provide the required services at the location of'. 1448 N. Krome Ave. Suite 101 Florida City, FL 33034 Phone: 305-245-0222 Fax: 305-246-3700 D. All urine screens will conform with the standard chain of custody protocols mandated by state and federal regulations. E. The Contractor will have an employee designated as coordinator or facilitator to assist in the communications with the Monroe County BOCC's primary contact personnel. F. Appointments will be available throughout the business hours of the facility: Monday — Friday 8:30 a.m. — 5:30 p.m. Walk-ins will also be accepted it an appointment cannot be reasonably scheduled. A. The facility will be available 24 hours a day, 7 days a week for post accident, random and reasonable suspicion alcohol and drug screening. ® The Human Resources office will contact PHC after Hours Service. • The authorized Human Resources representative or the authorized supervisor shall complete the appropriate forms either the same business day (or by the next business day if the test is after normal working hours) in order for the physician to perform the required test. • After normal working hours the employee will be tested at a location determined at the time of the call. I H. Appointments will be seen by the contractor in a reasonable and timely fashion. 1. The Contractor will provide the County with at least a 24 — 48 hour turnaround time for the receipt of any drug and/or physical results. J. The Medical Review Officer will be available for contact by the Monroe County BOCC or its employees to answer questions about the effect of prescribed drugs. Part of the requirements set forth by the State of Florida drug free workplace policy, which Monroe County has adopted, and the Department of Transportation, the County must have a qualified Medical Review Officer "MRO" perform drug screening services. The MRO receives lab reports from the laboratory (as governed by regulations); Reviews lab reports for integrity, authenticity, false negatives, and false positives, interprets lab results, including verification of lab positives, reports lab reports to the employer (as defined by rules and regulations). K. The personnel shall not be employees of or have any contractual relationship with the County. To the extent that Contractor uses subcontractors or independent contractors, this Agreement specifically requires that subcontractors and independent contractors shall not be an employee of or have any contractual relationship with County. L. All personnel engaged in performing services under this Agreement shall be fully qualified, and, if required, to be authorized or permitted under State and local law to perform such services. Section 2. QUALIFICATIONS NECESSARY OF CONTRACTOR The CONTRACTOR must certify at least annually that all staff members, independent contractors, subcontracted work, if any, all service providers it uses, engages or manages, comply with Health Insurance Portability and Accountability Act (HIPAA) privacy and security rules. Physical examinations will be conducted by, or under the direct supervision, of a physician or medical doctor currently licensed and practicing general medicine in the State of Florida. The examining physician may employ assistants properly licensed and trained, as necessary, to perform laboratory tests and/or assist in all phases of the examination. Section 3. COUNTY'S RESPONSIBILITIES 3.1 Provide all best available information as to the COUNTY'S requirements for the Scope of Services described in Section One to this Agreement. 3.2 Designate in writing a person with authority to act on the COUNTY'S behalf on all matters concerning said services. Section 4. TERM OF AGREEMENT 4.1 The term of this contract will be for one (1) year beginning June 10, 2015 and shall automatically renew for successive one year terms unless and until either party gives the other notice of cancellations in accordance with the terms set forth in Section 7. Section 5. COMPENSATION Compensation to CONTRACTOR is outlined in the Scope of Services — Section One. Section 6. PAYMENT TO CONTRACTOR 6.1 Payment will be made according to the Florida Local Government Prompt Payment Act. Any request for payment must be in a form satisfactory to the Clerk of Courts for Monroe County (Clerk). The request must describe in detail the services performed and the payment amount requested. The CONTRACTOR must submit invoices to the appropriate offices marked Human Resources. The respective office supervisor and the Administrator of Human Resources, who will review the request, note his/her approval on the request and forward it to the Clerk for payment. 6.2 Continuation of this Agreement is contingent upon annual appropriation by Monroe County Board of County Commissioners. Section 7. CONTRACT TERMINATION Either party may terminate this Agreement because of the failure of the other party to perform its obligations under the Agreement. Either party may terminate this Agreement without cause upon sixty (60) days' notice to the other party in accordance with Section 9 of this Agreement. The County shall pay CONTRACTOR for all work performed through the date of termination. Section 8. CONTRACTOR'S ACCEPTANCE OF CONDITIONS As CONTRACTOR hereby agrees that he has carefully examined the RFP, his response, and this Agreement and has made a determination that he/she has the personnel, equipment, and other requirements suitable to perform this work and assumes full responsibility therefore. The provisions of the Agreement shall control any inconsistent provisions contained in the specifications. All specifications have been read and carefully considered by CONTRACTOR, who understands the same and agrees to their sufficiency for the work to be done. Under no circumstances, conditions, or situations shall this Agreement be more strongly construed against COUNTY than against CONTRACTOR. B. Any ambiguity or uncertainty in the specifications shall be interpreted and construed by COUNTY, and its decision shall be final and binding upon all parties. C. The passing, approval, and/or acceptance by COUNTY of any of the services furnished by CONTRACTOR shall not operate as a waiver by COUNTY of strict compliance with the terms of this Agreement, and specifications covering the services. D4 CONTRACTOR agrees that County Administrator or his designated representatives may visit CONTRACTOR'S facility (ies) periodically to conduct random evaluations of services during CONTRACTOR'S normal business hours. E. CONTRACTOR has, and shall maintain throughout the term of this Agreement, appropriate licenses and approvals required to conduct its business, and that it will at all times conduct its business activities in a reputable manner. Proof of such licenses and approvals shall be submitted to COUNTY upon request. F. Pursuant to Florida Statute §119.0701, Contractor and its subcontractors shall comply with all public records laws of the State of Florida, specifically to: i. Keep and maintain public records that ordinarily and necessarily would be required by Monroe County in the performance of this Agreement. it. Provide the public with access to public records on the same terms and conditions that Monroe County would provide the records and at a cost that does not exceed the cost provided in Florida Statutes, Chapter 119 or as otherwise provided by law. 4 iii. Ensure that public records that are exempt or confidential and exempt from public records disclosure requirements are not disclosed except as authorized by law. iv. Meet all requirements for retaining public records and transfer, at no cost, to Monroe County all public records in possession of the contractor upon termination of this Agreement and destroy any duplicate public records that are exempt or confidential and exempt from public records disclosure requirements. All records stored electronically must be provided to Monroe County in a format that is compatible with the information technology systems of Monroe County. Section 9. NOTICES Any notice required or permitted under this agreement shall be in writing and hand delivered or mailed, postage prepaid, to the other party by certified mail, returned receipt requested, to the following: To the COUNTY: Human Resources Administrator 1100 Simonton Street, Suite 2-268 Key West, Florida 33040 To the CONTRACTOR: Richard L. Dolsey, PHC, Inc. doe Physician's Health Center 1448 N. Krome Ave., #101 Florida City, FL 33034 Section 10. RECORDS CONTRACTOR shall maintain all books, records, and documents directly pertinent to performance under this Agreement in accordance with generally accepted accounting principles consistently applied. Each party to this Agreement or their authorized representatives shall have reasonable and timely access to such records of each other party to this Agreement for public records purposes during the term of the agreement and for four years following the termination of this Agreement. It an auditor employed by the COUNTY or Clerk determines that monies paid to CONTRACTOR pursuant to this Agreement were spent for purposes not authorized by this Agreement, the CONTRACTOR shall repay the monies together with interest calculated pursuant to Section 55.03 of the Florida Statutes, running from the date the monies were paid to CONTRACTOR. Section1l. EMPLOYEES SUBJECT TO COUNTY ORDINANCE NOS. 010 AND 020-1990 The CONTRACTOR warrants that it has not employed, retained or otherwise had act on its behalf any former County officer or employee subject to the prohibition of Section 2 of Ordinance No. 010-1990 or any County officer or employee in violation of Section 3 of Ordinance No. 020-1990. For breach or violation of this provision the COUNTY may, in its discretion, terminate this agreement without liability and may also, in its discretion, deduct from the agreement or purchase price, or otherwise recover the full amount of any fee, commission, I percentage, gift, or consideration paid to the former County officer or employee. Section 12. CONVICTED VENDOR A person or affiliate who has been placed on the convicted vendor list following a conviction for public entity crime may not submit a bid on an Agreement with a public entity for the construction or repair of a public building or public work, may not perform work as a CONTRACTOR, supplier, subcontractor, or CONTRACTOR under Agreement with any public entity, and may not transact business with any public entity in excess of the threshold amount provided in Section 287.017 of the Florida Statutes, for the Category Two for a period of 36 months from the date of being placed on the convicted vendor list. Section 13. GOVERNING LAW, VENUE, INTERPRETATION, COSTS AND FEES This Agreement shall be governed by and construed in accordance with the laws of the State of Florida applicable to Agreements made and to be performed entirely in the State. In the event that any cause of action or administrative proceeding is instituted for the enforcement or interpretation of this Agreement, the COUNTY and CONTRACTOR agree that venue shall lie in the appropriate court or before the appropriate administrative body in Monroe County, Florida. Section 14. SEVERABILITY If any term, covenant, condition or provision of this Agreement (or the application thereof to any circumstance or person) shall be declared invalid or unenforceable to any extent by a court of competent jurisdiction, the remaining terms, covenants, conditions and provisions of this Agreement, shall not be affected thereby; and each remaining term, covenant, condition and provision of this Agreement shall be valid and shall be enforceable to the fullest extent permitted by law unless the enforcement of the remaining terms, covenants, conditions and provisions of this Agreement would prevent the accomplishment of the original intent of this Agreement. The COUNTY and CONTRACTOR agree to reform the Agreement to replace any stricken provision with a valid provision that comes as close as possible to the intent of the stricken provision. Section 15. ATTORNEY'S FEES AND COSTS The COUNTY and CONTRACTOR agree that in the event any cause of action or administrative proceeding is initiated or defended by any party relative to the enforcement or interpretation of this Agreement, the prevailing party shall be entitled to reasonable attorney's fees, and court costs, as an award against the non -prevailing party. Mediation proceedings initiated and conducted pursuant to this Agreement shall be in accordance with the Florida Rules of Civil Procedure and usual and customary procedures required by the Circuit Court of Monroe County. Section 16. BINDING EFFECT The terms, covenants, conditions, and provisions of this Agreement shall bind and inure to the benefit of the COUNTY and CONTRACTOR and their respective legal representatives, successors, and assigns. N Section 17. AUTHORITY Each party represents and warrants to the other that the execution, delivery and performance of this Agreement have been duly authorized by all necessary County and corporate action, as required by law. Section 18. ADJUDICATION OF DISPUTES OR DISAGREEMENTS COUNTY and CONTRACTOR agree that all disputes and disagreements shall be attempted to be resolved by meet and confer sessions between representatives of each of the parties. If the issue or issues are still not resolved to the satisfaction of the parties, then any party shall have the right to seek such relief or remedy as may be provided by this Agreement or by Florida law. This Agreement shall not be subject to arbitration. Section 19. COOPERATION In the event any administrative or legal proceeding is instituted against either party relating to the formation, execution, performance, or breach of this Agreement, COUNTY and CONTRACTOR agree to participate, to the extent required by the other party, in all proceedings, hearings, processes, meetings, and other activities related to the substance of this Agreement or provision of the services under this Agreement. COUNTY and CONTRACTOR specifically agree