Are you familiar with the QLFT form? It stands for quick look feedback and is an efficient way to get meaningful input from customers. This simple five step process can give small businesses a leg up on customer service, as it provides much-needed insight into what customers like or don't like about their products and services. In this blog post, we will review the components of the QLFT form and discuss how using it can help your business provide top-notch customer satisfaction. Read on to learn more about this helpful tool!
Question | Answer |
---|---|
Form Name | Qlft Form |
Form Length | 1 pages |
Fillable? | No |
Fillable fields | 0 |
Avg. time to fill out | 15 sec |
Other names | Administering, 2004, qlft, TTY |
Qualitative Fit Test (QLFT) Form
Employee Name
Date of Birth (Year) Height
Weight
Work Unit
Supervisor Name
A respirator fit test must be completed by an individual trained in respiratory fit testing procedures. This fit test is required annually.
Does employee wear glasses? _____ Yes _____ No
Does Employee have facial hair, dentures or other attributes that will prevent a positive face fit? _____ Yes _____ No
Respirator Type (Make Model and Certification Number) Testing media Compatible with eye glasses Positive pressure fit check Negative pressure fit check Head Stationary Normal Breathing (60 seconds)
Head Stationary Deep
Breathing (60 seconds)
Head Turning Side To Side (60 seconds)
Head Moving Up and Down (60 seconds)
Talking (recite Rainbow Passage or count backwards)
Bending Over (60 seconds) Head Stationary Normal Breathing (60 seconds)
Respirator fit test result
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Based on information provided on this form, I certify that the employee named on this form can wear the respiratory protective equipment listed above.
Signature of Person Administering Test _________________________ Date _________
Infectious Disease Epidemiology, Prevention and Control
If you require this document in another format, such as large print, please call
Revision 5/2004