Company Induction form - Revised

• Based?

• Conducted on

  Date

• Prepared by

• Location
  Address

Employee Record

• Full name

• Home Address

• Telephone

• Job Description

• 1. Emergency Contact name

• 1. Emergency contact relationship

• 1. Emergency contact Number

• 1. Emergency contact address

• 2. Emergency Contact name

• 2. Emergency contact relationship

• 2. Emergency Contact number

• 2. Emergency contact address

Health Deceleration

• Suffered with back injury, back pain or neck pain?

  Yes

  No

  N/A

• Suffered with disc injury?

  Yes

  No

  N/A

• Suffered with Hernias?

  Yes

  No

  N/A

• Suffered with nerve injury?

  Yes

  No

  N/A

• Suffered with ligament or muscular injuries?

  Yes

  No

  N/A

• Suffer with hearing problems or inner ear damage?

  Yes

  No

  N/A

• Suffer from Tinnitus? (ringing of the ears)

  Yes

  No

  N/A

• Suffer from Defective Vision?

  Yes

  No

  N/A

• Suffer from Ear Infections?

  Yes

  No

  N/A

• Suffer from Defective colour vision?

  Yes

  No

  N/A

• Do you wear a hearing aid?

  Yes

  No

  N/A

• Date of last hearing test?

• Do you wear glasses?

  Yes

  No

  N/A

• Date of last eye test?

• Have you been inoculated against tetanus?

  Yes

  No

  N/A

• Have you been inoculated against polio?

  Yes

  No

  N/A

• Have you suffered from any of the following

  Select Pains in chest High Blood pressure Epilepsy Fainting Attacks Asthma Shortness of breathe Skin trouble Heart Attacks Angina Fits or blackouts Hay Fever Anxiety Or depression Reoccurring Headaches Diabetes None of the above

  • Pains in chest
  • High Blood pressure
  • Epilepsy
  • Fainting Attacks
  • Asthma
  • Shortness of breathe
  • Skin trouble
  • Heart Attacks
  • Angina
  • Fits or blackouts
  • Hay Fever
  • Anxiety Or depression
  • Reoccurring Headaches
  • Diabetes
  • None of the above

• Please give details of any medication you are taking

• How would you consider your weight.

  Under

  Over

  Normal

• Is your general health good?

  Yes

  No

  N/A

• Please tick if you are limited in these areas- walking, standing, lifting, using your hands, working at height, driving, climbing ladders?

• How Many days have you had off due to illness in the last six months?

• I DECLARE THAT TO THE BEST OF MY KNOWLEDGE THE ABOVE IS CORRECT

  Sign

• Do you have any Physical Disabilities which should be noted?

  Yes

  No

  N/A

Height Measuring sticks

• <br>• Wagon must be loaded and ready for road travel, ensuring air suspension is inflated.<br>• Ensure ground is level and firm<br>• Extend measuring stick up and across to highest point of load off ground level<br>• Ensure stick is at 90 degree angle from the floor<br>• Read height from measuring stick and set height indicator in cab<br>• Put away stick in case and keep in secure place in the cab.<br><br>Were driver is unable to reach highest point of the load from the ground<br>• Extend measuring stick up and across <br>• Place the stick on the bed of the truck / trailer, driver to stay on ground level<br>• Ensure stick is at 90 degree angle from the floor<br>• Adjust the height measurement stick to the highest point of the load <br>• Read height from measuring stick <br>• measure with a tape from ground level to bed of trailer <br>• add both measurements together to equate the height of load and set height indicator in cab<br>• Put away stick in case and keep in secure place in the cab.<br>

  Agree

  N/A

• I agree to have read the above statements and agree to put it in place

  Sign

Eye Site test

• Name of Employee

• State the Number plate read at a distance of 20M+

• Result

  Pass

  Fail

• I hereby declare that i will report any changes to my vision or report any health impairments that may effect/impact my ability and entitlement to drive or work safely.

  Sign

Learning agreement

• This Learning Agreement is designed to ensure that both the Company and employee understand their obligations regarding further education and training. It is a standard quality measure to ensure that:  Employees understand what they have the right to expect from TPH LTD  Employees understand what is expected of them during their course  Line Managers are clear concerning their employees support needs. Company Pledge  You will receive information, advice and guidance about your chosen course from your Line Manager  TPH will fund an agreed proportion of your chosen course (subject to authorisation)  Your progress will be reviewed periodically by your Line Manager  TPH will provide adequate support for any specific learning needs you may have, either throughout the course, or at appropriate mutually identified times Line Manager’s Pledge Your Line Manager will agree to:  Provide adequate support and guidance throughout your chosen training course  Meet with you on a regular basis to discuss your progress and send a report to the Management regarding your progress on courses that are to take place over more than a week’s duration Employee Pledge You, the employee will agree to:  Undertake sufficient study to maintain progress and achieve success on your chosen course  Attend college/university/training center, where appropriate, when required to do so  Complete assignments, where appropriate, on time  Contact you’re Line Manager of a member of the Senior Management team if you are experiencing difficulties with the course  Give us authorization to obtain regular reports from the appropriate college/university/Training Center regarding your progress/attendance  Repay the costs of any course and examination fees in line with the table below if you resign from the Company’s employment during the course or for an unacceptable reason, withdraw or fail within twelve months. See below for the percentage of fees that need to be re-payed after leaving after a certain time scale. 3 months or less = 100% 3-6 months = 75% 6-9 months = 50% 9-12 months = 25% Following a successful period of 12 months or more, no training reimbursement is required.

  Sign

FOR EMPLOYER ONLY - Have all the below been discussed

• Induction to supervisors and managers

  Yes

  No

  N/A

• Site specific hazards identified

  Select Yes No N/A

  • Yes
  • No
  • N/A

• Job Description

  Yes

  No

  N/A

• Working hours and breaks

  Yes

  No

  N/A

• QA 002 Health declaration completed and signed forms

  Yes

  No

  N/A

• QA 003 employee/self employed record form

  Yes

  No

  N/A

• P45 From previous employment

  Yes

  No

  N/A

• Employee handbook (for direct employers only)

  Yes

  No

  N/A

• Contract of employment

  Yes

  No

  N/A

• Method of payment advised

  Yes

  No

  N/A

• Travel and expenses

  Yes

  No

  N/A

• QA 037 working time form

  Yes

  No

  N/A

• Welfare facilities - walk around the depot

  Yes

  No

  N/A

• Insurance of safe system of work

  Yes

  No

  N/A

• Company policies

  Yes

  No

  N/A

• FORS drivers handbook

  Yes

  No

  N/A

• QA 034 Right to work in the uk

  Yes

  No

  N/A

• QA 039 Driver mandate form and copy of driving licence

  Yes

  No

  N/A

• QA 038 Night shift opt out form (optional)

  Yes

  No

  N/A

• QA 0101 training reimbursement form

  Yes

  No

  N/A

• Copy of any Training Certificates

  Yes

  No

  N/A

• Method statement and SOP explained and signed off.

  Yes

  No

  N/A

• Employee Signature

  Sign

• Employer Signature

  Sign