that no party to this Agreement shall be required to enter into any arbitration proceedings related to this Agreement. Section 20, NONDISCRIMINATION COUNTY and CONTRACTOR agree that there will be no discrimination against any person, and it is expressly understood that upon a determination by a court of competent jurisdiction that discrimination has occurred, this Agreement automatically terminates without any further action on the part of any party, effective the date of the court order. The parties agree to comply with all Federal and Florida statutes, and all local ordinances, as applicable, relating to nondiscrimination. These include but are not limited to: 1) Title All of the Civil Rights Act of 1964 (PL 88-352) which prohibits discrimination in employment on the basis of race, color, national origin; 2) Title IX of the Education Amendment of 1972, as amended (20 USC as. 1681- 1683, and 1685-1686), which prohibits discrimination on the basis of sex; 3) Section 504 of the Rehabilitation Act of 1973, as amended (20 USC a. 794), which prohibits discrimination on the basis of handicaps: 4) The Age Discrimination Act of 1975, as amended (42 USC as. 6101- 6107) which prohibits discrimination on the basis of age; 5) The Drug Abuse Office and Treatment Act of 1972 (PL 29-255), as amended, relating to nondiscrimination on the basis of drug abuse; 6) The Comprehensive Alcohol Abuse and Alcoholism Prevention, Treatment and Rehabilitation Act of 1970 (PL 91-616), as amended, relating to nondiscrimination on the basis of alcohol abuse or alcoholism; 7) The Public Health Service Act of 1912, as. 523 and 527 (42 USC as. 690dd-3 and 290ee-3) as amended, relating to confidentiality of alcohol and drug abuse patient records; 8) Title gill of the Civil Rights Act of 1968 (42 US C as. 3601 at seq.), as amended, relating to nondiscrimination in the sale, rental or financing of housing; 9) The Americans with Disabilities Act of 1990 (42 DISC a. 1201), as may be amended from time to time, relating to nondiscrimination on the basis of disability; 10) Monroe County Code Chapter 13, Article VI, which prohibits discrimination on the basis of race, color, sex, religion, national origin, ancestry, sexual orientation, gender identity or expression, familial status or age; and 11) any other nondiscrimination provisions in any Federal or state statutes which may apply to the parties to, or the subject matter of, this Agreement. h Section 21. COVENANT OF NO INTEREST COUNTY and CONTRACTOR covenant that neither presently has any interest, and shall not acquire any interest, which would conflict in any manner or degree with its performance under this Agreement, and that only interest of each is to perform and receive benefits as recited in this Agreement. Section 22. CODE OF ETHICS COUNTY agrees that officers and employees of the COUNTY recognize and will be required to comply with the standards of conduct for public officers and employees as delineated in Section 112.313, Florida Statutes, regarding, but not limited to, solicitation or acceptance of gifts-, doing business with one's agency; unauthorized compensation-, misuse of public position, conflicting employment or contractual relationship; and disclosure or use of certain information. Section 23. NO SOLICITATION/PAYINENT The COUNTY and CONTRACTOR warrant that, in respect to itself, it has neither employed nor retained any company or person, other than a bona fide employee working solely for it, to solicit or secure this Agreement and that it has not paid or agreed to pay any person, company, corporation, individual, or firm, other than a bona fide employee working solely for it, any fee, commission, percentage, gift, or other consideration contingent upon or resulting from the award or making of this Agreement. For the breach or violation of the provision, the CONTRACTOR agrees that the COUNTY shall have the right to terminate this Agreement without liability and, at its discretion, to offset from monies owed, or otherwise recover, the full amount of such fee, commission, percentage, gift, or consideration. Section 24. PUBLIC ACCESS The COUNTY and CONTRACTOR shall allow and permit reasonable access to, and inspection of, all documents, papers, letters or other materials in its possession or under its control subject to the provisions of Chapter 119, Florida Statutes, and made or received by the COUNTY and CONTRACTOR in conjunction with this Agreement', and the COUNTY shall have the right to unilaterally cancel this Agreement upon violation of this provision by CONTRACTOR. Section 25. NON -WAIVER OF IMMUNITY Notwithstanding the provisions of Sec. 768.28, Florida Statutes, the participation of the COUNTY and the CONTRACTOR in this Agreement and the acquisition of any commercial liability insurance coverage, self-insurance coverage, or local government liability insurance pool coverage shall not be deemed a waiver of immunity to the extent of liability coverage, nor shall any Agreement entered into by the COUNTY be required to contain any provision for waiver. Section 26. PRIVILEGES AND IMMUNITIES All of the privileges and immunities from liability, exemptions from laws, ordinances, and rules and pensions and relief, disability, workers' compensation, and other benefits which apply to the activity of officers, agents, or employees of any public agents or employees of the COUNTY, when performing their respective functions under this Agreement within the territorial limits of the COUNTY shall apply to the same degree and extent to the performance of such functions and duties of such officers, agents, volunteers, or employees outside the territorial limits of the COUNTY. I Section 27. LEGAL OBLIGATIONS AND RESPONSIBILITIES Non -Delegation of Constitutional or Statutory Duties. This Agreement is not intended to, nor shall it be construed as, relieving any participating entity from any obligation or responsibility imposed upon the entity by law except to the extent of actual and timely performance thereof by any participating entity, in which case the performance may be offered in satisfaction of the obligation or responsibility. Further, this Agreement is not intended to, nor shall it be construed as, authorizing the delegation of the constitutional or statutory duties of the COUNTY, except to the extent permitted by the Florida constitution, state statute, and case law. Section 28. NON -RELIANCE BY NON-PARTIES No person or entity shall be entitled to rely upon the terms, or any of them, of this Agreement to enforce or attempt to enforce any third -party claim or entitlement to or benefit of any service or program contemplated hereunder, and the COUNTY and the CONTRACTOR agree that neither the COUNTY nor the CONTRACTOR or any agent, officer, or employee of either shall have the authority to inform, counsel, or otherwise indicate that any particular individual or group of individuals, entity or entities, have entitlements or benefits under this Agreement separate and apart, inferior to, or superior to the community in general or for the purposes contemplated in this Agreement. Section 29. ATTESTATIONS CONTRACTOR agrees to execute such documents as the COUNTY may reasonably require, including, but not being limited to, a Public Entity Crime Statement, an Ethics Statement, and a Drug -Free Workplace Statement, Lobbying and Conflict of Interest Clause, and Non -Collusion Agreement, Section 30. NO PERSONAL LIABILITY No covenant or agreement contained herein shall be deemed to be a covenant or agreement of any member, officer, agent or employee of Monroe County in his or her individual capacity, and no member, officer, agent or employee of Monroe County shall be liable personally on this Agreement or be subject to any personal liability or accountability by reason of the execution of this Agreement. Section 31. EXECUTION IN COUNTERPARTS This Agreement may be executed in any number of counterparts, each of which shall be regarded as an original, all of which taken together shall constitute one and the same instrument and any of the parties hereto may execute this Agreement by signing any such counterpart. Section 32. SECTION HEADINGS Section headings have been inserted in this Agreement as a matter of convenience of reference only, and it is agreed that such section headings are not a part of this Agreement and will not be used in the interpretation of any provision of this Agreement. Section 33. INSURANCE POLICIES 33.1 General Insurance Requirements for Other Contractors and Subcontractors. As a pre -requisite of the work governed, the CONTRACTOR shall obtain, at his/her own expense, insurance as specified in any attached schedules, which are made part of this 9 contract. The CONTRACTOR will ensure that the insurance obtained will extend protection to all Subcontractors engaged by the CONTRACTOR. As an alternative, the CONTRACTOR may require all Subcontractors to obtain insurance consistent with the attached schedules; however CONTRACTOR is solely responsible to ensure that said insurance is obtained and shall submit proof of insurance to COUNTY. Failure to provide proof of insurance shall be grounds for termination of this Agreement. The CONTRACTOR will not be permitted to commence work governed by this contract until satisfactory evidence of the required insurance has been furnished to the COUNTY as specified below, Delays in the commencement of work, resulting from the failure of the CONTRACTOR to provide satisfactory evidence of the required insurance, shall not extend deadlines specified in this contract and any penalties and failure to perform assessments shall be imposed as if the work commenced on the specified date and time, except for the CONTRACTOR's failure to provide satisfactory evidence. The CONTRACTOR shall maintain the required insurance throughout the entire term of this contract and any extensions specified in the attached schedules. Failure to comply with this provision may result in the immediate suspension of all work until the required insurance has been reinstated or replaced and/or termination of this Agreement and for damages to the COUNTY. Delays in the completion of work resulting from the failure of the CONTRACTOR to maintain the required insurance shall not extend deadlines specified in this contract and any penalties and failure to perform assessments shall be imposed as if the work had not been suspended, except for the CONTRACTOR's failure to maintain the required insurance. The CONTRACTOR shall provide, to the COUNTY, as satisfactory evidence of the required insurance, either: • Certificate of Insurance or • A Certified copy of the actual insurance policy. The County, at its sole option, has the right to request a certified copy of any or all insurance policies required by this contract. All insurance policies must specify that they are not subject to cancellation, non -renewal, material change, or reduction in coverage unless a minimum of thirty (30) days prior notification is given to the County by the insurer. The acceptance and/or approval of the Contractor's insurance shall not be construed as relieving the Contractor from any liability or obligation assumed under this contract or imposed by law, The Monroe County Board of County Commissioners, its employees and officials will be included as "Additional Insured" on general liability policies. 33.2 General Liability Insurance Requirements For Contract Between County And Contractor Prior to the commencement of work governed by this contract, the CONTRACTOR shall obtain General Liability Insurance. Coverage shall be maintained throughout the life of the contract and include, as a minimum- • Premises Operations • Bodily Injury Liability • Expanded Definition of Property Damage H The minimum limits acceptable shall be- $300,000 Combined Single Limit (CSL) If split limits are provided, the minimum limits acceptable shall be: $200,000 per Person $300,000 per Occurrence $ 50,000 Property Damage An Occurrence Form policy is preferred, If coverage is provided on a Claims Made policy, its provisions should include coverage for claims filed on or after the effective date of this contract. In addition, the period for which claims may be reported should extend for a minimum of twelve (12) months following the acceptance of work by the County. The Monroe County Board of County Commissioners shall be named as Additional Insured on all policies issued to satisfy the above requirements. 33.3 Workers' Compensation Insurance Requirements Prior to commencement of work governed by this contract, the CONTRACTOR shall obtain Workers' Compensation Insurance with limits sufficient to respond to the applicable state statutes. In addition, the CONTRACTOR shall obtain Employers' Liability Insurance with limits of not less than: $100,000 Bodily Injury by Accident $500,000 Bodily Injury by Disease, policy limits $100,000 Bodily Injury by Disease, each employee Coverage shall be maintained throughout the entire term of the contract. Coverage shall be provided by a company or companies authorized to transact business in the state of Florida. 