Manual Handling Competency Assessment Form
Assess and document manual handling competence for workplace safety and compliance.
Participant Full Name
*
First Name
Last Name
Assessment Date
*
 -
Month
 -
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Department/Job Role
*
Assessor's Name
*
First Name
Last Name
Has the participant completed manual handling training in the past 12 months?
*
Yes
No
Rate the participant's understanding of safe manual handling principles
*
1
2
3
4
5
Select the correct steps for safe lifting (choose all that apply)
*
Assess the load
Bend your knees
Keep back straight
Twist while lifting
Hold load close to body
Other
Manual Handling Practical Assessment
*
Rows
Not Demonstrated
Partially Demonstrated
Fully Demonstrated
Assessed load and environment
1
2
3
Used correct lifting technique
4
5
6
Maintained neutral spine
7
8
9
Communicated with team (if applicable)
10
11
12
Overall Assessment Result
*
Competent
Not Yet Competent
Assessor's Comments/Recommendations
Submit Assessment
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