Surveillance Questionnaire

Depending on the exposure level at your workplace, you may need to complete a medical surveillance questionnaire before you begin to work with formaldehyde.

This questionnaire helps determine your personal risk from exposure to formaldehyde.

If your level of exposure is high enough, you may be required to complete this questionnaire annually. The questionnaire is reviewed by a licensed physician and may require a medical follow-up exam. The questionnaire and exam are given at no cost to you and remain confidential.