33.4 Professional Liability Requirements Recognizing that the work governed by this contract involves the furnishing of advice or services of a professional nature, the Contractor shall purchase and maintain, throughout the life of the contract, Professional Liability Insurance which will respond to damages resulting from any claim arising out of the performance of professional services or any error or omission of the Contractor arising out of work governed by this contract. The minimum limits of liability shall be: $250,000 per occurrence and $750,000 aggregate Section 34. INDEMNIFICATION The CONTRACTOR does hereby consent and agree to indemnify and hold harmless the COUNTY, its Mayor, the Board of County Commissioners, appointed Boards and Commissions, Officers, and the Employees, and any other agents, individually and collectively, from all fines, suits, claims, demands, actions, costs, obligations, attorney's fees, or liability of any kind arising out of the sole negligent actions of the CONTRACTOR or substantial and unnecessary delay caused by the willful nonperformance of the CONTRACTOR and shall be solely responsible and answerable for any and all accidents or injuries to persons or property arising out of its performance of this contract. The amount and type of insurance coverage requirements set forth hereunder shall in no way be construed as limiting the scope of indemnity set forth in this paragraph. Further the CONTRACTOR agrees to defend and pay all legal costs attendant to acts attributable to the sole negligent act of the CONTRACTOR. At all times and for all purposes hereunder, the CONTRACTOR is an independent contractor and not an employee of the Board of County Commissioners, No statement contained in this agreement shall be construed so as to find the CONTRACTOR or any of his/her employees, contractors, servants or agents to be employees of the Board of County Commissioners for Monroe County. As an independent contractor the CONTRACTOR shall provide independent, professional judgment and comply with all federal, state, and local statutes, ordinances, rules and regulations applicable to the services to be provided. The CONTRACTOR shall be responsible for the completeness and accuracy of its work, plan, supporting data, and other documents prepared or compiled under its obligation for this project, and shall correct at its expense all significant errors or omissions therein which may be disclosed. The cost of the work necessary to correct those errors attributable to the CONTRACTOR and any damage incurred by the COUNTY as a result of additional costs caused by such errors shall be chargeable to the CONTRACTOR. This provision shall not apply to any maps, official records, contracts, or other data that may be provided by the COUNTY or other public or semi-public agencies. The CONTRACTOR agrees that no charges or claims for damages shall be made by it for any delays or hindrances attributable to the COUNTY during the progress of any portion of the services specified in this contract. Such delays or hindrances, if any, shall be compensated for by the COUNTY by an extension of time for a reasonable period for the CONTRACTOR to complete the work schedule. Such an agreement shall be made between the parties. 17 IN WITNESS WHEREOF, the parties hereto have caused these presents to be executed on the - day of Attest', AMY HEAVILIN CLERK By Deputy Clerk (CORPORAT E SEAL) ATTEST' Print name i I 1, BOARD OF COUNTY COMMISSIONERS OF MONROE COUNTY, FLORIDA M Mayor/Chairman Richard L, Dolsey, RISC, Inc, dba Physician's Health Center by SECTION ONE SCOPE OF SERVICES EMPLOYMENT PHYSICAL SERVICES The scope of services to be provided on an as needed basis by the Provider and may include, but not be limited to, the following. The forms to be reviewed and completed by the Contractor are attached to this agreement (Attachments A - C). All results will include: • Written interpretation of test results in common terms and written explanation of the significance of each abnormality or written explanation of those results which are outside the normal range. • Examining physician's written recommendation concerning future action on any condition considered outside the normal range. • Written recommendation of specific reasonable accommodations in accordance with the AIA. SERVICE FEE DRUG SCREEN: When requested, a drug screen will (Collection, Lab, MRO be performed by the physician's review)10 panel State tech and will be either scheduled or $40.00 Requirement done on a walk-in basis _ After hours drug testing for post- $I75 plus accident, random, and cost of un- reasonable suspicion drug site screening. services. (which is the cost of test being erformed) DRUG SCREEN: When requested, a drag screen will (Collection, Lab, MRO be performed by the physician's review) 5 panel tech and will be either scheduled or $40.00 Department of done on a walk-in basis. Transportation Requirement After hours drug testing for a $175.00 moving violation or an accident plus cost where a fatality occurs. of on -site services (which is cost of test being _ - The MRO receives lab reports from erforme_d) $5.00 y Medical Review Officer (MRO) REVIEW the Iaboratory (as governed by relations); Reviews lab reports for 14 integrity, authenticity, false negatives, and false positives; interprets lab results, including verification of lab positives; reports lab reports to the employer (as .................................................................................................................................................. defined by rules and re�11.ulations)- .................................................... . .................................................................. . ............................................. .......................... .............. BLOOD ALCOHOL When requested, Blood Alcohol (Collection, Lab, 1 x Screens will be performed by the review) physician's tech& and will be either $35.00 scheduled or done on a walk-in .................................................................................................................................................. basis. ................................................................................................................................................................................................................. ................................................................................ After hours testing for post -accident, r $175,00 plus random and reasonable suspicion cost of on -site alcohol screen. r services (which is cost I of test bein- .................................................................................................................................................. BREATH ALCOHOL ................................................................................................................................................................................................................ When requested, may be used for ................................................... .................... screening. If breath alcohol screen is $35.00 positive, a blood screen will be �erformed. After hours testing for post -accident, $175.00 plus random, and reasonable suspicion cost of on -site alcohol screening. If breath alcohol services screen is positive, a blood screen will which is cost ( be performed at the rate designated of test being above, ............ ............................................................................................................................................................................................................... performed) ... .... ........................................................................ PPD- TB screen When requested, a PPD-.TB screen will be scheduled and performed by the $25.00 physician's tech. during the facility's I'M normal business hours. ............. ............................................................................................................................................................................................................... .............................................................................. HEPATITIS A When requested, a Hepatitis A $82.00 inoculation will be scheduled and performed by the physician's tech. during the facility's normal business ............................................................................................................. hours. ............................................................................................................................................................. ............................................................ HEPATITIS B When requested, as Hepatitis B I inoculation(s) will be scheduled and $72.00 x 3 performed by the physician's tech. I during the facility's normal business $40.00 Titer hours. TYPHOID t When requested, as Typhoid inoculation ................ will be scheduled and performed by the $56.00 physician's tech. during the facility's normal business hours, ....................... .................. ........... �TETANIJS .................................... ................. ................................................................................ When requested, a Tetanus inoculation ................................................................................ $20.00 will be scheduled and performed by the physician's tech. during the facility's normal business hours. 15 DIPHTHERIA When requested, a Diphtheria inoculation will be scheduled and $2T00 performed by the physician's tech, during the facility's normal business hours, quested, a DOT physical will EELI be haled and performed by the $45.00 "B" to be completed by physician during the facility's normal employee and physician) business hours. Includes exam and physician review of employee health history and job description. The DOT physical is initially performed in conjunction with a post - offer physical. Thereafter, only a DOT physical is performed by the physician, Physician may also perform a urine drug screen if requested separately by Monroe gaunt r BOCC, POST -OFFER - When requested, a post -offer physical PHYSICAL: will be scheduled and performed by the (SEE ATTACHMENT physician during the facility's normal $5000 "A" to be completed by business hours. Includes exam and employee and physician) physician review of employee health history and job description. Physician may also perform a urine drug screen if requested separately by Monroe County BOCC. FITNESS FOR DUTY When requested, a Fitness for Duty PHYSICAL (SEE Physical may be requested at any time ATTACHMENT "A" to be by the employer in the employee's $100.00 completed by employee respective area of work, The exam will and physician) be scheduled during the facility's normal business hours. Includes physician review of employee health history, exam, review of job duties and medical records if necessary. Physician may also perform a urine drug screen if requested separately by Monroe County BOCC. RESPIRATOR When requested, a Respirator physical PHYSICAL (SEE will be scheduled and performed by the ATTACHMENTS "C" physician during the facility's normal $45.00 for PART I & IT to be business hours. Includes exam and physical completed by employee physician review of employee health clearance to and physician) history and job description. wear Physician may also perform a urine respirator. drug screen if requested separately by Monroe County BOCC. 16 Also required: Chest X-ray and SpIrtaneirrv. CHEST X RAY Chest X Ray is normally done in conjunction with the Respirator $40.00 physical if there is an issue with the a irometr results. SPIROMETRY Normally done in conjunction with tbe­ T_ Respirator physical. All employees who use a respirator will have a $30.00 1 . irornetr when hired. Normally done in conjunction with the HEARING/AUDIOGRAM appropriate physical. May be $20.00 requested separately by Monroe County Id CHEMICAL Tests Glucose (sugar), kidneys, liver (1 $20.00 PANEUCMP tube of blood drawn). CBC2 Test to see if Anemic; if any infections $20.00 within the body-, if dehydrated (test frorn I of the tubes of blood drawn). UA DIP Normally done in conjunction with the $15.00 D ph sical. URINE TESTING FOR When requested, a nicotine test will be $10.00 NICOTINE USE performed by the physician's tech. and will be either scheduled or done on a walk-in basis 17 SECTION TWO: COUNTY FORMS AND INSURANCE FORMS LOBBYING AND CONFLICT OF INTEREST CLAUSE SWORN STATEMENT UNDER ORDINANCE NO. 010-1990 MONROE COUNTY, FLORIDA ETHICS CLAUSE "RICHARD L. DOLSEY PHC Inc. doe PHYSICIANS HEALTH CENTER" "Company) k —warrants that he/it has not employed, retained or otherwise had act on his/her behalf any former County officer oi r employee n violation of Section 2 of Ordinance No, 010-1990 or any County officer or employee in violation of Section 3 of Ord�nance No, 010-1990, For breach or violation of this provision the County may, in its discretion, terminate this Agreement without liability and may also, in its discretion, deduct from the Agreement or purchase price, or otherwise recover, the full amount of any fee, commission, percentage, gift, or consideration paid to the former County officer or employee." STATE OF, Flo r t de", COUNTY OF: i —baffl-- Subscribed and sworn to (or affirmed) before me on 11 /I 0e 1 0 - -1 (date) byy me of affiant). He/She is pe sonally (type of identification) as identific@t'on, 0.0 ...... VAS E VELUNZA re or Florida c So V 015 6 T 0 r diary Pu NO I ARY PUBLICJ Notary publIc St ote or Florida y Cr.rnm ExpffeS NOV 17, 2015 'P 4731 n EE I rcrnrrussion EE 147316 My Commission Expires: E NON -COLLUSION AFFIDAVIT it ke vi�n J 11 of the city of 161 rn I according to law on my oath, and under 'enalty of perjury, depose and say that 1, lam— 1116e of the firm of LnIthe bidder making the c _r proposal fort project described in the Request for proposals for a and that I executed the said proposal with full authority to do so; 2, The prices in this bid have been arrived at independently without collusion, consultation, communication or agreement for the purpose of restricting competition, as to any matter relating to such prices with any other bidder or with any competitor; 3, Unless otherwise required by law, the prices which have been quoted in this bid have not been knowingly disclosed by the bidder and will not knowingly be disclosed by the bidder prior to bid opening, directly or indirectly, 4. to any other bidder or to any competitor-, and 4, No attempt has been made or will be made by the bidder to induce any other person, partnership or corporation to submit, or not to submit, a bid for the purpose of restricting competitio', and 5he statements contained in this affidavit are 'true and correct, and made with full knowledge that IMonme County relies upon the truth of the statements contained in this affidavit in awarding contracts for said project, (Sig Wre' Date, e �2 STAT E OF: _—EL01 ri —de-L COUNTY OF, I �"l I dw)1, - bne fe- 111111111 ubscrib d and sworn to (or affirmed) before me on (date) by ke v, ifi I Rt SC_ (name of affiant), He/She is per r illy l rl n to mor has produced (type of identification) as identification. "011M, E, VIELUNZA 5o S� Fio;�Odla5 W'C Notary Public Sr;ile of Ficuida V 7 E-Agires Nov 17 2015 ri IV Cr wn M S sutit C 316 EE 47 , EE 147316 M NOTARY P&BR My Commission Expires: I /I _/� DRUG -FREE WORKPLACE FORM The undersigned vendor in accordance with Florida Statutes Section 287,087 here. by certifies that', RICHARD L. DOLSEY PFIC INC. dba PHYSICIANS HEALTH CENTER ,Name of Business) 1, Publishes a statement notifying employees that the unlawful manufacture, distribution, dispensing, possession, or use of a controlled substance is prohibited in the Wor place and specifying the actions that will be taken against employees for violations of such prohibition, sl 2, Informs employees about the dangers of drug abuse in 'the workplace, the cosines policy of maintaining a drug -free workplace, any available drug counseling, rehabilitation, and employ ee assistance programs, and the penalties that may be imposed upon employees for drug abuse violations, 3, Gives each employee engaged in providing the commodities or contractual services that are Linder bid a copy of the statement specified in subsection (1), 4, In the statement specified in subsection (1), notifies the employees that, as a condition of work Ing on the commodities or contractual services that are under bid, the employee will @bNe by the terms of the statement and will notify the employer of any conviction of, or plea of guilty or nolo contenders to, any violation of Chapter 893 (Florida Statutes) or of any controlled Substance 'law of the United States or any state, for a violation occurring in the workplace no later than five (5) days after such conviction. 5: Imposes a sanction on, or require the satisfactory participation in a drug abuse assistance or rehabilitation program if such is available in the employee's community, or any employee who is so convicted. 6. Makes a good faith effort to continue to maintain a drug -free workplace through implementation of this section. As the person authorized to sign the statement, I certify that this firm complies fully with the above requirements. E STATE F OF: �V- -d COUNTY OR M ir —IX6 Subscribed and sworn to or affirmed) before me on —5kJ—/-5—rebate) by ke V jr (name of affliant). He/She is to me or has produced as i "VS E ill V IS E VVEELUUN NOlary hbfic s State ZZoAAf Ffaf;d 11V COMM EXMre,r4QVI7,201a55 MMir, 147 "MMI's P- ff EF 147316 (type of identification) as identification. NOTARY PUB My Commission Exp'res, _ E PUBLIC ENTITY CRIME STATEMENT "A person or affiliate who has been placed on the convicted vendor list following a conviction for a a Public entity crime may not submit a bid on a contract to provide any goods or service to a public entity for the construction or repair public entity, may not submiL a bid on a contrt acwitth @ property to public Of a Public building or public work, may not submit bids on leases of re I entity, may not be awarded or perform work as a contractor, supplier, subcontractor, or CONTRACTOR under a contract with any public entity, and may not transact business with any public entity in excess of the threshold amount provided in Section 287,017, Florida Statutes, for CATEGORY TWO for a period of 36 months from the date of being placed on the convicted vendor list," I have read the above and state that neither RICHARD L. DOLSEY� PHC. INC. dba PHYSICIANS HEALTH CENTER (Contractor's name) nor any Affiliate has been placed on the convicted vendor list within the last 36 months. E D$ ST ATE OF' I I v rief 6- COUNTY OF: Subscribed and sworn to (or affirmed) before me on $5 (dateby name of affian-0. He/She personally kno to 'n me ) or has produced (type of identification) as identification IVIS E VELUNZA "A"t Notary Public • State of Florida My Comm Expires Nov 17.2015015 1,1r rcV Commission # EE 147316 16 ----���NOTARY 'PUBL My Commission ExpiresI 1—/1,1s, MONROE COUNTY, FLORIDA RISK MANAGEMENT POLICY AND PROCEDURES CONTRACT ADMINISTRATION MANUAL Indemnification and Hold Harmless For Other Contractors and Subcontractors The Contractor covenants and agrees to indemnify and hold harmless Monroe County Board of County Commissioners from any and all claims for bodily injury (including death), personal injury, and property damage (including property owned by Monroe County) and any other losses, damages, and expenses (including attorneys fees) which arise out of, in connection with, or by reason of services provided by the Contractor or any of its Subcontractor(s) in any tier, occasioned by negligence, errors, or other wrongful act of omission of the Contractor or its Subcontractors in any tier, their employees, or agents. In the event the completion of the project (to include the work of others) is delayed or suspended as a result of the Contractor's failure to purchase or maintain the required insurance, the Contractor shall indemnify the County from any and all increased expenses resulting from such delay. The first ten dollars ($10.00) of remuneration paid to the Contractor is for the indemnification provided for above. The extent of liability is in no way limited to, reduced, or lessened by the insurance requirements contained elsewhere within this agreement. 1) 1 WORKERS'COMPENSATION INSURANCE REQUIREMENTS FOR EMPLOYMENT PHYSICAL SERVICES BETWEEN MONROE COUNTY, FLORIDA AND RICHARD L. DOLSEY, PHC, INC. d1ba PHYSICIANS HEALTH CENTER Prior to the commencement of work governed by this contract, the Contractor shall obtain Workers' Compensation Insurance with limits sufficient to respond to the applicable state statutes. In addition, the Contractor shall obtain Employers' Liability Insurance with limits of not less than: $100,000 Bodily Injury by Accident $500,000 Bodily Injury by Disease, policy limits $100,000 Bodily Injury by Disease, each employee Coverage shall be maintained throughout the entire term of the contract. Coverage shall be provided by a company or companies authorized to transact business in the state of Florida, If the Contractor has been approved by the Florida's Department of Labor, as an authorized self -insurer, the County shall recognize and honor the Contractor's status, The Contractor may be required to submit a Letter of Authorization issued by the Department of Labor and a Certificate of Insurance, providing details on the Contractor's Excess Insurance Program. If the Contractor participates in a self-insurance fund, a Certificate of Insurance will be required. In addition, the Contractor may be required to submit updated financial statements from the fund upon request from the County. 23 GENERAL LIABILITY INSURANCE REQUIREMENTS FOR EMPLOYMENT PHYSICAL SERVICES BETWEEN MONROE COUNTY, FLORIDA AND RICHARD L. DOLSEY, PHA, INC. dba PHYSICIANS HEALTH CENTER Prior to the commencement of work governed by this contract, the Contractor shall obtain General Liability Insurance. Coverage shall be maintained throughout the life of the contract and include, as a minimum: • Premises Operations • Products and Completed Operations • Blanket Contractual Liability • Personal Injury Liability • Professional Liability ® Expanded Definition of Property Damage The minimum limits acceptable shall be: J3QQ,000 Combined Single Limit (CSL) If split limits are provided, the minimum limits acceptable shall be: 200,000 _ per Person 300,000 per Occurrence 50�000 Property Damage An Occurrence Form policy is preferred. If coverage is provided on a Claims Made policy, its provisions should include coverage for claims filed on or after the effective data of this contra In addition, the period for which claims may be reported should extend for a minimum of twelve (12) months following the acceptance of work by the County. The Monroe County Board of County Commissioners shall be named as Additional Insured on all policies issued to satisfy the above requirements. 24 INSURANCE REQUIREMENTS Worker's Compensation $100 00 Bodily Injury by Ace. ,0 $500,.000 Bodily Inj. by Disease, policy Irate $_100,000 Bodily Inj. by Disease, each emp. General Liability, including $ 300 000 Combined Single Limit Premises Operation Products and Completed Operations Blanket Contractual Liability Personal Injury Liability Expanded Definition of Property Damage Professional Liability $250,000 per Occurrence and Including errors and omissions $750,000 Aggregate The Monroe County Board of County Commissioners shall be named as Additional insured on general liability policy. 25 ,#VtV 0 N Ctd NO OF ATTACHED SHEETS MEDICAL RECORD NOTE: This hildhornation Is for official and pri 1 NAME OF PATIENT (Last, first middle) REPORT OF MEDICAL HISTORY lCbEhITIFiC�TIi��t NUMBER � DE 4a. HOME STREET ADDRESS (Street or RFD, City or Town. State and ZIP Cape,' 15 [!XAMINING FACILITY in 7 STATEMENT OF PATIENT'S PRESENT HEALTH AND MEDICATIONS CURRENTLY USED (Use additional pages if necessary) a PRESENT HEALTH GULAR OR INTERM a, ALLERGIES (include insect bilesinfings and common foods) Household contact with anyone with tuberculosis Tuberculosis or positive TIE test Blood in sputum or when coughing Excessive bleeding offer Injury or dental work Suicide attempt or plans Sleepwalking Wear corrective lenses Eye surgery to correct vision Lack vision In either eye —1 R Wear a hearing aid a Stutter or stammer Wear a brace or back support v Swed at fever 'or Rheumatic fever Swollen or painful Pines Frequent or severe headaches Cosmetic or fainting spells Eye trouble Hearing loss Recurrent ear Infections Chronic or frequent colds Severe tooth or gum trouble Sinusitis Hey fever or Allergic mindis Head injury Asthma PON 7540-00-181-8368 Previous edition not usable 9 ARE YOU (Check one) [—] RIGHT HANDED 10. PAST/CURRENT MEDICAL HISTORY YES NO DON7 CH D KNOW KNOONTW Shortness tat breath Paid or pressure to cites! Chronic ugh Palpitation or pounding Dead trouble High or low blood pressure Cramps in your lags Frequent ind gest on Stomach. liver or intestinal trouble Gall bladder trout a or gallstones Jaundice or hepatitis Broken bones Adverse react on to medication Skin diseases Turner, growth. cyst. cancer Hernia Romantic us or rectal disease Frequent or painful ur-nation Bed wetting since age 12 Kidney stone or blood in urine Sugar or album -n in urine Sexually transmitted diseases Recent gain or loss of weight Going it sorder (anorexia bulimia, etc,) Arthritis. Rheumatism, or Bursitis Thyroid trouble or go ter Doh rT ,CHECK EACH ITEM YES NO KNOW C Bone, joint or other deformity Loss of finger or toe .10 . are" Painful or "trick" shoulder or elbow Recurrent back pain or any back injury "Trick" or locked knee Foot trouble Nerve Injury Epilepsy or seizure Car, train, sea or air sickness Frequent trouble sleeping Depression or excessive worry Loss of memory or amnesia Nervous trouble of any sort Periods of unconsciousness Parenhaftiling with diabetes, cancer, stroke or heart disease X-ray or other radiation therapy Chemotherapy Asbestos or toxic chemical exposure Plate, pin or rod in any bone Been told to cut down or criticized a her for alcohol use re " use Used illegal substances used lobs STANDARD FORM 93 (REV 6.96) Prescribed by ICMRIGSA POOR (41 CFR) 201-9,202.1 11 FEMALES ONLY CHECK EACH ITEM YES I No I SORT I DATECIF LAST MENSTRUAL JDATE OF LAST PAP SMEAR JDATE OF LAST MAPAMOGMM I KNOW PERIOD Treated for a female disorder Change in menstrual pattern CHECK EACH ITEM IF "YES" EXPLAIN IN BLANK SPACE TO RIGHT LIST EXPLANATION BY ITEM NUMBER ITEM 12. Have you been refused employment or been unable to he d a job or stay in slowed because of a. Sensitivity to chemicals dust sunlight, etc b. Inability to Mariann certain motions. c. Inability to assume certain positions, d. Other medical reasons fifyies, give reasons) 13. Have you ever been treated for a mental send lion? {!ties. specify when, where, and give details.) 14, Have you ever been denied life insurance? (!foes. state reason and give details.) 15, Have you had, or have you been advised to have. any operation iffives, describe and give age at which occurred) 16. Have you ever been a patient in any type of hospital? (if yes, specify when, where, why, and name of doctor and complete address of hospital.} 17. Have you consulted or been treated by clinics phys crone headers or other practitioners within the past 5 years for other than minor illnesses? 'a g Afyes, give complete address of doctor. hospital, clinic and details.) it 18. Have you ever been rejected for military service because of physical ,Joe re mental, or other reasons? (it yes, give date and reason for raj 19. Have you ever been discharged from military service because of physical, mental, or other reasons? Rfyerc give dale. reason, and type of discharge, whether honorable, other than honorable for unfitness or unsuitability.} 20. Have you ever received is there pending or have you ever sop -ad to, pension or compensation for existing A saffility? fifyies, specify what triad. granted by whom, and what amount, when, why) 21. Have you ever been arrested or convicted of a crime, other than minor traffic violations, (If yes, provide details.) 22. Have you ever been diagnosed with a hearing disability? (If yes, give type, where, and how diagnosed it 23. LIST ALL IMMUNIZA—iIONS RECEIVED I car* that I have reviewed the foregoing Information supplied by me and that it is true and complete to the best of any knowledge I authorize any of the doctors, hospitals or dinks mentioned above to tarnish the Government a complete transcript of my medical record for purposes of processing my application for this employment or service 1 understand that falsification of information on Government forms is punishable by fine andlor imprisonment Wa, TYPED OR PRINTED NAME OF EXAMINEE 124b SIGNATURE No NOTE: HAND TO THE DOCTOR OR NURSE, OR IF MAILED MARK ENVELOPE "TO BE OPENED BY MEDICAL OFFICER ONLY. 25. PHYSICIAN'S SUMMARY AND ELABORATION OF ALL PERTINENT DATA (Physician shall comment on all posilive answers in items 7 through 11 Physician may develop by interview any additional medical history deemed important and record any significant findings here) Sea TYPED OR PRINTED NAME OF PHYSICIAN OR EXAMINER 126b SIGNATURE 126c, DATE STANDARD FORM 93 (REV 6.96) BACK MEDICAL RECORD REPORT OF MEDICAL 'EXAMINATION DAT E OF EXAM T _ 10 NAME 1 J'n :iLA:ST NAME - FIRST NAME - MIDDLE NAME� 2. IDENTIFICATION NUMBER Position back a. happe am, .let, trad zip Cood S. EME G 4 HOW! E ADDRESS Paundpor amad or RFD, edry or Man, Abatis are Zip Code) 5. EMERGE NOT CONTACT (Name and address oficonoic!) S. RATE OF BIRTH 10. PLACE OF BIRTH 12s, AGENCY AGE & sox So X FEMAI E M Ed 111. RACE I C 41 WHITE M 13LACK *12b, ORGANIZATION UNIT (Check oach som ki appmeaddis comma, enter WE, year ongas2led, A. MEAD, FACE, NECK AND SCALP B. EARS - GENERAL (INTERNAL CANALS) Madero, twWrl underhanad 39 and 44) C DRUMS aPoodrarlarm ro —ROSE I'NU S�S M TH AND THE, AT ON I VdMAX EYE _ ilu I va I anty arulmilar pan und-4. r-ru 20, 19, 8,,ol j 6) II GPTNAUMOSCOPIC I AD ILE OF reactIon Ad drod, orn P C C LAR EITYN18—�,'Wopa� ard"I's "yongeres .5 MOT'L BE mon lhcv�� G AND E ON _ T U K LUN L HEART frannel, do. wask., proarea so rM ­KASCULAR SYSTEM (Ida :Ye to) A VN:A5.ra'EN �XNO 111SCIR to '11. ndyouramordy it eis 4Qt a! S"J.'andappardabour bpdraw� I. 9. RELATIONSHIP OF CONTACT 1 AMERIT AN INDIAN! HISPANIC F--j � JaPttaC rj joblANIPAt"Illoo ALASKA NATIVE RHITS 13, TOTAL YEARS GOVERNMENT SERVICE MILITARY b. CIVILIAN I S. RATING OR SPECIALTY OF EXAMINER 16, PURPOSE OF EXAMINATION ATION (Chisoll each Item inappropidaidwaturrin, anferNE'Anorevatua 0 PROSTATE (Near 40 or Alhocially reelected) A TESTICULAR R ENDOGRINESYSTE-10 S. G-U SYSTEM T. UPPER EXTREMITIES OdnotgM, tainge Alinsithoo U, FEET A LONVER, EXTREMITIES tExceas deal (Sticingth, onage of W. SPINE, OTHER MUSCULOSKELETAL A IDENTIFYING BODY MARKS, SCARS, TATTOOS Y SKIN, LYMPHATICS Z NEUROLOGIC (Equildhfurn tests under Jam 4 1) AA PSYCHIATRICIS R-dy any persormaly dowebtad and use ankfalonal Senate 18, DENTAL shown in camestes, share of below number of upper and Near loeft) REMARKS AND ADDITIOIItail. DENTAL to Jplan x Replaced 7,-71—T DEFECTS AND DISEASES in F,xed 'able 1-- 1 2 3 Panel 37, Or New -4414 Town finue, T by a x A x X A L R L 1 1 2 3 4 5 5 7 8 9 10 11 112 13 14 15 18 E G 32 31 30 29 28 27 26 25 24 23 22 21 20 19 18 17 F H T T 1% TEST RESULTS (Copies of results are preferred as attachments) A.URINALYSIS (1) SPECIFIC GRAVITY 8 CHEST X-RAY OR PRO (Place. drim. Not n-anaterand month (2) URINE ALBUMIN N) MICROSCOPIC (3) URINE SUGAR C SYPHILIS SEROLOGY ISpecid, licst us D, EKG E BLOOD ND RH TYPE AF OTHER TESTS XOTy and Tanaka) FACTOR 88-126 'An Agned unad; Ped arm Pro, AYiSAjoR. bin 91 STANDARD FORM 88 (Rev 10-94) {SG) Prescribed by GSAACMR FIONA (41 CFFU 201.9 202-1 DENTIFICATION NUMBER NO OF SHEETS ATTACHEE MEASUREMENT; AND OTHER FINDINGS 20, HEIGHT 21 WRIGHT 22. COLOR HAIR 23 OR EYES N. BUILD TEMPERATURE 26 BLOOD PRESSURE (Affn at heart leved) 27 PULSE (Ann at heaft level) HIS B. RECUMBENT C. 5 01 2 D. AFTER EXERCISE E, 2 MI MS AFTER Ul non) 1 ON 30 NEAR VISICN OR CORR TO BY on CISRR- TO BY lance) ---------- --------- ----- ESO SAO ON. LML PRISM DIV PRISM COUP, PC PC CT 32 ACCOMMODA71ON 33, COLOR VISION (Test used andmicia 3 ECTED RIGHT LEFT TED 35. FIELD OF VISION 36,MIGHT VO-ON (Test used and wore) 3 TRACCULAR TENSION RIGHT LEFT Rf aliT LEFT 39 HEARING 40. AUDIOMETER 41 PSYCHOLOGICAL AND PSYCHOMOTOR (Goo used and sciase RIGHT GeV ;IGEV ,15 2913 Sea 1000 2000 3000 40Ia0 6OW 8000 256 512 l 1024 2048 2898 40 6 6144 8192 LEFT WAF N55V GI I LEFT 42 NOTES (CcolftealoAND SIGNIF-CANT OR NTERVAL HISTORY (Use addiflonal Amea; if nocessafy) 43 SUMMARY OF DEFECTS AND DIAGNOSES (Lot dboinses With, Juirrinumberal 44 RECOMMENDATIONS r PURTHER SPECIALIST EXAMINATIONS INDICATED (Specify) 45A. PHYSICAL PROFILE P E 1 S 46 EXAMINEE (Check) Ai. E] IS QUALIFIED FOR In accordance with attached job 4- 5 S PH Y S I C A-L CA TEARY A 8 C E 48 TYPED OR PRINTED NAME OF PHYSICIAN S:GNA7,j-RE 49 TYPED OR PRIM IED NAME OF PHYSICIAN S GNATURE 50 TYPED OR PRINTED NAME OF DENTIST OR PHYSICIAN VadIcapiwim-h) S-ONATURE 51 TYPED OR PRINTED NAME OF 01,11GER OR APPROVING AUTHOIS I S ONATURE STANDARD FORM 88 IRev io-94) BACK Medical Examination Report FOR CIAO, DRIVER FITNESS DETERMINATION X ¥ WY uxv 649-F 6 45) ............... 01 111 r e vrr �vr r per err triver completes this section ... .............. ........ ...................................................................................................... riverxs Name (Last, Fiat„ Middle) Social Security No. Birthdate t Age ,Sex t New Certification Gate of Exam IS } Decertification ' D ' Y F I Follow-up .............. x...,x,xxx,xxxxxxxx ..............................................x.. ................. x ........ ............ .. ........ ....................... Address „City, State, Zip Code f ork Tel: Driver License No, I License Class H State of Issue A 'Home Tel; { } S D i Other r� HEALTH HISTORY y illness or injury in the last 5 years? Headfivilm injuries, disorders or illnesses Seizures, epilepsy medication Eye disorders or impaired vision (except conandure lenses) Ear disorders, loss or hearing or balance Heart disease or heart attack: other cardiovascular condition med t6on Heart surgery (valve replacemenVbypass, angioplasty, pacemaker) High blood pressure medication Musculardisease Shortness of breath Yes No Yes No Lung disease, emphysema, asthma, chronic bronchitis Kidney disease, dialysis Liver disease Digestive problems Diabetes or elevated blood sugar controlled by: diet pills insulin Nervous or psychiatric disorders, e.g., severe depression medication Loss of, or altered consciousness Fainting, dizziness Sleep disorders, pauses in breathing while asleep, daytime sleepiness, loud snoring Stroke or paralysis Missing or impaired hand, arm, foot, leg, finger, toe Spinal injury or disease Chronic low back pain Regular, frequent alcohol use ` Narcotic or habit forming drug use I For any YES answer, indicate onset date, diagnosis, treating physician's name and address, and any current limitation. List all medications (including over-the-counter medications) used regularly or recently. 1 certify that the above information is complete and true. I understand that inaccurate, false or missing information may invalidate the examination and ray Medical Examiners Certificate. Driver's Signature Em Medical Examiner's Comments on Health History (The medical examiner must review and discuss with the driver any "yes" answers and potential hazards of medications, including over-the-counter medications, while driving, This discussion must be documented below, TESTING (Medical Examiner completes Section 3 through 7) Namw Last, First, Middle, EEMStandard, At least 20140 acuity (Snellem in each eye with or without correction. At least 70 degrees peripheral in horizontal meridian measured in each eye. The use of corrective lenses should be noted on the Medical Examiner's Certificate, INSTRUCTIONS: When other than the Snellen chart is used, give test results in Snellen-comparable values. In recording distance vision, use 20 feet as no al, Report visual acuity as a ratio with 20 as numerator and the smallest type read at 20 feet as denominator, If the applicant wears corrective lenses, these should be worn while visual acuity is being tested. If the driver habitually wears contact lenses, or intends to do so while driving, sufficient evidence of good tolerance and adaptation to their use must be obvious. Monocular drivers are not qualified. Numerical readings must be provided. ACUITY UNCORRECTED CORRECTED HORIZONTAL FIELD OF VISION Applicant can recognize and distinguish among traffic control Yes signals and devices showing standard red, green, and amber colors ? No Right Eye 20/ 201 Right Eye Applicant meets visual acuity requirement only when wearing, Left Eye 201 201 Left Eye Corrective Lenses Both Eyes 201 201 Monocular Vision: Yes No Complete next line only if vision testing is done by an opthalmologist or optometrist Date of Examination Name of Ophthalmologist or Optometrist (print) ................ ........ . I —ic-e—n "Se— NE I a to A a sue Signature [!]j1j= Standard; as Must first perceive forced whispered voice > 5 ft., with or without hearing aid, or b) average hearing loss in better ear < 40 xB Check if hearing aid used for tests. Check if hearing aid required to meet standard. INSTRUCTIONS: To convert audiometric test results from ISO to ANSI, -14 dB from ISO for 500Hz, AOM for 1,000 Hz, -8,5 dB for 2000 Hz, To average, add the readings for 3 frequencies tested and divide by 3. Numerical readings must be recorded. Right Ear Left Ear a) Record distance from individual at which Right ear Left Ear N If audiometer is used, record hearing loss in 500 Hz 1000Hz 2000Hz 500 Hz 1000 Hz 20DO He forced whispered voice can first be heard, % Feet % Feet decibels. (acc. to ANSI Z24,5-1951) Average: Average: 5, czmm���� Numerical readings must be recorded. Medical Examiner should take at least two readings to confirm Blo. Blood Systolic Diastolic q is at _gory, Expiration Date Pressure 140-159190-99 Stage 1 1 year Driver qualified if <140/90, Pulse Rate- Regular Irregular 160-1791100-109 Stage 2 One-time certificate for 3 months. F ecord pulse bate: >1 80/110 Stage 3 6 months from date of exam if <140/90 SIMMEM 1 year if <1 40190, One-time certificate for 3 months if 141-159/91-99. 1 year from date of exam if <140/90 6 months if < 140/90 [d- ZZMEMSEREE= Numerical readings must be recorded. SSP. GR. PROTEIN BLOOD SUGAR URINE PECIMEN Urinalysis is required. Protein, blood or sugar in the urine may be an indication for further testing to rule out any underlying medical problem. Other Testing (Describe and record) F_K0MZ2NZ= Height: (in.) Weight: (lbs.) Name: Last, First, Middle, The presence of a certain condition may not necessarily disqualify a driver, particularly if the condition is controlled adequately, is not likely to worsen or is readily amenable to treatment. Even if a condition does not disqualify a driver, the medical examiner may consider deferring the driver temporarily. Also, the driver should be advised to take the necessary steps to correct the condition as soon as possible particularly if the condition, if neglected, could result in more serious illness that might affect driving. Check YES if there are any abrionnalities. Check NO if the body system is normal. Discuss any YES answers in detail in the space below, and indicate whetherit would affect the driver's ability to operate a commercial motor vehicle safely. Enter applicable item number before each comment, If organic disease is present, note that it has been compensated for, See Instructions to the Medical Examirwr for guidance. BODY SYSTEM CHECK FOR: YES* NO 1. General Appearance Marked overweight, tremor, signs of alcoholism, problem drinking, or drug abuse, 2. Eyes Pupillary equality, reaction to light, accommodation, ocular motility, ocular muscle imbalance, extraricular movement, mrstagmus, exophthalmos, Ask about retinopathy, cataracts, aphakia, glaucoma, macular degeneration and refer to a specialist if appropriate, 3 Ears Scarring of tympanic membrane, occlusion of external canal, perforated eardrums. 4. Mouth and Throat Irremediable deformities likely to interfere with breathing or swallowing. 5. Heart Murmurs, extra sounds, enlarged heart, pacemaker, implantable defibrillator. 6, Lungs and chest, Abnormal chest wall expansion, abnormal respiratory rate, not including breast abnormal breath sounds including wheezes or alveolar rates, examination impaired respiratory function, cyanosis. Abnormal findings on physical exam may require further testing such as pulmonary tests and/ or xray of chest. *COMMENTS: Note certification status here. See Instructions to the Medical Examiner for guidance. Meets standards in 49 CFR 391,41 ; qualifies for 2 year certificate Does not meet standards Meets standards, but periodic monitoring required due to Driver qualified only for: 3 months 6 months 1 year Other Temporarily disqualified due to (condition or merficatiorff: Return to medical examinees office for follow up on BODY SYSTEM CHECK FOR: 7. Abdomen and Viscera Enlarged liver, enlarged spleen, masses, bruits, hernia, significant abdominal wall muscle weakness, S. Vascular System Abnormal pulse and amplitude, cadrod or casual bruits, varicose veins. 9. Genfle-urinary System Hermes, 10. Extremilies- Limb Loss or impairment of leg, fool, toe, arm. hand, impaired. Driver may finger. Perceptible limp, deformities. atrophy, be subject to SIDE weakness, paralysis, clubbing, edema, certificate of otherwise hypotonia, Insufficicent grasp and prehension qualified, in upper limb to maintain steering wheel grip. Insufficient mobility and strength in lower limb to operate pedals properly. 11 Spine, other Previous surgery, deformities, limitation of musculoskeletal motion. tenderness. 