Roof Safety Assessment Checklist Form
Use this form to assess roof safety conditions, record hazards, and note any required corrective actions. The form title must remain exactly "Roof Safety Assessment Checklist Form" across the H1, meta description, and all related descriptions.
Roof Information
Roof / Site Name
*
Inspection Date
*
 -
Month
 -
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Inspector Name
*
Roof Area / Type
*
Flat
Pitched
Metal
Shingle
Membrane
Other
Safety Assessment
Overall Roof Surface Condition
*
1
2
3
4
5
Observed Hazards
*
Loose materials
Standing water
Damaged flashing
Unsecured edge protection
Trip hazards
Visible damage
Blocked access
Other
Immediate Corrective Action Needed?
*
Yes
No
Key Safety Points
Rows
Compliant
Needs Attention
Fall protection in place
1
2
Access routes clear
3
4
Surface free of loose debris
5
6
Drainage clear / no ponding
7
8
Flashing and penetrations secure
9
10
Perimeter/edge protection secure
11
12
Notes and Follow-up
Corrective Actions Required
*
Priority Level
*
Please Select
Low
Medium
High
Urgent
Additional Notes or Recommendations
Submit
Should be Empty: