PPE Assessment

• Site conducted

• Conducted on

  Date

• Prepared by

• Location

• Type of PPE

PPE Details

• Manufacturer

• Model/Serial Number

• Date of Issue

  Date

• Intended Use

Fit and Comfort

• Does the PPE fit properly?

  Yes

  No

  N/A

• Is the PPE comfortable to wear for extended periods?

  Yes

  No

  N/A

• Are there any areas of discomfort or irritation?

  Yes

  No

  N/A

Functionality and Performance

• Does the PPE provide the intended protection?

  Yes

  No

  N/A

• Is the PPE easy to put on and take off?

  Yes

  No

  N/A

• Does the PPE interfere with any tasks or movements?

  Yes

  No

  N/A

• Are there any noticeable defects or issues?

  Yes

  No

  N/A

User Feedback

• Overall satisfaction with the PPE

• Any suggestions for improvement?

Visual Documentation

• Attach photos of PPE in use

  Media

• Attach videos demonstrating any issues

  Media

Summary and Recommendations

• Summary of Findings

• Recommendations for further action

• Date and time of approval

  Date

• Approver's signature

  Sign