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Use this Template

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Information

Client / Site
Conducted on
Prepared by
Location
Personnel

Can I be injured by being caught in, on or between anything
Can I strain or over exert myself?
Can I fall into, onto or from anything?
Can I slip or trip on anything?
Can I come into contact with or be exposed to somethibg that may harm me? (electricity, heat, gas, hazardous substances or stored energy?
Can I be struck by a moving object?
Does anything need to be isolated and tested for dead?
Can something fall on me or can I cause something to fall onto someone else?
Can I be injured by nearby activities or can my activities injure others nearby?

Take5

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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.