• Site conducted

  • Client / Site

  • Conducted on

  • Prepared by

  • Driver Name and Employee ID:

  • Vehicle Type and Weather Conditions:

Before Driving

  • Inspects Vehicle Before Entering/Starting?

  • Adjusts Seats and Mirrors?

  • Wears Safety Belt?

While Driving

  • Accelerates Smoothly?

  • Stops Smoothly?

  • Maintains Legal Speeds?

  • Adjusts Speed to Conditions?

  • Uses Turn Signals Appropriately?

  • Stops Completely at Stop Signs and Red Lights?

  • Leaves Sufficient Space when Stopping in Traffic?

  • Obeys All Traffic Laws?

  • Backs Safely?


  • Scans Ahead?

  • Checks for Cross Traffic and Intersections?

  • Maintains Safe Distance from Other Vehicles? (3 second rule)

  • Merges Smoothly Into Traffic?

  • Changes Lanes in a Controlled Manner?

  • Avoids Following Oversized Vehicles?

  • Avoids Driving in Other Driver's Blind Spots?

  • Shows Awareness of Pedestrians and Cyclists?

  • Reacts Early Enough to Respond to Potential Hazards?

  • Avoids Distractions? (Cell Phones/Eating/Conversations)

  • Driver 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.