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Lockout tagout procedure template

Lockout tagout procedure template

Standardize your lockout tagout procedures with this template. It provides clear guidelines for isolating energy sources and securing equipment.

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Lockout tagout procedure template

Standardize your lockout tagout procedures with this template. It provides clear guidelines for isolating energy sources and securing equipment.

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

Protect your maintenance team with this lockout tagout procedure template that walks workers through the entire energy control process. From initial equipment shutdown to final restart, this template verifies you’ve gone through all critical safety steps. You can then establish consistent protocols that prevent the unexpected release of hazardous energy during equipment servicing.

Research shows that 74-82% of all lockout/tagout-related incidents occur in manufacturing environments, emphasizing the critical need for proper documentation. When your facility faces an unexpected equipment breakdown requiring immediate maintenance, this template aids you in performing repairs safely without compromising worker protection.

Related categories

  • Health and safety management templates
  • Facility management templates
  • Manufacturing templates
  • Risk assessment templates
  • Workplace safety templates
Preview of the template
Lockout Tagout Procedure
Identify all energy sources
Shut down equipment and machinery
Isolate all energy sources
Apply lockout devices
Verify zero energy state
Perform maintenance or service
Remove lockout devices
Restore energy and restart equipment

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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

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Lockout tagout: A comprehensive guideWarehouse safety guide: The best practices and principlesToolbox talks: A safety leader's guide
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Use cases

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Equipment maintenance software Electrician AppForklift inspection appSafety Incident Reporting Software
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Other resources

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6 main types of maintenance4 types of predictive maintenance for your businessHow to perform safety inspectionsThe importance of personal protective equipment (PPE) in workplace safety

Frequently asked questions

How do I customize this lockout tagout template for my specific equipment?

First, conduct an equipment energy audit to identify all power sources. For each machine, document the exact locations of disconnect points, valves, and energy isolation devices. Add equipment-specific details to each step, including photos of isolation points when possible. Remember to involve experienced operators and maintenance staff who understand the equipment’s energy hazards.

Who should be responsible for creating our lockout tagout procedures?

Your procedures should be developed by a team including maintenance supervisors, safety professionals, and equipment operators who understand the machinery. This collaborative approach ensures procedures are both technically accurate and practical. While safety managers typically coordinate the documentation process, input from those who regularly service the equipment is crucial for creating effective, realistic procedures.

What’s the difference between lockout and tagout?

Lockout involves placing a physical lock on energy-isolating devices, preventing equipment activation. Tagout uses warning tags when locks cannot be applied. This template accommodates both approaches, though lockout is preferred for its physical barrier. Remember that if you use tagout alone, OSHA requires additional protective measures to provide equivalent safety to lockout.

How do I train employees to properly use this lockout tagout procedure?

Training should include hands-on practice with actual equipment and locks. Walk through each step of your procedures, demonstrate proper isolation techniques, and have employees perform lockout under supervision. Focus on energy identification, proper sequence, and verification methods. Create equipment-specific training modules and test comprehension through practical demonstrations rather than just written tests.


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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