• Working at Heights Safety Form

    Use this form to record the information needed before working at height, including job details, access equipment, training, site conditions, and safety acknowledgment.

  • Worker and Job Details

  • Date of Work*
     - -
    2 digit month, 2 digit day, 4 digit year
  • Start Time*
  • Expected End Time

  • Height Access and Equipment Information

  • Type of access equipment to be used*
  • Fall protection equipment being used*
  • Has the equipment been inspected before use?*

  • Training, Conditions, and Acknowledgment

  • Current working-at-heights training or qualification status*
  • Site, weather, or environmental hazards affecting the job
  • Format: (000) 000-0000.
  • Should be Empty:
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