Title Page

  • Site conducted

  • Conducted on

  • Prepared by

  • Location

  • Department

Pre-Emptive Safety Event

  • Employee Name:

  • What was Observed:

  • Describe Your Observation in Detail

  • Describe What You Did to Improve, Correct or Respond to the Observation

  • Did Your Actions Correct the Observation

  • If No, How do you "Suggest" the Observation be Corrected

  • Employee Signature

  • Supervisors 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.