Lawn Mower Safety Assessment
Evaluate operator readiness, equipment condition, and adherence to lawn mower safety procedures.
Operator Full Name
*
First Name
Last Name
Operator Email Address
*
example@example.com
Contact Phone Number
Please enter a valid phone number.
Format: (000) 000-0000.
Date of Assessment
*
 -
Month
 -
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Operator Experience Level
*
Beginner
Intermediate
Advanced
Pre-Operation Equipment Inspection Checklist
*
Rows
Pass
Fail
N/A
Blades are sharp and securely fastened
1
2
3
Safety guards/shields in place
4
5
6
Oil and fuel levels checked
7
8
9
Tires/wheels in good condition
10
11
12
Cables and controls working properly
13
14
15
Which of the following safety gear do you wear while mowing? (Select all that apply)
*
Protective eyewear
Hearing protection
Sturdy footwear
Gloves
Long pants
Other
How confident are you in your knowledge of lawn mower safety procedures?
*
Not confident
1
2
3
4
Very confident
5
1 is Not confident, 5 is Very confident
Have you ever been involved in or witnessed a lawn mower-related incident or near-miss?
*
Yes
No
If yes, please describe the incident or near-miss (optional)
Additional Comments or Suggestions for Improving Safety (optional)
Submit Assessment
Should be Empty: