OSHA Silica Standard: Medical Surveillance / Report Authorization

Form Template

This app is used for medical surveillance and report authorization for crystalline silica exposure.

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Your employer should make available to your medical examination for exposure to crystalline silica at no cost to you. This medical examination could reveal a medical condition that results in recommendations for (1) limitations on respirator use, (2) limitations on exposure to crystalline silica, or (3) examination by a specialist in pulmonary disease or occupational medicine. This app has been developed to protect site employees, who in the course of their work, may be exposed to various operations where the dust generated may contain respirable crystalline silica. This app applies to all occupational exposures to respirable crystalline silica in construction work, except where employee exposure will remain below 25 micrograms per cubic meter of air (25 μg/m3) as an 8-hour time-weighted average (TWA) under any foreseeable conditions. The OSHA Silica Standard: Medical Surveillance / Report Authorization mobile app allows you to replace your paper OSHA form with a smartphone, tablet or desktop. The mobile form includes fields to document items such as name, employer, date of exam, recommendations for limitations on crystalline silica exposure and the app captures the signature of the person completing the app. Once the mobile app is filled out a secure PDF is generated. The PDF is easy to share, and a copy is stored in your account for your health and safety records. You can also use the App Builder to personalize and customize this mobile form.

Features
  • Signature Capture
  • Submission Editing
  • Reference Data
  • Dispatch
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Platforms
  • iPhone
  • iPad
  • Android
  • Windows
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Integrations
  • Quickbooks
  • Salesforce
  • Google Docs
  • Dropbox
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*The Capterra SoftwareAdvice ​and GetApp logos are a service mark of Gartner, Inc. and/or its affiliates and is used herein with permission.*

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