Working at Height Drill Form
Complete this form to record all key details of a working-at-height drill, including participants, equipment, hazards, and outcomes.
Drill Date
*
 -
Month
 -
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Drill Location
*
Drill Supervisor Name
*
First Name
Last Name
Participants (List all names)
*
Equipment Used (Select all that apply)
*
Harnesses
Lanyards
Anchorage Connectors
Helmets
Ladders/Scaffolds
Other
Hazards Identified
*
Drill Scenario Description
*
Actions Taken During Drill
*
Drill Outcome/Results
*
Recommendations or Follow-up Actions
Submit
Should be Empty: