MEWP Training Assessment Form

MEWP Training Assessment Form
Use this form to assess MEWP training knowledge, practical competence, and readiness to operate mobile elevating work platforms safely.
Candidate Information
Full Name
First NameMiddle NameLast Name
Job Title / Role
Company / Department
Training Date
MonthDayYear
Date
Assessment Date
MonthDayYear
Date
Location / Site
Contact Email
example@example.com
Training Background
MEWP types previously trained on
Other
Years of MEWP operating experience
Months of MEWP operating experience
Have you completed formal MEWP training before?
Date of most recent MEWP training
MonthDayYear
Date
Prior MEWP incident or near-miss history
Knowledge Assessment
Which of the following is the most appropriate pre-use inspection practice for a MEWP?
Other
How would you rate your understanding of hazard identification when operating a MEWP?

1
2
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9
10
1 is Limited, 10 is Excellent

Select the correct safe operating action for each scenario.

Rows	Stop and assess before proceeding	Proceed if the area is controlled	Not a safe action
Operating near overhead power lines
Moving the MEWP on a level surface with the area clear
Using the MEWP with an unstable support surface
Working where pedestrians are separated from the work area

What is the correct first action if a MEWP becomes stuck aloft and the operator cannot descend normally?
Other
Which statement best describes fall protection requirements while working in a MEWP?
Other
What is the safest approach to load limits and platform capacity?
Other
Which site hazard controls should be confirmed before MEWP operation?
Other
Which action best supports safe operation when conditions change during the task?
Other
Practical Competence Evaluation
Pre-operation checks

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9
10
1 is Needs Improvement, 10 is Excellent
Mounting and dismounting

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9
10
1 is Needs Improvement, 10 is Excellent
Controls familiarity

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9
10
1 is Needs Improvement, 10 is Excellent
Maneuvering

1
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7
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9
10
1 is Needs Improvement, 10 is Excellent
Working at height

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10
1 is Needs Improvement, 10 is Excellent
Platform positioning

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8
9
10
1 is Needs Improvement, 10 is Excellent
Communication and signaling

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10
1 is Needs Improvement, 10 is Excellent
Shutdown and storage procedures

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10
1 is Needs Improvement, 10 is Excellent
Assessment Outcome
Final Assessment Result
Reason or Next Steps
Overall Competency Level

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10
1 is Needs Significant Improvement, 10 is Fully Competent
Recommended Retraining Topics
Other
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