SafetyCulture Staff

Safety Observation Form

Safety observation form is used to identify hazards in the workplace. Provide details of the hazard and the appropriate control measure needed. An infograph of hierarchy of controls is included in this template as the safety officer’s reference.

Use this Template

Print as PDF

Use this Template

Go digital today!

Convert your paper checklists into digital forms

Scan this QR code to use this paper checklist on your smartphone or tablet or visit https://safetyculture.com/

Title Page

Company
Name of Inspector
Conducted on
Location

Hazards and Risks

Spotted a hazard? Click “Add”
Description of identified hazard
Select control needed
- PPE
- Administrative
- Engineering
- Substitution
- Elimination
- Other
Details of control measure
Hierarchy of Controls reference

Completion

Additional recommendation
Full Name & Signature of Inspector

SafetyCulture Staff

Safety Observation Form

Use this Template

Print as PDF

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.