Title Page

  • The PPE listed has been issued to the named employee in accordance with the Management of Health and Safety at Work Regulations 1999 and the Personal Protective Equipment at Work Regulations 1992.

    The employee has a responsibility to:

    • Take reasonable care of the PPE provided;
    • use PPE in accordance with the training and instruction given;
    • To keep the PPE clean and return it to its place of storage after use; and
    • report any loss or defect immediately to your supervisor

  • Employee Name

  • Date of issue

  • PPE issued

  • What other PPE was issued

  • I confirm that the above PPE has been issued to me and I understand that it is my responsibility to wear it when required. I have been trained in the correct use, storage, cleaning and care of the PPE and also understand that I must report any lost or defective/damaged items immediately to my manager or supervisor who will reissue as applicable.

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.