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Fall protection rescue plan template

Fall protection rescue plan template

Create a comprehensive fall rescue response strategy with this template that ensures your team is prepared to act quickly when every second counts.

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Fall protection rescue plan template

Create a comprehensive fall rescue response strategy with this template that ensures your team is prepared to act quickly when every second counts.

Use this template with Lumiform

  • Customize this template or build your own
  • Fill out templates via mobile app
  • Get reports and analyse your data
Prices start from ░░░ per month
Book a demo
Learn more
or Download template as PDF

This fall protection rescue plan template helps you prepare for the critical moments after a fall incident occurs. While standard fall protection focuses on prevention, this template addresses the often-overlooked rescue component that OSHA requires.

Falls remain one of the top causes of workplace fatalities across industries, and in construction alone, workers are seven times more likely to have fatal falls compared to other sectors, according to the National Safety Council. This template guides you through documenting essential rescue elements including anchorage points, equipment verification, and rescue team assignments.

Related categories

  • Health and safety management templates
  • Construction templates
  • Risk assessment templates
  • Safety templates
  • Workplace safety templates
Preview of the template
Page 1
General Information
Job Location
Date of Rescue Plan
Site Supervisor
Fall Arrest System
Anchorage point identified
Anchorage point adequate
Vertical lifeline length adequate
Horizontal lifeline length adequate
Fall arrest equipment inspected
Rescue Equipment
Rescue equipment available
Rescue equipment in good condition
Rescue equipment easily accessible
Rescue Procedures
Rescue procedures established
Rescue team members identified
Rescue team members trained
Emergency Response
Emergency services contacted
First aid kit available
Communication system tested

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Related resources

Access a complete set of resources aimed at maximizing safety, quality, and operational excellence, including detailed guides, related templates, and real-world use cases.

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Frequently asked questions

Who should be identified as rescue team members in this template?

Identify workers who have received specialized rescue training, understand the fall protection systems in use, and are physically capable of performing rescues. Include at least two trained rescuers per shift who can work together, as solo rescues are rarely safe or effective. Always ensure rescue team members are readily available on site.

How do I properly test and document communication systems?

Test your communication system by conducting a drill where team members communicate from different work areas, verify reception in noisy environments, confirm backup methods work when primary systems fail, and ensure emergency services can be contacted promptly. Document the test results and any corrective actions needed.

What should I cover in the rescue procedures when filling out the template?

Your established rescue procedures should outline step-by-step response protocols for different fall scenarios, assign specific roles to team members, include contact information for emergency services, and detail methods for safely accessing and retrieving fallen workers based on your specific work environment.

How should I integrate this rescue plan template with my broader fall protection program?

Incorporate this rescue plan as a critical component of your comprehensive fall protection program by referencing it in safety meetings, including it in worker training, storing it with fall protection equipment, and using it as the basis for regular rescue drills and practice sessions.


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.
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