OHS Templates

Health and safety templates that form the basis of the health and safety management system for the organisation.

Authority for the Release of Personal and Health Information

A form that employees complete to authorise the release of personal information to the employer.

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Checklist - Contractor Induction

A checklist when employing Contractors.

  • Microsoft Word format
  • 2 pages
  • Easy to use
  • Checklist required to adhere that all induction topics have been addressed such as:
    • Outline of site rules
    • Outline of permit to work system
    • Emergency procedures etc

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Checklist - Contractor OHS Evaluation

A checklist when employing Contractors.

  • Microsoft Word format
  • 3 pages
  • Easy to use
  • Checklist requiring the evaluation of OHS issues
  • Addresses checks such as:
    • Insurance requirements
    • Contractor OHS management
    • Contractor site safety
    • General criteria
    • Consultation and communication of OHS
    • OHS inspections/monitoring
    • OHS training and qualifications
    • Evaluation

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Checklist - Electrical Equipment Inspection

A checklist for electrical equipment.

  • Microsoft Word format
  • 1 page
  • Easy to use
  • Checklist form which allows the listing and determination of risk ranking of electrical equipment

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Checklist - First Day Induction

A check list for use with new employees during induction.

  • Microsoft Word format
  • 2 pages
  • Easy to use
  • Checklist template to ensure appropriate induction methods have been carried out inclusive of:
    • Tour of the Workplace
    • Explanation of OHS

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Checklist - Health and Safety Pre-Purchase

This document can be used to confirm that the health and safety requirements have been considered prior to purchasing equipment or materials.

  • Microsoft Word format
  • 3 pages
  • Easy to use
  • Checklist template to confirm that the health and safety requirements have been considered prior to purchasing equipment or materials
  • Items on the checklist should be complied with to ensure a safe working environment

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Checklist - Machinery and Equipment

Checklist for machinery and equipment.

  • Microsoft Word format
  • 1 page
  • Easy to use
  • Machinery and equipment are major sources of hazards and
  • workplace injuries, therefore this checklist can be complied with to
  • ensure that all machinery and equipment in your workplace in safe, used properly and maintained in good repair
  • Common safety issued are addressed in the checklist to ensure a safe working environment 

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Checklist - Plant Registration & Equipment Pre-start

A checklist used prior to initial plant operation within the workplace.

  • Microsoft Word format
  • 1 page
  • Easy to use
  • This checklist is completed prior to initial plan operation at the workplace

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Checklist - Plant Registration & Equipment Regular

A checklist used as a general and regular check on plant operation at the workplace.

  • Microsoft Word format
  • 2 pages
  • Easy to use
  • Checklist conducted as a general and regular check on plan operation at the workplace
  • This checklist covers plan and equipment such as:
    • Scissor lifts / boom lifts
    • Excavators/backhoes
    • Bob cats
    • Forklifts/Manitou's
    • Cranes
    • Concrete pumps

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Checklist - Risk Assessment for Construction

A checklist for risk assessments in Construction.

  • Microsoft Word format
  • 2 pages
  • Easy to use
  • Worksheet format assessing potential hazards within the workplace
  • Risk matrix is provided

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Checklist - Site Induction

A template of a site induction checklist.

  • Microsoft Word format
  • 2 pages
  • Easy to use
  • Form which outlines the obligation to adhere to OHS requirements whilst engaged in the performance of work
  • Checklist outlines awareness by employee

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Checklist - Site Safety Inspection

The purpose of this inspection is to identify any OHS issues, unsafe equipment or work practices at the work site and to identify the appropriate corrective action required to eliminate or control the identified risk.

  • Microsoft Word format
  • 4 pages
  • Easy to edit and use
  • Checklist used to identify:
    • OHS issues
    • Unsafe equipment
    • Work practices at the work site
  • Checklist will identify and therefore allow for appropriate corrective action to eliminate or control the identified risk

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Checklist - Site Safety Management Plan

Reviews OHS polices and procedures to determine the effectiveness of the OHS Management Plan in addressing the OHS in the workplace.

  • Microsoft Word format
  • 2 pages
  • Easy to use
  • Checklist reviews all OHS policies and procedures to determine the effectiveness of the OHS management plan in addressing OHS in the workplace

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Checklist - Threat

Checklist in case of bomb, hold-up etc.

  • Microsoft Word format
  • 1 page
  • Easy to edit and use
  • Threat checklist in the event ok:
    • Hold-Up
    • Telephone bomb threat etc
  • Description checklist which allows for use after the fact

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Checklist - Workplace Inspection

Inspects the work activity(s) and work area, and provide a completed Workplace Inspection Checklist each week to the principal contractor for the duration of the works.

  • Microsoft Word format
  • 3 pages
  • Easy to use
  • Checklist ensuring the frequent inspection of the work activity(s) and work area
  • Checklist should be completed frequently in hopes of sustaining high levels of workplace safety

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Combined Plant and Risk Register

Lists the hazards, rates the risk and controls applied.

  • Microsoft Excel
  • 3 Worksheets

-        Plant List

-        Risk Register

-        SWMS Register

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Confined Spaces Entry Permit Form

Permit must be signed by the authorised person(s) before work is to proceed and only work listed may be done.

  • Microsoft Word format
  • 4 pages
  • Easy to use
  • This permit allows that an employee is permitted to work in confined spaces and is familiar with all OHS hazards

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Contractor Safety Rules Sample

Site safety rules and procedure for contractors.

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Dangerous Goods Risk Assessment Form

A template for risk assessment of dangerous goods.

  • Microsoft Word format
  • 8 pages
  • Easy to use
  • Risk assessment worksheet addressing:
    • Product identification
    • Details of storage and handling system
    • Hazard identification
    • Assessment of risk

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Defective Plant and Equipment Report

Ensures plant and equipment that has been inspected and found faulty is recorded and dated

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Driver and Contractor Site Rules

A template for setting out OHS requirements when contractors and drivers enters your workplace.

  • Microsoft Word format
  • 3 pages
  • Easy to edit and use
  • Rules detailing health and safety inclusive ok:
    • Fire and emergency procedures
    • Health and safety rules (e.g. equipment, accidents)
    • Acknowledgement

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Driver Worksheet with Safety Instructions Form

A template to ensure driver safety when loading and unloading.

  • Microsoft Word format
  • 2 pages
  • Easy to edit and use
  • Inclusive of OHS driver safety checklist
  • Inclusive of driver delivery safety instructions

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Electrical Equipment Register Form

A template / register to ensures that all electrical equipment brought on site is listed in the Electrical Equipment Register.

  • Microsoft Word format
  • 2 pages
  • Easy to use
  • Form to be used to ensure that all electrical equipments brought on site are listed in the Electrical Equipment register

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Emergency Drill Mgt Record

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Emergency Evacuation Drill Procedure Form

Procedure for an Emergency Evacuation Drill.

  • Microsoft Word format
  • 1 page
  • Easy to use
  • Fire emergency evacuation procedure outlining:
    • Raising the alarm
    • Additional action required
    • Control

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Emergency Procedures Form

A procedure detailing the companies emergency evacuation procedures.

  • Microsoft Word format
  • 1 page
  • Easy to use
  • Emergency procedure form outlining evacuation procedures
  • Includes signs (pictures)
  • Uses colour as emphasis of caution to be taken

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Emergency, Accident and Incident Contact Numbers

Listed Contact Telephone Numbers for all workers to use in the workplace in case of an emergency

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First Aid Procedure for a Remote Site

Procedure for employees who are working remotely.

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FirstAid Facilities Assessment Report

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FirstAid Kit Requirement

Details where first aid kits are located in the workplace and who is responsible for the kits

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Forklift Trainee Log Book

A logbook for forklift training 

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Hazard, Incident and Injury Report

Form for recording Workplace Hazards, Incidents and / or Injuries

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Hazardous Substances / Dangerous Goods and Chemical Register V1

Template for a Hazardous Substances, DGs and Chemical Register.

