Fire Safety Induction Form
Complete this form to acknowledge fire safety induction, confirm awareness of emergency procedures, and record basic preparedness for your workplace or site.
Full Name
*
First Name
Last Name
Job Title or Role
*
Department or Work Area
*
Date of Induction
*
 -
Month
 -
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Have you received a fire safety briefing for this site?
*
Yes
No
Are you aware of the location of fire exits and evacuation routes?
*
Yes
No
Are you aware of the location of fire extinguishers and alarms?
*
Yes
No
Who should you contact in case of a fire or emergency?
*
Emergency Contact Name
*
Emergency Contact Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Submit
Should be Empty: