Title Page

  • Document No.

  • Worker / Inductee (Full Name)

  • Inducted By (Full Name)

  • Conducted on

Induction

  • Each of the following elements of the company Health and Safety Management Plan (HSMP) must be explained to the worker in a way that he/she understands. As each item is completed, simply check the box to indicate it has been explained and understood.

  • I know where to find the company HSMP (stored in Google Drive).

  • I understand the key terms used in the HSMP, such as PCBU, officer, worker, and reasonably practicable.

  • I have read an understood the company health and safety policy statement.

  • I understand that the HSMP is reviewed at least annually and that as a worker I am expected to actively participate in the review process by offering my feedback and ideas.

  • I know the roles and responsibilities of the PCBU, officers, management and workers, including my individual health and safety responsibilities. I know that my performance review will include an assessment of my performance against these responsibilities.

  • I understand that my training and supervision needs will be assessed based on my role, qualifications and previous experience. I know that this information will be kept in the Training Register and individual records held on my employee file.

  • I understand that I am only permitted to conduct work that the company has deemed me sufficiently trained, experienced and competent to perform independently, unless I am directly supervised for the purposes of training.

  • I understand that a training plan will be developed to ensure I gain the necessary skills to perform my work safely, and agree to adhere to the training and supervision requirements as set out in my individual training record.

  • I know how to access the health and safety information library (Google Drive).

  • The processes for worker engagement, participation and representation have been explained to me and I know how I can participate in health and safety at work.

  • I understand the company processes for identifying hazards, selecting controls and assessing risk.

  • I have reviewed and understood the company risk register.

  • I understand that I must report new hazards and how to report them (iAuditor).

  • I understand that workplace exposure monitoring and individual health monitoring may be required to ensure health risks are known and effectively managed.

  • I understand the company procedures for the management of hazardous substances, including hazardous products, asbestos, soil contaminants and environmental risks.

  • I know where to find the hazardous substances register and product safety data sheets (SDS).

  • I know where to find the hazardous substances register and product safety data sheets (SDS).

  • I understand the on site and regular procedures.

  • I know that it is important that I report all incidents, including near misses, so that we can learn from them. I know how to report incidents.

  • I understand the company procedures for investigating incidents.

  • I understand the company procedures for rehabilitation and return to work.

  • I understand the company procedures for emergencies and have read and understood the emergency response and evacuation procedures.

  • I understand that I must participate in emergency response drills and trial evacuations as required.

  • I know where to find emergency provisions such as first aid supplies, fire extinguishers and spill kits.

  • I understand that it is important that I inform the company of current emergency contact details to be kept in my personnel file.

  • I understand that health and safety data is collected and analysed to monitor performance, identify areas requiring improvement and inform decision making.

  • By signing this induction record you agree that the company health and safety expectations and procedures have been explained to you and understood, and that you will work in accordance with them.

  • Worker Signature

  • TDE Representative 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.