  • Microsoft Word format
  • 2 pages
  • Easy to use
  • Register for hazardous substances or dangerous goods and chemicals in the workplace which should be recorded for safety purposes and to demonstrate where first aid attention should be emphasised
  • All products and substances to be brought to the workplace are to be documented by:
    • Product name
    • Application
    • Quantity

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Incident and Injury Report

Form for recording Workplace Incidents and / or Injuries

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Induction Guide

Step by Step guide on how to conduct and induction for your employees.

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Injury Investigation Form

Form designed to help investigate a reported incident.

  • Microsoft Word format
  • 1 page
  • Easy to use
  • Template form with detailed questions to be answered when conducting an injury investigation 

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Job Hazard Analysis (Mining) Template

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Manual Handling Training Form

A Policy that outlines organisational manual handling training.

  • Microsoft Word format
  • 14 pages
  • Easy to edit and use
  • Is inclusive of:
    • Manual handling policy
    • Manual handling training (diagrams provided)
    • Team lift
    • Back facts
    • Manual handling safe work method statements
    • Employee sign off form
    • Manual handling references

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Medical Emergency Procedure

Procedure of a Medical Emergency.

  • Microsoft Word format
  • 1 page
  • Easy to edit and use
  • Fact sheet in case of a medical emergency, inclusive of bomb threat, hold up, etc.

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Medicial Questionnaire for Existing Employees

Template / questionnaire for existing employees regarding their medical history.

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Meeting Agenda and Minutes

Form for Agenda items, meeting minutes and action plans

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NZ Authority for the release of personal & health information

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NZ Checklist for Risk Assessment Construction

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NZ Combined Plant & Risk Register

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NZ Confined Spaces Entry Permit

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NZ Contractor Health & Safety Evaluation Checklist

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NZ Contractor Induction Checklist

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NZ Contractor Induction Handbook

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NZ Contractor Site Sign-In Register

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NZ Dangerous Goods Risk Assessment Worksheet

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NZ Defective Plant & Equipment Report

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NZ Driver & Contractor Site Rules for Health & Safety

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NZ Driver Worksheet with Safety Instructions

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NZ Electrical Equipment Inspection Checklist

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NZ Electrical Equipment Register

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NZ Emergency Accident / Incident Contact Numbers

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NZ Emergency Drill Management Record

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NZ Emergency Evacuation Drill Procedure

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NZ Emergency Procedures

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NZ Environmental Risk Assessment Worksheet

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NZ First Aid Facilities Assessment Report

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NZ First Aid Kit Requirement

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NZ First Day Induction Checklist

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NZ Hazard, Incident & Injury Report

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NZ Hazardous Substances / Dangerous Goods / Chemcial Register

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NZ Health & Safety Compliance Checklist - Site Work

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NZ Health & Safety Contractor Performance Review

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NZ Health & Safety Dispute Resolution

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NZ Health & Safety Evaluation of Proposed Contractor

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NZ Health & Safety Pre Purchase Checklist

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NZ Health & Safety Representative Nomination Form

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NZ Health & Safety Tender Review

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NZ Health & Safety Training Register

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NZ Injury Investigation

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NZ Insert into Visitor's book

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NZ Machinery & Equipment Checklist

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NZ Manual Handling Training

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NZ Medical Emergency

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NZ Meeting Agenda & Minutes

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NZ Offer of Suitable Duties

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NZ On the Job Training Record

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NZ Permit to Work

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NZ Plant Registration & Equipment Pre-start Checklist

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NZ Plant Registration & Equipment Regular Checklist

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NZ Plant Registration & Maintenance Register

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NZ PPE Register

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NZ Pre-Work Site Inspection

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NZ Product Incident Reports

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NZ Record of Agreed Consultation

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NZ Remote Site First Aid Procedure

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NZ Report That Hazard

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NZ Restricted Access Register

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NZ Return to Work Plan

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NZ Risk Assessment Worksheet

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NZ Risk Assessment Worksheet - Manual Handling

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NZ Risk Rating Chart Matrix

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NZ Risk Register

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NZ Safe Work Method Statement

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NZ Safe Work Method Statement - Construction Sub Contractor

