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JSA template – NZ

JSA template – NZ

Comprehensive template to assess job hazards and mitigation measures for safety in New Zealand

Use this template
or download pdf
JSA template – NZ

Comprehensive template to assess job hazards and mitigation measures for safety in New Zealand

Use this template
or download pdf

About the JSA template – NZ

Ensuring workplace safety is a top priority, especially in industries like construction, agriculture, and manufacturing. With the JSA template (NZ), you can break down complex tasks into manageable steps while identifying and mitigating potential hazards. This template aligns with New Zealand’s Health and Safety at Work Act 2015, making it easier to maintain compliance while improving the efficiency of your team’s safety protocols.

Key elements of the JSA template

The template captures crucial components of the job safety analysis process:

  1. Job details and task breakdown: Start by clearly outlining the job title, location, and duration. You’ll then break down the job into individual steps so each stage can be analyzed thoroughly.
  2. Hazard identification and risk assessment: It’s crucial to identify potential hazards at each job step. Once hazards are listed, assess their severity (low, medium, or high).
  3. Control measures and PPE: List all the measures that need to be implemented to minimize or eliminate the risks identified. From personal protective equipment (PPE) to specific tools or protocols, this section ensures all team members are adequately prepared.
  4. Competency and emergency preparedness: Next, you’ll record who is supervising the job and verify that all workers are trained and competent to perform the tasks safely. Also, emergency preparedness is essential, so include available emergency equipment and resources on-site.
  5. Review and approval: Before work begins, the job safety analysis must be thoroughly reviewed and approved by a supervisor or manager. This final step confirms that all safety measures have been evaluated and signed off, providing accountability and assurance that the job can proceed safely.

Best practices for using the JSA template (NZ)

To make the most of your job safety analysis, it’s important to use the template consistently and correctly.

First, use the template to verify that all equipment is in good condition and suited to the specific hazards of the task. Regular inspections of helmets, gloves, goggles, and other gear are part of the JSA process.

Plan for external factors when filling out the template. While job hazards are often tied to the tasks at hand, external factors such as weather, lighting conditions, or even nearby public events can influence safety. For example, poor weather conditions might require additional equipment or delay certain tasks.

The template also allows you to enable photo uploads to support your hazard assessments. Taking photos of potential hazards or areas of concern helps everyone involved—especially those off-site or in management—better understand the situation.

Download Lumiform’s JSA template for New Zealand today

With this job safety analysis form, you can streamline safety procedures conveniently. Use it to document hazards, assign responsibilities, and track risk controls, all while keeping compliance in check. Simplifying your job safety assessments will lead to more efficient workflows and a safer work environment for your team.

Related categories

  • Health and safety management templates
  • Construction templates
  • General templates
  • Risk assessment templates
  • Workplace safety templates
Preview of the template
Page 1
Job Details
Job Title
geolocation!!!
Date
Estimated Job Duration (hours)
Task Breakdown
List the key steps required to complete the job in the order they will be performed
Hazard Identification
Identify all potential health and safety hazards associated with each step of the job
For each hazard identified, assess the risk level
Risk Control Measures
List control measures that will be implemented to eliminate or minimize the risks
Is additional personal protective equipment (PPE) required?
Competency & Authority
Who will be responsible for supervising the job?
What are the required competencies (skills, knowledge, experience) for workers performing this job?
Have all workers been trained and deemed competent to perform the tasks safely?
Emergency Preparedness
What emergency equipment and first aid resources are available on site?
Have workers been trained in emergency response procedures?
Review & Approval
Name of Supervisor/Manager Approving the JSA
Supervisor/Manager Signature
Date of Approval

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JSA template – Australia
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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.

Construction site safety: Essential guidelines and best practicesJob safety analysis (JSA): A comprehensive guideOccupational health and safety: A comprehensive guide
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Template collections

See comprehensive collections of best practice templates related to this topic.

3 free OSHA 300 form templates for informed workplace safety6 free health and safety risk assessment templates12 free JSA templates for safer workplaces
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Use cases

Check out how the Lumiform software can be utilized for related use cases.

Safety inspection appSafety Management SoftwareJob safety analysis software
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Other resources

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

4 ways that workplace safety increases worker productivity10 reasons why workplace safety is important4 benefits of safety management and how to communicate themHow digitization improves construction safety

Frequently asked questions

What is the purpose of a JSA?

A Job Safety Analysis (JSA) aims to improve workplace safety by breaking down tasks into steps and identifying potential hazards. This process allows teams to implement preventive measures, reducing the risk of accidents. JSAs also enhance communication among workers and provide a structured approach to safety management.

What are some common mistakes to avoid when filling out the JSA template?

Avoid being too vague or generic–provide specific details about each task and hazard. Don’t skip steps in the process, since this can lead to overlooked risks. Involve all relevant team members to gather diverse insights, and update the JSA regularly to reflect any changes in the work environment.

How can I tailor the JSA template to fit different types of jobs or industries?

Customize the template by focusing on industry-specific hazards and regulations. Adjust the language and format to match the complexity of the tasks. Incorporate examples and scenarios relevant to the specific job, and consult with industry experts to address unique challenges.


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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