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General permit to work template

General permit to work template

Document hazards, approvals, and safety protocols with this general permit to work template. Ensure compliance and keep your team protected.

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The Lumiform application helps frontline teams uphold internal standards effortlessly.
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General permit to work template

Document hazards, approvals, and safety protocols with this general permit to work template. Ensure compliance and keep your team protected.

Use this template with Lumiform

The Lumiform application helps frontline teams uphold internal standards effortlessly.
  • Customize this template or build your own
  • Fill out templates via mobile app
  • Assign and track corrective actions
  • Get reports and analyse your data
Prices start from ░░░ per month
Book a demo
Learn more
or Download template as PDF

Complete critical safety checks before beginning hazardous work with the help of this general permit to work template. You can document job details, identify potential hazards, then outline necessary precautions. Signature fields are also available for recording authorizations. 

Research shows around 30% of permit to work systems in process industries have deficiencies that compromise safety. By following an organized workflow, this template supports you in pinpointing hazards, establishing control measures, and securing all necessary approvals. 

Related categories

  • Risk management and compliance templates
  • Facility management templates
  • General templates
  • Risk assessment templates
  • Workplace safety templates
Preview of the template
Page 1
Work Permit Details
Permit Number
Permit Requestor
Permit Approver
Work Description
Permit Start Date
Permit End Date
Hazard Identification
Mechanical Hazards
Electrical Hazards
Chemical Hazards
Working at Height
Confined Space
Other Hazards
Precautions and Controls
Barricades and Signage
Lockout/Tagout
PPE Required
Fire Extinguisher
First Aid Kit
Communication Plan
Safety Briefing
Reviewed Hazards
Reviewed Controls
Employees Trained
Emergency Response
Authorizations
Permit Requestor Signature
Permit Approver Signature
Safety Officer Signature
Date

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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.

Topic guides

Read in-depth guides covering key topics related to this article.

Scope of work: Steps for writing and best practicesSite inspections: A practical guide for compliancePermit to work (PTW): Your guide for safe operations
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Template collections

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17 free scope of work templates3 free OSHA 300 form templates for informed workplace safety13 free permit to work templates
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Safety management softwareProject management system softwarePermit to work softwareEmployee safety app
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Other resources

Explore all the additional resources we offer to assist you in mastering this topic.

10 reasons why workplace safety is importantWriting a project status report4 benefits of safety management and how to communicate themHow digitization improves construction safety

Frequently asked questions

What happens if conditions change after a general permit to work is issued?

Stop work immediately and suspend the permit. You’ll need to conduct a reassessment of risks, implement new control measures if needed, and revalidate the permit with appropriate signatures. Continuing work under changed conditions without reassessment significantly increases the risk of accidents.

How do you determine which hazards to include in the permit to work?

Conduct a thorough workplace inspection and risk assessment specific to the task. Consider energy sources, confined spaces, heights, chemicals, moving parts, and environmental conditions. Review past incidents in similar work, consult with experienced workers, and reference industry standards for common hazards in your specific operation.

How do you properly close out a general permit to work after job completion?

Inspect the work area to ensure it’s clean and safe, all tools are accounted for, and systems are properly restored. Document any incidents or issues encountered. Have both the permit holder and issuer sign the closeout section, confirming work completion and workspace handover. File the permit according to your record-keeping procedures.

When should you use digital versus paper general permits to work?

Digital permits excel in environments with good connectivity, offering real-time updates, automatic notifications, and searchable records. Paper permits work better in remote locations, during power outages, or where digital access is limited. Many organizations use hybrid systems—digital for processing and approval, with printed copies available at work sites.


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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