12. Neurological Impaired equilibrium, coordination or speech pattern; asymmetric deep tendon reflexes, sensory or positional abnormalities, abrionnal patellar and Babinki's reflexes, ataxia. UNNEIM Wearing corrective loose Wearing hearing aid Accompanied by a waiver/ exemption. Driver must present exemption at time of certification, Skill Perfonnance Evaluation (SPE) Certificate Driving within an exempt intracity zone (See 49 CFR 391,62) Qualified by operation of 49 DER 391.64 Medical Examinees signature Medical Examiners name Address Telephone Number If meats standards, complete a Medical Examiner's Certificate as stated in 49 CFR 391 .43(h). (Driver must carry certificate when operating a commercial vehicle,) 49 CFR 391.41 Physical Qualifications for Drivers THE DRIVER'S ROLE Responsibilities, work schedules, physical and emotional demands, and lifestyles among commercial drivers vary by the type of driving that they do. Some of main types of drivers include the following: to around or short relay (drivers return to their home base each evening); long relay (drivers drive 9-11 hours and then have at least a 10-hour off - duty period), straight through haul (cross country drivers); and team drivers (drivers share the driving by alternating their 5-hour driving periods and 5-hour rest periods.) The following factors may be involved in a driver's performance of duties: abrupt schedule changes and totaling work schedules, which may result in irregular sleep patterns and a driver beginning a trip in a fatigued condition; long hours; extended time away from family and friends, which may result in lack of social support- tight pickup and delivery schedules, with irregularity in work-, rest, and eating patterns, adverse road, weather and traffic conditions, which may cause delays and lead to hurriedly loading or unloading cargo in order to compensate for the lost time; and environmental conditions such as excessive vibration, noise, and extremes in temperature. Transporting passengers or hazardous materials may add to the demands on the commercial driver. There max be duties in addition to the driving task for which a driver is responsible and needs to be fit. Some of these responsibilities are: coupling and uncoupling trailer(s) from the tractor, loading and unloading trailer(s) (sometimes a driver may lift a heavy load or unload as much as 50,000 lbs. of freight afler sitting for a long period offintre without any stretching period); inspecting the operating condition of tractor and/or trailer(s) before, during and after delivery of cargo; lifting, installing, and removing heavy tire chains; and, lifting heavy tarpaulins to cover open top trailers. The above tasks demand agility, the ability to bend and stoop, the ability to maintain a crouching position to inspect the underside of the vehicle, frequent entering and exiting of the cab, and the ability to climb ladders on the tractor and/or trailer(s). In addition, a driver must have the perceptual skills to monitor a sometimes complex driving situation, thejudgmentskills to make quick decisions, when necessary, and the manipulative skills to control an oversize steering wheat, sing gears using a manual transmission, and maneuver a vehicle in crowded areas. §391.41 PID'SICAL QUALIVICATIONS FOR DRIVERS (a) A person such not drive a commercial ranter vehicle unless lie is physically qualified to do so and. except as provided in §391.67, has on his person the original, or a photographic copy, era medical examinees certificate that lie is physically qualified it) drive a commercial motor vehicle (b) A person is physically qualified to drive a motor vehicle ifthat person: (1) Flats no loss ofa fact, a leg, a hand, or an arm, or has been granted a Skill performance Evaluation (SPE) Certificate (formerly Limb Waiver program) pursuant to §391.49. (2) 1 las no impairment or, (i) A hand or finger which interferes %van prehension or power grasping-, or (it) An arm, fool, or lcg %%-Inch interferes with the ability to perform normal tasks associated with encoding as commercial motor vehicle. or any other significant hour defect or limitation which interferes with the ability to perform normal tasks associated with operating a commercial motor vehicle; or Naas been granted a SPF, Certificate pursuant it) §391.49. (3) 1 las tit) established medical history or clinical diagnosis ofifilanoes mellitus currently requiring insulin for control; (4) l4as no current clinical diagnosis ofniyocardial infaretion, angina fissions, coronary insufficiency, thrombosis, or any other cardiovascular disease ol'a variety known to be accompanied by syncope, dystaica, collapse. or congestive cardiac failure. (5) Has no established medical history or clinical diagnosis of a respiratory dysfunction likely to interlere %van his ability to control and drive a commercial motor vehicle sureiv, (6) 1 ho no current clinical diagnosis of high blood pressure likely to interfere pith his ability to operate as commercial motor vehicle safely. (7) 1 las no established medical history or clinical diagnosis oft-licumatic, arthritic, orthopedic, muscular. 11CUmmuscular. or vascular disease which interfaces with his ability to control and operate a commercial motor vehicle safely. (8) Flas no established medical history or clinical diagnosis of epilepsy or any other condition Much is likely to cause loss of consciousness or any loss ol'abilily to control a commercial motor vehicle; (9) Has no mental, nervous, organic, or functional disease or psychiatric disorder likely to inlerlere with his ability to drive a commercial motor vehicle smelv- (10) Has distant visual acuity ofat [cast 20/40 (Suellen) in cacti eye without corrective lenses or visual acuity separately corrected to 20140 (Sachem or better with corrective lenses, distant binocular acuity of least 20140 (Suellen) in both eyes wall or without corrective lenses, field oaf vision of at least 70degriew in [lie horizontal meridian in cacti eye. and (lie ability to recognize the colors of traffic signals and devices showing standard red, green and amber, (11) F irst perceives a raised whispered voice in the better car not less (Iran 5 feet with or without the use of hearing aid, or, iriested by use oran archomearic device, does not have an average hearing loss in the better car greater than 40 decibels at 500 tiz, 1,000 I-hr and 2.000 I-Iz with or WitimUl as hearing device when the audiormaric device is calibrated to the American National Standard (formerly ASA Standard) Z24.5-195 I : (I 2di) Does not use any drug or substance identified in 21 CFR 1308,11 Schedule 1, an amphetamine. a narcotic, or other habit-forming drug, (if) Does not use any non -Schedule I drug or substance that is identified in the labor Schedules in 21 part 1308 except when the use is prescribed by a licensed medical practitioner, as defined fit § 382.107. %%-Ile is familiar %vidi the driver's medical history and has advised the driver that the substance will not adversely affect the driver's ability to safety operate a commercial motor vehicle, 0 3) rise no current clinical diagnosis or alcoholism INSTRUCTIONS TO THE MEDICAL EXAMINER accompanied by" is designed to include a clinical diagnosis of a cardiovascular disease (1) which is accompanied by symptoms of syncope, airspace, collapse or congestive cardiac failure'. and/or (2) which is likely to cause syncope, dyspnea, collapse or congestive cardiac failure. It is the intent of the FMCSRs to render unqualified, a driver who has a current cardiovascular disease which is accompanied by and/or likely to use symptoms of syncope, dyspnea, collapse, or congestive cardiac failure. However, the subjective decision of whether the nature and severity of an individual's condition will likely cause symptoms of cardiovascular insufficiency is on an individual basis and qualification rests with the medical examiner and the motor carrier. In those cases where there is an occurrence of cardiovascular insufficiency (myocardial infarction, thrombosis, etc.), it is suggested before a driver is certified that he or she have a normal resting and stress electrocardiogram (ECG), no residual complications and no physical limitations, and is taking no medication likely to interfere with safe driving. Coronary artery bypass surgery and pacemaker implantation are remedial procedures and thus. not unqualifying. Implantable commander defibrillators are disqualifying due to risk of syncope Cournaffin is a medical treatment which can improve the health and safety of the driver and should not, by its use, medically disqualify the commercial driver The emphasis should be on the underlying medical condition(s) which require treatment and the general health of the driver. The FM SA should be contacted at (202) 366-4001 for additional recommendations regarding the physical qualification of drivers on cournadin, (See Cardirwasular Advisory Panel Guidelines for the Medical examination of Commercial Motor Vehicle Drivers at: hit if prics-1,cir, i.rK)Wnjh':�W. ................................................................................................. Respiratory Dysfunction §391.41(b)(6) A person is physically qualified to drive a commercial motor vehicle if that person: Has no established medical history or clinical diagnosis of a respiratory dysfunction fikery to interfere with ability to control and drive a commercial motor vehicle safely. Since a driver must be alert at all times, any change in his or her mental state is in direct conflict with highway safety. Even the slightest impairment in respiratory function under emergency conditions (when greater oxygen supply is necessary for performance) may be detrimental to safe driving. There are many conditions that interfere vain oxygen exchange and may result in incapacitation, including emphysema, chronic asthma, carcinoma, tuberculosis, chronic bronchitis and sleep apnea. if the medical examiner detects a respiratory dysfunction, that in any way is likely to interfere with the driver's ability to safely control and drive a commercial motor vehicle, the driver must be referred to a specialist for further evaluation and therapy. Anticoagulation therapy for deep vein thrombosis and/or pulmonary thromboembofism is not unqualifiang once optimum dose is achieved, provided lower extremity venous examinations remain normal and the treating physician gives a favorable recommendation, (See Conference on Pulmonary/Respiratory Disorders and Commercial Drivers at: ....... . ................. . ............. Hypertension §391.41(b)(6) A person is physicafty qualified to drive a commercial motor vehicle if that person: Has no current clinical diagnosis of high blood pressure likely to interfere with ability to operate a commercial motor vehicle satisfy. Hypertension alone is unlikely to use sudden collapse', however, the likelihood increases when target organ damage, particularly cerebral vascular disease, is present. This regulatory criteria is based on FMCSA% Cardiovascular Advisory Guidelines for the Examination of CMV Drivers, which used the Sixth Report of the Joint National Committee on Defection, Evaluation, and Treatment of High Blood Pressure (1997), Stage I hypertension corresponds to a systolic BP of 140-159 mmHg and/or a diastolic BP of 90-99 mmHg- The driver with a BP in this range is at low risk for hypertension - related acute incapacitation and may be medically certified to drive for a one-year period. Certification examinations should be done annually thereafter and should be at or less than 140190. It less than 1601100 certification may be extended one time for 3 months A blood pressure of 160-179 systolic and/or 100-109 diastolic is considered Stage 2 hypertension, and the driver is not necessarily unqualified during evaluation and institution of treatment The driver is given a one time certification of three months to reduce his or her blood pressure to less than or equal to 140190 A blood pressure in this range is an absolute indication for anti -hypertensive drug therapy. Provided treatment is well tolerated and the driver demonstrates a BE value of 140190 or less, he or she may be certified for one year from date of the initial exam. The driver is certified annually thereafter. A blood pressure at or greater than 180 (systolic) and 110 (diastolic) is considered Stage 3. high risk for an acute BP -related event. The driver may not be qualified, even temporarily, until reduced to 140190 or less and treatment is wall tolerated. The driver may be certified for 6 months and biannually (every 6 months) thereafter if at recheck BP is 140190 Or less, Annual recertification is recommended If the medical examiner does not know the severity of hypertension prior to treatment. An elevated blood pressure finding should be confirmed by at least two subsequent measurements on different days. Treatment includes nommarmaciskiffic and phannaccloffic modalities as well as counseling to reduce other risk factors. Most anthypertensive medications also have side effects, the importance of which must be judged on an individual basis. Individuals must be alerted to the hazards of these medications while driving. Side effects of somnolence or syncope are parliculary undesirable in commercial drivers. Secondary hypertension is based on the above stages. Evaluation is warranted if patient is persistently hypertensive on maximal or near -maximal doses of 2-3 pharmacologic agents. Some causes of secondary hypertension may be amenable to surgical intervention or specific pharmacologic disease. (See Cardiovascular Advisory Panel Guidelines for the Medical Examination of Commercial Motor Vehicle Drivers at: jlkl /f wwv fin dotwin xxxxxxN hm Rheumatic, Arthritic, Orthopedic, Muscular, Neuromuscular or Vascular Disease §391.41 (b)(7) A person is physically qualified to drive a commercial motor vehicle if that person: Has no established medical history orclaucal diagnosis of rheumatic, arthritic, orthopedic, muscular, neuromuscularor vascular disease which interferes with the abiloy to control and operate a commercial motor vehicle safely, Certain diseases are known to have acute episodes of transient muscle weakness, poor muscular Coordination (ataxia), abnormal sensations firarestmeard, decreased muscular tone firrypolordid, visual disturbances and pain which may be suddenly incapacitating. With each recurring episode, these symptoms may become more pronounced and remain for longer perrods, of time. Other diseases have more insidious onsets and displays ptoms of muscle wasting (atrophy), swelling and parestherea, which may not suddenly incapacitate a person but may restrict herher movements and eventually interfere with the ability to safely operate a motor vehicle, In many instances these diseases are degenerative in nature or may result in deterioration of the involved area. Once the individual has been diagnosed as having a rheumatic, arthritic, orthopedic, muscular, neuromuscular or vascular disease, then he/she has an established history of that disease. The physician, when examining an individual, should consider the following: (1) the nature and severity of the individual's condition (such as sensory loss or loss of strength); (2) the degree of limitation present (such as range of motion); (3) the likelihood of progressive limitation (not always present initially but may manifest itself over time): and (4) the likelihood of sudden incapacitation. If severe functional impairment exists, the driver does not quality. In cases where more frequent monitoring is required, a certificate for a shorter period of time may be issued. (See Conference on Neurological Disorders and Commercial Drivers at: http-://www.fmcsa.dot,govlrulesregs/medreporls,him) Epilepsy §3911AI(b)(8) A person is physically qualified to drive a commercial motor vehicle if that person: Has no established medical history or clinical diagnosis of epilepsy or any other condition which is likely to cause loss of consciousness or any loss of ability to control a motor vehicle. Epilepsy is a chronic functional disease characterized by seizures or episodes that occur without warning, resulting in loss of voluntary control which may lead to loss of consciousness and/or seizures. Therefore, the following drivers cannot be qualified- (1) a driver who has a medical history of epilepsy; (2) a driver who has a current clinical diagnosis of epilepsy" or (3) a driver who is taking anfisedure medication, If an individual has had a sudden episode of a noneffileplic seizure or loss of consciousness of unknown use which did not require antiseizure medication, the decision as to whether that person's condition will likely use loss of consciousness or loss of ability to control a motor vehicle is made an an individual basis by the medical examiner in consultation Win the treating physician. Before certification is considered, 11 is suggested that a 6 month waiting period elapse from the time of the episode. Fighwang the waiting period, it is suggested that the individual have a complete neurological examination. If the results of the examination are negative and antaudzure medication is not required, then the driver may be qualified. In those individual cases where a driver has a seizure or an episode of loss of consciousness that resulted from a known medical condition (e.g., drug reaction, high temperature, acute infectious disease, dehydration or acute metabolic disturbance), certification should be deferred until the driver has fully recovered from that condition and has no existing residual complications, and net taking anfiselzure medication, Drivers with a history of epilepsy/seizures off antiseizure medication and seizure -free for to years may be qualified to drive a CNIV in interstate commerce. Interstate drivers with a history of a single unprovoked seizure may be qualified to drive a CMV in interstate commerce it seizure -free and off antiseizure medication for a 5-year period or more. (See Conference an Neurological Disorders and Commercial Drivers at, http:lhvww,fmcsa,dot,gov/rulasregstmedreporls,htm) Mental Disorders §391.41(b)(9) A person is physically qualified to drive a commercial motor vehicle if that person: Has no mental, nervous, organic or functional disease or psychiatric disorder likely to interfere with ability to drive a motor vehicle safely, Emotional or adjustment problems contribute directly to an individual's level of memory, reasoning, attention. and judgment. These problems often underlie physical disorders. A variety of functional disorders can cause drowsiness, dizziness. confusion, weakness or paralysis that may lead to incoordination, motivation, loss of functional control and susceptibility to accidents while driving. Physical fatigue, headache, impaired coordination, recurring physical ailments and chronic "nagging" pain may be present to such a degree that cereification for commercial driving is inadvisable. Somatic and psychosomatic complaints should be thoroughly examined when determining an individual's overall fitness to drive. Disorders of a periodically incapacitating nature, even in the early stages of development, may warrant disqualification. Many bus and truck drivers have documented that "nervous froubm" related to neurotic, personality, or emotional or adjustment problems is responsible for a significant fraction of their preventable accidents. The degree to which an individual is able to appreciate, evaluate and adequately respond to environmental strain and emotional stress is critical when assessing an individual's mental alertness and flexibility to cope Win the stresses of commercial motor vehicle driving. When examining the driver, it should be kept In mind that individuals who live under chronic emotional upsets may have deeply ingrained malsomplive or erratic behavior patterns. Excessively antagonistic, instinctive impulsive. openly aggressive, paranoid or severely depressed behavior greatly interfere with the driver's ability to drive safely. Those individuals who are highly susceptible to frequent states of emotional Instability (schizophrenia, affective psychoses. paranoia, anxiety or depressive neuroses) may warrant disqualification. Careful consideration should be given to the side effects and interactions of medications in the overall qualification determination. See Psychiatric Conference Report for specific recommendations on the use of medications and potential hazards for driving, (See Conference an Psychiatric Disorders and Commercial Drivers at: htlp-://www.finesa,doLgovlrutesregs/medreports. him) Vision §391AI(b)(10) A person is physically qualified to drive a commercial motor Vehicle if that person: Has distant visual acuity of at least 20140 (Section) in each eye with or without corrective lenses or visual acuity separately corrected to 20140 (gradient or better with corrective lenses, distant binocular acuity of at least 20140 Cynarged in both eyes with or without corrective lenses, field of vision of at least 70 degrees in the horizontal mencrour in each eye, and the ability to recognize the colors of traffic signals and devices showing standard red, green, and amber. The term 'ability to recognize the colors or is interpreted to mean if a person can recognize and distinguish among traffic control signals and devices showing standard red, green and amber, he or she meets the minimum standard, even though he or she may have some type of for perception deficiency. If certain color perception tests are administered, (such as Ishmara, Pseudolsochromatic, Yam) and doubtful findings are discovered, a controlled test using signal red, green and amber may be employed to determine the driver's ability to recognize these colors. Contact lenses are permissible if there is sufficient evidence to indicate that the driver has good tolerance and is well adapted to their use. Use of a contact lens in one eye for distance visual acuity and another lens in the other eye for near vision is not acceptable, nor telescopic lenses acceptable for the driving of commercial motor vehicles. If an individual meets the criteria by the use of glasses or contact lenses, the following statement shall appear on the Medical Examiner's Certificate: "Qualified only if wasting corrective lenses,' CMV drivers who do not meet the Federal vision standard may call (703) 448-3094 for an application for a vision exemption (See Visual Disorders and Commercial Drivers at: Intlixlhisaw.fincea.dol goviruiesregs/medreporis him) Hearing §391.411(fi)j11) A person is physically qualified to drive a commercial motor vehicle if that person First perceives a forced whispered voice in the better ear at not less than 5 feet with or without the use of a hearing aid. or ' if tested by use of an auctrometric device, does not have an average hearing loss in the better ear greater than 40 decibels at 500 Nz, 1.000 Us. and 2,000 ylz with or without a hearing aid when the audermourn device is calibrated to American National Standard (formerly AAA Standard) Z24 5-1951. Since the prescribed standard under the FMCSRs is the American Standards Association (ANSI). it may be necessary to convert the cooperator results from the ISO standard to the ANSI standard, Instructions are included on the Medical Examination report form. It an individual meets the unless by using a hearing aid, the driver must wear that hearing aid and have it in operation at all times while driving. Also. the driver must be in possession of a spare power source for the hearing aid. For the whispered voice test, the individual should be stationed at least 5 feet from the examiner with the ear being tested turned toward the examiner The other ear is covered. Using the breath which remains after a normal expiration the examiner whispers words or random numbers such as 66, 18. 23, etc. The examiner should not use only sibilants (s sounding materials). The opposite ear should be tested in the same manner. If the individual fails the whispered voice test, the audiometric test should be administered. If an individual meets the criteria by the use of a hearing aid, the following statement must appear on the Medical Examiners Certificate "Qualified only when wearing a hearing aid." (See Hearing Disorders and Commercial Motor Vehicle Drivers at-, http-/Iwwwlfmcsa,doLgovlruiesregslmedreports. him) Drug Use §391.41(b)(12) A person is physically qualified to drive a commercial motor vehicle if that person does not use any drug or substance identified in 21 CFR 1308.11. an amphetamine, a narcotic, or other habit-forming drug. A driver may use a non -Schedule I drug or substance that is identified in the other Schedules in 21 part 1308 if the substance or drug is prescribed by a licensed medical practitioner who: (A) is familiar with the driver's medical history, and assigned duties, and (B) has advised the driver that the prescribed substance or drug will not adversely affect the driver's ability to safely operate a commercial motor vehicle. This exception does not apply to methadone. The intent of the medical certification process is to medically evaluate a driver to ensure that the driver has no medical condition which interferes with the safe performance of driving tasks on a public road. If a driver uses an amphetamine, a narcotic or any other habit-forining drug, it may be use for the driver to be found medically unqualified. If a driver uses a Schedule I drug or substance, it will be cause for the driver to be found medically unqualified. Motor carriers are encouraged to obtain a practitioners written statement about the effects on transportation safety of the use of a particular drug. A test for controlled substances is not required as part of this biennial certification process. The FMCSA or the anodes employer should be contacted directly for information on controlled substances and alcohol testing under Part 382 of the FMCSRs. The to "uses" is designed to encompass instances of prohibited drug use determined by a physician through established medical means. This may or may not involve body fluid testing. If body fluid testing takes place, positive test results should be confirmed by a second test of greater specificity The to "habit-forming" is intended to include any drug or medication generally recognized as capable of becoming habitual, and which may impair the users ability to operate a commercial motor vehicle safely. The driver is medically unqualified for the duration of the prohibited drug(s) use and until a second examination shows the driver is free from the prohibited drug(s) use. Recertification may involve a substance abuse evaluation. the successful completion of a drug rehabilitation program, and a negative drug test result Additionally, given that the certification period is normally two years, the examiner has the option to certify for a period of less than 2 years if this examiner determines more frequent monitonng is required. (See Conference on Neurological Disorders and Commercial Drivers and Conference on Psychiatric Disorders and Commercial Drivers at: http:llwww fmcsa dot,goviruissregstmedreports him) Alcoholism §391.41(b)(13) A person is physically qualified to drive a commercial motor vehicle if that person: Has no current clinical diagnosis of alcoholism The to "current clinical diagnosis of' is specifically designed to encompass a current alcoholic illness or those instances where the individual's physical condition has not fully stabilized, regardless of the time element. If an individual shows signs of having an alcohol -use problem, he or she should be referred to a specialist. After counseling and/or treatment, he or she may be considered for certification. Cr MEDICAL EXAMINERT CERTIRCATF ' I "" " T I scrfi�h' ?that I lines exanlimfli in arcurnmuc m Rh the Federal NDaur Carrier Safely 7 D Ragulallomp9CUR 3NA415-39IA49) and olth knomkdgc of the a'".). 