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Employee safety evaluation form

Employee safety evaluation form

Assess how well your team understands and follows safety procedures. This evaluation form helps you document and track key insights.

Use this template
or download pdf
Employee safety evaluation form

Assess how well your team understands and follows safety procedures. This evaluation form helps you document and track key insights.

Use this template
or download pdf

About the Employee safety evaluation form

When you’re responsible for keeping teams safe on-site or in the office, it’s critical to spot risks before they turn into problems. An employee safety evaluation form helps you take stock of how well safety protocols are being followed across the board. It’s your go-to tool for tracking awareness, compliance, and comfort levels around workplace safety.

Key elements of an employee safety evaluation form

Here are the core elements included in the template:

  • Safety awareness questions: Gauge how well employees understand safety policies, procedures, and emergency protocols. This helps you assess whether training is effective or if additional education is needed.
  • Work environment checks: Identify physical risks by asking about lighting, workspace hazards, ventilation, and equipment conditions. You can use this to spot recurring facility issues early.
  • PPE usage and access: Evaluate if employees have the right protective gear and know how to use it. This is a critical compliance checkpoint for many industries with regulatory standards.
  • Incident history and reporting comfort: Find out if staff have experienced or witnessed safety incidents, and whether they feel confident reporting them without fear of backlash.
  • Open feedback and suggestions: Give space for honest input. This uncovers concerns that planned questions might miss and shows your team their voice matters.

Customizing your employee safety evaluation form

Whether you’re working with a small crew or managing multiple job sites, the employee safety evaluation form should reflect your specific environment, roles, and risks.

Start by editing the language in the safety awareness section to match your internal terminology. If your company uses specific equipment or follows industry-specific protocols, include direct references to those. This helps employees connect the questions to their real, day-to-day tasks.

Add or remove questions based on role types. Office-based staff don’t need to answer questions about PPE, for example, but field workers do. You can also break the form into role-specific versions if your teams work under very different conditions.

Scale the form to match your reporting structure. Smaller teams might review safety monthly, while larger operations may need quarterly reviews with department-specific evaluations. Use Lumiform’s logic tools to adjust how the form behaves depending on the answers provided.

Start improving your safety evaluations today

Get straight to the insights that matter. This template gives you a systematic way to track safety knowledge, flag risks early, and gather team input in one place. You can assign sections, add logic to hide irrelevant questions, and adjust the layout to match your internal review flow.

Related categories

Preview of the template
entity_item!!!
Page 1
Employee Information
Employee Name
Employee ID
Department
Job Title
Supervisor Name
Safety Awareness
Are you familiar with the company's safety policies and procedures?
Have you completed all required safety training courses?
Do you know how to properly report safety incidents or concerns?
Are you aware of the location of emergency exits, fire extinguishers, and first aid kits in your work area?
Work Environment
Is your work area free of tripping hazards (e.g., cords, clutter, uneven floors)?
Are all work surfaces (e.g., desks, benches) in good condition and free of sharp edges?
Is adequate lighting provided in your work area?
Is the temperature, humidity, and ventilation in your work area comfortable and suitable for the tasks performed?
Personal Protective Equipment (PPE)
Do you have access to and use the appropriate PPE for your job tasks (e.g., safety glasses, gloves, hard hat)?
Is the PPE you use in good condition and properly maintained?
Have you been trained on the proper use and care of the PPE required for your job?
Incident Reporting and Response
Have you been involved in any safety-related incidents or near-misses in the past year?
If yes, did you report the incident through the proper channels?
Were appropriate actions taken to investigate and address the incident?
Do you feel comfortable reporting any safety concerns or incidents without fear of retaliation?
Suggestions and Feedback
What aspects of the company's safety program do you think are working well?
What areas of the safety program do you think could be improved?
Do you have any other suggestions or feedback to enhance employee safety?

Frequently asked questions

Who should be responsible for maintaining the safety handbook?

Assign ownership to a safety officer, site manager, or whoever oversees compliance and training. But make sure to collect input regularly too from frontline workers. They’re the ones who spot gaps first. If a procedure changes or new equipment is introduced, the handbook should reflect that within a reasonable time frame, ideally within a week.

What’s the best format for distributing a safety handbook?

Offer both a digital and printed version, depending on where your team works. On-site crews may benefit from printed handbooks in breakrooms or lockers, while office or mobile workers might prefer accessing it through an internal system or app. Accessibility is key, so make sure it’s easy to reach when needed.

What common mistakes should you avoid when creating a safety handbook?

Avoid vague instructions. For example, only use terms like “follow standard procedure” should only be used if those procedures are clearly defined within the document. Stick with clear, practical language that’s easy for all team members to understand, regardless of role. Keep the content focused and relevant, and avoid overwhelming readers with excessive information.

This template, developed by Lumiform employees, serves as a starting point for businesses using the Lumiform platform and is intended as a hypothetical example only. It does not replace professional advice. Companies should consult qualified professionals to assess the suitability and legality of using this template in their specific workplace or jurisdiction. Lumiform is not liable for any errors or omissions in this template or for any actions taken based on its content.