Title Page

  • Company Name

  • Project Name & No.

  • Work Activity

  • Conducted on

  • Date to be Reviewed

  • Prepared by

  • Location

Safe Work Method Statement

SWMS Details

  • Brief description of Work Activity

  • High-risk Construction Work

  • Employer/Contractor

  • Personnel Responsible for Monitoring this Activity

  • Codes of Practice / Standards Consulted

  • Assumptions

  • Details of Maintenance Checks Required for this Activity

  • Review date

  • Reviewer's signature

Work Activity Breakdown

  • Break the work activity down into steps below by clicking '+' and provide the possible associated hazards and its control measures.

  • Work Method
  • Work Method Description

  • Possible Hazards
  • Hazard

  • Risk Level

  • Control Measures

  • Person Responsible (to ensure management that this method is applied)

Sign Off

  • We the undersigned, confirm that the SWMS nominated above has been explained and its contents are clearly understood and accepted, we have been given the opportunity to have input and make suggestions if required. We also confirm that our required qualifications to undertake this activity are current and we are fit for duty having adequate rest and we are not under the influence of drugs or alcohol. We also clearly understand the controls in this SWMS must be applied as documented; otherwise, work is to cease immediately.

  • Worker signatures
  • Add signature

The templates available in our Public Library have been created by our customers and employees to help get you started using SafetyCulture's solutions. The templates are intended to be used as hypothetical examples only and should not be used as a substitute for professional advice. You should seek your own professional advice to determine if the use of a template is permissible in your workplace or jurisdiction. You should independently determine whether the template is suitable for your circumstances.