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NZ Safe Work Method Statement - Extended

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NZ Sample Contractor Safety Rules

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NZ Sample Hazardous Substances / Dangerous Goods / Chemical Register

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NZ Sample Plant Registration & Maintenance Register

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NZ Site Induction Checklist

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NZ Site Induction Checklist - Building & Construction

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NZ Site Risk Assessment Template

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NZ Site Safety Inspection Checklist

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NZ Site Safety Mgt Plan Checklist

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NZ Staff Information Notice

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NZ Tag Out Notice

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NZ Testing and Inspection Intervals for Electrical Equipment

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NZ Threat Checklist

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NZ Working Alone or in Isolation Guide

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NZ Workplace Inspection - General Environment

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NZ Workplace Inspection Checklist

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Offer of Suitable Duties Form

A template to offer employees suitable duties when returning to work.

  • Microsoft Word format
  • 2 pages
  • Easy to use
  • Form outlining duties given to specific employees which require particular job description
  • Outlines how to prepare for an offer of suitable duties so to comply with the law

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OHS Contractor Performance Review Form

Template to review the performance of a contractor.

  • Microsoft Word format
  • 2 pages
  • Easy to use
  • Template form detailing contract requirements and review of whether these requirements have been met by the contractor

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OHS Dispute Resolution Procedure

A procedure for OHS Dispute Resolution.

  • Microsoft Word Format
  • 3 pages
  • Easy to edit and use
  • Outlines clauses in relation to:
    • Parties to the resolution of issues
    • Agreed procedure for resolution of health and safety issues
    • Procedure for reporting issues
    • Procedure for resolving issues
    • Nominated representatives

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OHS Evaluation of Proposed Contractor Form

A template to evaluate a proposed contractor.

  • Microsoft Word format
  • 1 page
  • Easy to edit and use
  • OHS evaluation of proposed contractor form outlining if the proposed contractor has kept OHS standards to an acceptable level
  • Enables the identification of problems which need to be resolved

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OHS Nomination Form for a Representative

Nomination form asking employees to vote on their OHS Representative.

  • Microsoft Word format
  • 1 page
  • Easy to edit and use
  • Form outlining the OHS representative to be selected
  • File kept to comply with the OHS Act

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OHS Tender Review Form

A document to assist in the review of the OHS components of a tender or contract documents.

  • Microsoft Word format
  • 1 page
  • Easy to use
  • Form outlining:
    • Issues that were identified and addressed where a site safety plan can be developed
    • This is then tender approved where the documentation can be examined for adequately addressing occupational health and safety issues that could

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OHS Training Register

Lists and dates employees who have and who need to complete OHS training.

  • Microsoft Word format
  • 3 pages
  • Easy to use
  • Training resister outlining employees which have undertaken particular OHS training components inclusive of:
    • OHS management training
    • Emergency procedures
    • First aid
    • Qualifications, certifications etc.
  • Allows for the dates to be recorded after appropriate training has been completed

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On the Job Training

A checklist for on the job training of employees.

  • Microsoft Word format
  • 1 page
  • Easy to use
  • On the job training checklist to ensure:
    • Instruction
    • Information
    • Demonstration
    • Supervision
  • Check listing that appropriate training has been provided

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Permit to Work Authorisation Register Form

Allows workers into high risk or restricted areas providing they have been trained and have appropriate PPE.

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Permit to Work Form

Allows workers into high risk or restricted areas providing they have been trained and have appropriate PPE

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Plant Registration and Maintenance Register

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Pre-employment Medical Questionnaire

Template / questionnaire for prospective employees regarding their medical conditions.

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Pre-Work Site Inspection Form

A pre work site inspection is required before starting work on a site.

  • Microsoft Word format
  • 2 pages
  • Easy to use
  • Questionnaire template enabling inspection of health and safety issues prior to the commencement of work at a site

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Product Incident Report Form

A report form used to record incidents related to the company's products.

  • Microsoft Word format
  • 1 page
  • Easy to use
  • Template designed to report incidents for evaluation purposes

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Record of Agreed Consultation Agreements

Sets out how you will consultation with your employees about OHS information and to take your workers’ views  into account, before you make decisions.

  • Microsoft Word format
  • 1 page
  • Easy to use
  • Establishes record of:
    • Consultation arrangement
    • How employees will be consulted about OHS
    • Establishment of consultation arrangements
    • Review of consultation arrangements

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Remote Site First Aid Procedure Form

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Report That Hazard Form

Notice to employee advising who they should report all Hazards to.

  • Microsoft Word format
  • 1 page
  • Easy to use
  • Form outlining the importance of reporting something that you may think is dangerous

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Restricted Access Register Form

A list which allows personnel to enter restricted work are.

  • Microsoft Word format
  • 2 pages
  • Easy to use
  • Access register detailing:
    • Area
    • Restriction
    • Person responsible for access control
  • An example copy is provided as a template of how to maintain the register

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Return to Work Plan Form

A template for employee return to work plan.

  • Microsoft Word format
  • 2 pages
  • Easy to use
  • Template outlining specific details surrounding an employees' return to work (e.g. any restrictions which may now apply due to medical prescription)

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Risk Assessment Worksheet for Manual Handling

A worksheet to assist in completing a risk assessment for manual handling.

  • Microsoft Word format
  • 5 pages
  • Easy to use
  • Worksheet designed to assess manual handling and:
    • Risks which may be involved
    • Environmental factors which may be involved
    • How risk is going to be reduced if evident (risk control)

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Risk Assessment Worksheet Form

A worksheet to assist in completing a risk assessment.

  • Microsoft Word format
  • 2 pages
  • Easy to use
  • Assessing risk by detailing the hazard identified and methods of control
  • Risk matrix is also provided

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Risk Rating Matrix Chart

Risk rating chart based on AS/NZS 4360 – Risk Management Standard.

  • Microsoft Word format
  • 1 page
  • Easy to use
  • Risk assessment chart convey the likelihood of risk and consequence

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Risk Register Form

Lists the Hazard, rates the risk and controls applied to the risk.

  • Microsoft Word format
  • 3 pages
  • Easy to edit and use
  • Register which allows the documentation of:
    • The hazard
    • The risk involved
    • Rating of the risk
    • Risk control to be applied

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Safe Work Method Statement - Extended

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Safe Work Methods Statement

Template for Safe Work Methods Statement.

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Scaffolding Checklist

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Site Risk Assessment Template

Template for site risk assessment.

  • Microsoft Word format
  • 5 pages
  • Easy to use
  • Incorporates:
    • Pre-work site inspection form
    • Risk assessment form
    • Risk rating chart

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Site Risk Assessment Template V2

Template for site risk assessment.

  • Microsoft Word format
  • 5 pages
  • Easy to use
  • Incorporates:
    • Pre-work site inspection form
    • Risk assessment form
    • Risk rating chart

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Site Rules for Drivers and Contractors

A template for setting out OHS requirements when contractors and drivers enter your workplace.

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Site Safety Inspection Checklist

The purpose of this inspection is to identify any OHS issues, unsafe equipment or work practices at the work site and to identify the appropriate corrective action required to eliminate or control the identified risk.

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Slips, Trips and Falls Checklist

6 page Checklist for Slips, Trips and Falls

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Staff Information Notice Form

Notice advising employees who their OHS Representative is.

  • Microsoft Word format
  • 1 page
  • Easy to use
  • Information notice for staff concerning:
    • OHS Representative
    • Hazard, incident and injury reporting
    • First aid

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Toolbox Pre-Start Talks Form

All Toolbox / Pre-start Talks are recorded on this form and signed by participants.

  • Microsoft Word format
  • 2 pages
  • Easy to use
  • Minutes form recording participants of Pre-start Talks which enables the documenting of:
    • Persons present
    • Points raised/comments
    • Corrective action to be taken

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Working Alone and or in Isolation Guide

A guide for employers and employees who work alone or in isolation.

  • Microsoft Word format
  • 2 pages
  • Policy and procedure to be taken when working alone
  • Includes a guideline for hazard identification/work limitation when working alone or in isolation

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