• Prepared by

  • Add name:

  • Travelling to:

  • Date of Journey:

  • Journey Manager / Scheduled Contact:

  • Have you discussed the journey with them?

Risk Assessment

  • Is this the driver's first time journey on this route?

  • Discuss with Road Journey Manager/Contact

  • Is the anticipated driving time for the journey greater than eight hours?

  • Discuss with Road Journey Manager/Contact. Ensure Breaks from driving every 3 hours.

  • Will the journey require driving in darkness?

  • Discuss with Road Journey Manager/Contact


  • Route description / Summary:

  • Screenshot of route in Google Maps/QGis or Mudmap

  • Is there a need for towing on the journey?

  • Discuss with Road Journey Manager/Contact & refer to Towing Guideline + Towing checklist

  • Estimated Arrival:

  • Will this be a return journey?

  • Estimated return date & time:


  • It is the drivers responsibility to notify their scheduled contact before departure and maintain scheduled contact

  • Contact frequency: - Departing for Journey, 11h00 and arrival at destination as per standard Moho scheduled check-ins


Vehicle details

  • Driver Name:

  • Add name:

  • Passenger(s)

  • Add name:

  • Vehicle Type

  • Relevant licenses and/or competencies to operate this vehicle

  • All necessary vehicle pre-starts will be completed prior to travel


  • Driver confirms an InReach device will be kept on for the entire trip and scheduled check-ins will be abided to:

  • Drivers name & 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.