Lumiform / Templates / Safety Hazard Report Template

Safety Hazard Report Template

This Venue Inspection Checklist helps the team to keep track of when and where the hazard was reported, to describe the hazard using text, to determine the seriousness of the injury and the medical attention required and to implement control measures for accident prevention.

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Safety Hazard Report Template

Report

Have you notified your supervisor/manager?

Describe the Hazard

How important could the injury be?

How likely is it to be that serious?

Comments

Actions

Have control measures been implemented?

Hazard Report Form completed on:

Comments

Final comments and signature

Comments

Signature

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Please note that this checklist template is a hypothetical appuses-hero example and provides only standard information. The template does not aim to replace, among other things, workplace, health and safety advice, medical advice, diagnosis or treatment, or any other applicable law. You should seek your professional advice to determine whether the use of such a checklist is appropriate in your workplace or jurisdiction.