Observations

Observation

Are there any hazards?

Falls, trips and slips of a person hazard types.....

Hitting objects with a part of the body hazard types.....

Being hit by moving objects hazard types....

Sound and pressure hazard types....

Body stressing hazard types....

Heat, electricity and other environmental factors hazard types....

Chemicals and other substances hazard types....

Biological factors hazard types....

Mental stress hazard types....

Other and unspecified mechanisms of incident hazard types....

Description of other hazard:

Photo(s) of observation

Short description of photo (if accompanying)

Action required:

Action assigned to:

Any further observations?

Observation
Are there any hazards?

Description of other hazard:

Photo(s) of observation

Short description of photo (if accompanying)

Action required:

Action assigned to:

Please note that this checklist is a hypothetical example and provides basic information only. It is not intended to take the place of, among other things, workplace, health and safety advice; medical advice, diagnosis, or treatment; or other applicable laws. You should also seek your own professional advice to determine if the use of such checklist is permissible in your workplace or jurisdiction.