1), driving dutim I find this person isilunfified'und, irapplicable, 4no). mhou E3 we aria g comecM e lasee s CIE drKin as MW an exempt (49CFRage 62) 13 wcohm hevain hit] M mccompankA by a 51HI Po -fortuance I-o+-flunflon Cerfificutr (SHEt 0 accompanied by a-- wokwexemv6on 0 qualifled by operation of 49 CFR 391,64 Ile WfOrmation I We proWd regarding MIS phyAW is was and compkic, A comploic examWadon Rwm with my mumiumeal radmuMn my RudhMs cmupkidy and correcily, and is on rile in aly office. SIGN—vallu", ol"'NIVDIC"Ll, FXAMIN1,14 ITLEPI)ONl' DATE,', MEDICAL EXAMINED'S NAME (PRISTJ 0 In V! D .vAdE3 C10droWaKton- E3 DO 0 Wonevel AwNce Nurse 0 Physidon Assistant E2 Ckhrr PraeHifuner ,%lb',DICAL IXANIINFIVS Oil NATIONAI, REGISTRYNO. CIFIHIFICATE rommsLINc srATI-', T* MINATURE (W DRIVER IFURMATE ONLY CDL DRIVERS LICE NSE NU KFATI,', "r'-V' r 0' DA' E3 I I"n E3 VES 0 VES b"s 0 : :MN"' (o -------------- ADDIMSS 0FDRIN1,1E, I NIFDICAL DATE L Search 1:3 1 H I 1 A to Z Index I an Estriffol pointact Us UxWs I About OSHA i OSHA Newsletter USS Feeds Menu Occupational Safety & Health Administration We Can Help -------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------- - 1 0 Regular ons (Ste- lords, - 29 CFI} - Table of Contents • Part Number: 1910 • Part Title: Occupational Safety and Health Standards • Subpart I • Subpart Title: Personal Protective Equipment • Standard Number: 1910,134 App C • Title: OSHA Respirator Medical Evaluation Questionnaire (Mandatory), • GNO, Source: e-CFR Appendix C to Sec. 1910.134: OSHA Respirator Medical Evaluation Questionnaire (Mandatory) To the employer: Arsovers to questions in Section 1, and toguestion 9 in Section 2 of Part A, do not require a medical examination, To the employee; Your employer must allow you to answer this questionnaire during normal working hours, or at a time and place that is convenient to you. To maintain your confidentiality, your employer or supervisor must not look at or review your answers, and your employer must tell you how to deliver or send this questionnaire to the health care professional who will review it, Part A. Section 1, (Mandatory) The following Information must be provided by every employee who has been selected to use any type of respirator (please print), 1. Todays date:.. 1 Your name: 3. Your age (to nearest year): 4. Sex (circle one): Male/Female 5 Your height:... ft . ..................... . in, 6. Your weight _ __ INS, 7, Your lob title:.. 8. A phone number where you can be reached by the health care professional who reviews this questionnaire (include the Area Code): ..................... 9. The best films to phone you at this number: ................. 10, Has your employer told you how to contact the health care professional who wil: review this questionnaire (circle one). Yes/No 11, Check the type of respirator you will use (you can check more than one category): a. N, R, or P disposable respirator (fiter- mask-, non -cartridge tore only). ti. Other type (for example, half.. or full-faceldece type, powered -air purifying, supp farl-a r, selprontained breathing apparatus), 12. Have you worn a respirator (circle one), Yes/No If "yes," what type(s): Part A. Section 2. (Mandatory) Questions I through 9 below must be answered by every employee who has been selected to use any type of respirator (please ci rde 'yes" or "no"). 1. Do you currently smoke tobacco, or have you smoked tobacco in the last month: Yes/No 2, Have you ever had any of the following conditions? a. Seizures-, Yes/No b, Diabetes (sugar disease): Yes/No c, Allergic reactions that interfere with your breathing: Yes/No d. Claustrophobia (fear of closed -in places): Yes/No a, Trouble smelling odors: Yes/No 3. Have you ever had any of the following pulmonary or lung problems? a, Askestaisho Yes/No b, Asthma. Yes/km c, Chronic bronchitis, Yes/No d, Emphysema: Yes/loo a. Pneumonia: Yes/No IF, Tuberculosis: Yes/No g, silicosis; Yes/No In. Pneurnothorax (collapsed lure: Yes/No I, Lung cancer: Yes/No j, Broken ribs'. Yes/No k, Any chest injuries or surgeries: Yes/No 1, Any other lung problem that you've been told about: Yesk'No 4, Do you currently have any of the following symptoms of pulmonary or lung illness? a, Shortness of breath: Yes/No b, Shortness of breath when walking fast on level ground or walking up a slight bill or indine, Yes/No c, Shortness of breath when walking with other people at an ordinary pace on level ground: Yes/No d, Have to stop for breath when walking at your own pace on level ground: Yes/No a, Shortness of breath when washing or dressing yourself: Yes/No F. Shortness of breath that interferes with your job! Yes/No g, Coughing that produces Phlegm (thick sputum): Yes/No h, Coughing that wakes you early In the morning: Yes/No I, Coughing that occurs mostly when you are lying down: Yest No j, Coughing up blood in the last month: Yes/No k, Wheezing. Yes/No 1. Wheezing that Interferes with your job: Yes/No an, Chest pain when you breathe deeply: Yes/No n, Any other symptoms that you think may be related to lung problems: Yes/No 5, Have you ever had any of the following cardiovascular or heart problerns? a. Heart struck: Yes/No b. Stroke, Yes/No c, Angina. Yes/No d. Heart (allure: Yealklo a. Swelling in your legs or feet (not used by walking): Yes/No f. Heart arrhythmia (heart beating irregularly): Yes/No g, High blood pressure: Yes/No K Any other heart problem that you've been told about: Yes,'N.o 6, Have you ever had any of die following cardiovascular or heart symptoms? a, Frequent pain or tightness In your chest: Yes/No tc Pain or tightness In your chest during physical activity: Yes/No c, Pain or tightness in wrur chest that interferes with your job: Yes/No d, In the past two years, have you noticed your heart skipping or missing a beat: Yes/No a, Heartburn or Migestion that is riot related to eating: Yes/No d, Any other symptoms that you think may be related to heart or circulation proloems, Yes/No 7, Do you currently take medication for any of the following problems? a, Breathing or lung problems: Yes/No b, Heart trouble: Yes/No c, Blood pressure-. Yes/No d, Seizures: Yes/No B. If you' ve used's respirator, have you ever had any of the following problems? (if you've never used a respirator, check the following space and go to question 9o) a, Eye irritation; Yes/No b, Skin allergies or rashes: Yes/No c, Anxiety: Yes/No d, General weakness or fatigue. Yes/No a, Any other problem that interferes with your use of a respirator: Yes/No 9, Would you like to talk to the Health care professional who will review this questionnaire about your answers to this questionnaire: Yes/No Questions 10 to 15 below rout' answered by every employee who has been selected to use either a full-facepiece respirator or a self-contained breathing apparatus (SCBA), For employees who have been selected to use other "- of respirators, answering these questions is voluntary, 10, Have you ever lost vision in either eye (temporarily or permanently): Yes/No I L Do you currently have any of the following vision problems? a, Wear contact lenses: Yes/No b, Wear glasses: Yearklo c. Color blind: Yes/No d, Any otiver eye or vision problem., Yes/No 12, Have you ever had an injury to your ears, including a broken ear drurn: Yes/No 13, Do you currently have any of the following hearing problems? a. Difficulty hearing. Yes/No b, Wear a hearing aid: Yes/No c. Any other hearing or ear problem-, Yewipm 14, Have you ever had a back injury: Yestlea 15. Do you currently have any of the following musculoskeletal problems? a, weakness in any Of your arms, hands, legs, or feet: Yes/No b, Bark pain: Yes/No c. Difficulty fully moving your arras and legs: Yes,'fro d, Pain or stiffness when you lean forward or backward at the waist; Yes/No a. Difficulty fully moving your head up or down: Yes/No f, Difficulty fully moving your head side to side: Yes/No g, Difficulty bending at your knees: Yes/No h, Difficulty squatting to the ground: Yes/No i, Climbing a flight of stairs or a ladder carrying more than 25 lbs: Yes/No j, Any other muscle or skeletal problem that interferes with using a respirator: Yes/No Part B Any of the following questions, and other questions not listed, may be added to the questionnaire at the discretion of the health care professional who will review the questionnaire. 1. In your present job, are you working at h gh altitudes (over 5,000 feet) or in a place that has lower than normal amounts of oxygen: Yes/No If "yes," do you have feelings of dizziness, shortness of breath, pounding in your chest, or other symptoms when you're working under these conditions: Yes/No 2. At work or at home, have you ever been ex ' Dosed to hazardous solivents, hazardous airborne chern-lods (e,g,, gases, fumes, or dust), or he you come into skin contact with hazardous chemicals: Yes/No If "yes," name the chemicals if you know them: . ........................ 3. Have you ever worked with any of the materials, or urAer any of the conditions, listed below a. Asbestos: Yes/No b, Rica ha-g., in sandblasting): Yes/No c, Tungsten/cobalt (e,g,, grueling or welding this material): Yes/No d, Beryllium: Yes/No a, Aluminum: Yes/No I, Coal (for example, m ning)., Yes/No 9, from: Yes/No h, Tim YesiNo i, Dusty environments: Yes/No j, Any other hazardous exposures: Yes/No If "yes,". describe these exposures: 4. Ust any second jobs or side businesses you have: 5, List your previous occupations: 6. List your current and previous hobbies: 7. Have you been in the military services? Yes/No If "fires," were You exposed to biological or chemical agents Neither in training or combat): Yes/No & Have you ever worked on a HAZIAAT Learn? Yes/No 9, Other than medications fix breathing and lung problems, heart trouble, blood pressure, and seizures mentioned earlier in this questionnaire, are you taking any other medications for any reason (including over -the -counter med-catesoo, Yes/No If "Yes," name the med cations if you know them: W, %l I you be using any of the following items w th your resp retorts)? a, HEPA Filters: Yes/No b, Canisters (for example, gas masks): Yes/No c, Cartridges: Yes/No 11, How often are you expected to use the respirator(s) (circle 'We' or "no" for all answers thot apply to you)?. a. Escape only (no rescue): Yes No b. Emergency rescue only: Yes/No c, Less than 5 hours per week: Yes/No d, Less than 2 hours per clay: Yes/No a. 2 to 4 hours per day: Yesirkto f, Over 4 hours per day., Yes/No 12. During the period you are using the respiratisr(s), is your work effort, a, Light (less than 200 kcal per hour)o Yes/No If 'Yes," how long does this period last during the average shift: fire, rains, Examples of a light work effort are sitting while writing, typing r drafting, or performing light assembly work; or standing white operating a drill press (1 .3 lbs,) or controlling machines, b, Moderate (200 W 350 kcal per hour): Yes; Edo If"Yes," how long does this period last during die average shift: fires ........... mins, Examples of moderate work effort are sitting while nailing or filing, driving a truck or bra; in urban traffic; standing while drilling, nailing, performing assembly work, or transferring a moderate load (about 39- bs,) at trunk level; walking on a level surface about 2 mph or down a 5-degree grade about 3 mph; or pushing a wheelbarrow with a heavy load (about IDD lbs.) on a level surface, c, Heavy (above 350 kcal per hour); Yes/No If "yes," how long does this period last duung the average shift- fire, miss, Examples of heavy work are lifting a heavy load (about 50 ibs,) from the floor to your waist or shoulder; working on a loading dock, shoveling; standing while bricklaying or chipping castings; walking Lip art 8--c1egree grade about 2 mph; climbing stairs with a heavy load (about 50 ibs,), 13, Will you be wearing protective clothing and/or eqUipfflent (other then the respirator) when you're using your respirator: Yes/No If 'Yes," describe this protective clothing and/or Win pment: 14. Will you be working order hot conditions (temperature exceeding 77 deg, F); Yes No 15, Will you be working tinder humid conditions: Yes No 16, Describe the work you'll be doing while you're using your respiTator(s): 17. Describe any special or hazardous conditions you might encounter when you're using your res'pirator(s) (for example, confined spaces, life -threatening gases): 18. Provide the followneJ information, if you know it, for each toft subsurice that you'll be exposed to when you're using your respirator(s): Name of the first toxic substancev. Estimated maximurn exposure level par shift: Duration of exposure per smfty Narne of the second toxic substance ............................................ Estimated maximurn exposure level per shift: Duration of exposure per shift: Name of the third toxic substance:_ . Estimated maximium exposure level par shift: Duration of exposure per smfb. The name of any other toxic substances ftwt you'll be exposed to wh fe using your respirator: 19. Descr&- any special, responsibilities you'll have while using your respirator(s) that may affect die safety and well-being of others (for example, rescue, security): [63 FR 1152, Jlarr 8, 1998; 63 FR 20098, Apr 12 3, 1998; 76 Fly 33607, June 8, 2011; 77 Fly 46949, Aug, 7, 2012] 0 Next Standard (1910, 134 Apo D) 0 Regulations (Standards - 29 CFR) -fable of Contents Freedom of Information Act I privacy & Security Statement I Discalmers I Important Web Site Notices I International I Contact its U5,1vepartrivintref tabor i Oc;--patlor.,alSafety &tlealtliAdmiroStrat!.Ii I 21H, --onst tut1:1 Ave., My, Washington, DC 20210 Telephone � SIL-321 -OSHA (6742) 1 Wr www,i)W..gov -&, ........................................................................................ RESPIRATOR USE PHYSICAL .............................................................................................. NAME: AGE-. SEX: TELEPHONE: OCCUPATION: fagree -t-o-tWe-r-elease -oT-tWis-ire fo-rm-a-ti-on-To-r-tFie-Mate -a-n-a-Fe-di-r-aT'Feg—u]5fory —purposes iE-tFe-extent -prow lTeWEy-a-p-pTi-ca-M-elaw—s - - - - - - - -------------------------------- ------- --------------------------------------------------------------------------------------------------------------------------------------------------------------- ----------------- nFollow-up Medical Evaluation Physical Required. (positive response -questions 1-8) [-]Past-Offer Physical: Medical Evaluation. Physical Required NAME: Job Title: Date Of this Follow Up Apo: Reasons for follow-up Actions PLHCP Follow UP Medical Examination J Recommendations about employee use of the respirator., Limitations - Need for follow-up evaluations - Signed: Date Signed copy of recommendation give to employee? E) yes 0 no Date Given: [ | ^See Attached Job Description RESPIRATOR USE PHYSICAL - NAME- AGE- SEX; HOME ADDRESS: TELEPHONE: OCCUPATION: l ItFF-r-e-Fea-se 'Stg� poses ----- - tfATG- -ST3NELi - � l ZRIlffiffifflow OUTSIDE NORMAL LIMITS: OUTSIDE NORMAL LIMITS: |t|smyopinion that the above named patient is. orisnot medically qualified towear arespirator inthe performance ofhis/her duties