Hand-Arm Vibration Monitoring Log Form
Log hand-arm vibration exposure and equipment usage for safety monitoring.
Worker Name
*
First Name
Last Name
Date of Exposure
*
 -
Month
 -
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Work Shift
*
Please Select
Morning
Afternoon
Night
Rotating
Tool/Equipment Used
*
Vibration Exposure Time (minutes)
*
Trigger Time (minutes)
*
Job/Task Description
*
Exposure Points or Total Duration
*
Symptoms or Observations (if any)
Supervisor/Reviewer Notes
Submit Log
Should be Empty: