End of Day Safety Sign Off

• Document No.

• Conducted on

  Date

• Prepared by

• Location
  Address

Today I worked safely and have no accidents or injuries to report.

• Team Member

  Sign

• Team Member

  Sign

• Team Member

  Sign

• Team Member

  Sign

• Team Member

  Sign

• Add signature

  Sign

I have an accident or injury to report.

• Description of incident

• Person affected

  Sign

• Witness

  Sign

• If an incident is noted you must contact the office immediately