Special Resources » Forms: Environmental Health & Safety


Download forms for workplace safety and health. Examples: job hazard analysis forms, confined entry permit form, TRI forms, building evacuation plan form, JCAHO medical errors reporting form, ergonomics cost / benefit form, etc.

The following is the collection of special resources throughout the library. Click on main category / sub-category for that section of the library OR Click on resource title for immediate access to the resource.
Chemicals » Asbestos
Asbestos control programs, health effects, abatement, technical resources, etc.

Asbestos Management Plan [pdf] [2658] ?

Text of an asbestos safety program

Chemicals » Carcinogens
Environmental and workplace chemicals that are known or suspected carcinogens

SOP for Safe Handling of Carcinogenic Materials [pdf] [6656] ?

A fill-in-the-blank form outlines the standard operating procedure for carcinogens and highly toxic materials

Chemicals » Safety Guides
Chemical safety guidelines, NIOSH Pocket Guide, workplace guides

Disasters » Checklists
Emergency preparedness checklists, bomb threat checklists

Disaster Planning Checklists [37776] ?

How prepared is your business for a disaster

EAP - Emergency Action Plan Checklist [pdf] [40570] ?

Useful for EAP planning

Disasters » Emergency Plans
Examples of emergency management and action plans

School Emergency Preparedness Plan & Forms [8864] ?

Model program can be adapted to the needs of your site

Disasters » Health Services
Emergency plans and disaster guidance for health care facilities

Decontamination Self-Assessment Tool for Hospitals [30050] ?

A means of evaluating decontamination plans and capabilities

Healthcare Emergency Management [30048] ?

Focus is on California hospitals

Hospital Crisis Care [pdf] [30047] ?

Guidance that health officials can use to establish and implement standards of care during disasters

Hospital Disaster Preparedness Guidelines [30051] ?

Focus is on California hospitals

Hospital Hazard Vulnerability Analysis Tool [30054] ?

Recognizing hazards that may affect demand for the hospitals services

Hospital Treatment Guidelines - Terrorism Agents [pdf] [30052] ?

Treament guidelines for hospitals and clinicians on terrorism agents

Mass Casualty Care Strategy for Biological Terrorism Incidents [pdf] [30049] ?

An approach to disaster medical response with mass casualties

Mass Medical Care with Scarce Resources [30053] ?

A planning guide - strategies

Environment » Reports
White papers, studies, reports, projects on environmental topics

Global Reporting Initiative Guidelines [12940] ?

The G3 Guidelines for Corporate Environmental Reporting

Environment » Software
Download software for EPA safety & health programs, site-specific sampling

Right-To-Know Application [3652] ?

Toxics Release Inventory Mobile application to locate industrial facilities releasing toxic chemicals

Environment » TRI
EPA Toxic Release Inventory (TRI) forms, reports, data

TRI Reporting Forms and Reporting Requirements [13596] ?

Download reporting forms and instructions

TRI-MEweb [3653] ?

Enables facilities to file a paperless TRI report

Ergonomics » Checklists
Checklists designed to evaluate proper ergonomic workstation arrangements

Computer Workstation Assessment Form [pdf] [36130] ?

An ergonomics checklist for computer work

Driving Ergonomics Checklist [36127] ?

Ergonomics assessment for analyzing driver ergonomics

Ergonomics Resources [25107] ?

Ergonomics tools, data and documents for ergonomist use in workplace task analyses

Individual Computer Workstation Evaluation Form [doc] [36733] ?

Clerical Workstation Ergonomic Evaluation

Lab Workstation Ergonomics Checklist [40573] ?

For laboratory workers

Microscope Use Checklist [26812] ?

An ergonomics checklist

Performance Oriented Ergonomic Checklist For Computer (VDT) Workstations [19238] ?

Designed to help you to evaluate what is needed for a good ergonomic workstation arrangement

United Kingdom: Sample Ergonomics Checklists [23712] ?

A series of ergonomics checklists and forms

Ergonomics » Computers
Computer use hazards and guidelines

Ergonomic Keyboard & Mouse Platform Systems Evaluation Form [19241] ?

Worksheet to help you gather information on the quality of keyboard & mouse platforms being assessed

Ergonomics » Management
Role of management in ergonomics, cost of injuries, cost/benefits, etc.

Ergonomic Cost-Justification Worksheets [19239] ?

Helps you to calculate a return-on-investment (ROI) for an ergonomics intervention

Ergonomics » Symptom Surveys
Ergonomics medical symptom survey questionnaires

Ergonomics Evaluation Form [148] ?

Employee checklist for medical symptoms from computer workstations

Sample Worker Ergonomics Symptoms Questionnaire [19244] ?

Questions use a five point or ten point scale

Fleet » Fleet Policies
Sample fleet-related company policies - vehicle use, drivers, seat belts, etc.

Central Fleet Administration Forms [23620] ?

Sample forms to be used in fleet administration

VA-Virginia Office of Fleet Management Services [19671] ?

Fleet rules and regulations for state agencies in Virginia

Fleet » Hazmat
DOT hazardous materials regulations, guides & reference materials

DOT Hazardous Materials Library [3570] ?

Documents from the Office of Hazardous Materials

Fleet » Maintenance
Guidance & checklists for vehicle preventive maintenance procedures

Light Vehicle Preventive Maintenance Checklists [21059] ?

Series of service checklists based on mileage

Truck Preventive Maintenance Schedule [21060] ?

Series of service checklists based on hours of use

Fleet » MVR
Guidance on driver selection criteria, what to look for in an MVR

NC-North Carolina Forms for Driver License [15893] ?

Driver release forms

OH-Ohio Driving Records [15877] ?

Forms for ordering MVR records in Ohio - consent forms, etc.

Fleet » Safety Programs
Articles, topics and tips related to fleet safety programs

FMCSA Motor Carrier and Highway Safety Forms [5733] ?

Various forms to help motor carriers achieve compliance

Health » Accreditation
Organizations & their procedures for accreditation of health care facilities

JCAHO Mock Audit Tools [22282] ?

Environment of Care JACHO Walkthrough Assessment audit

Health » Poison Control

Poison Lookout Checklist [pdf] [26904] ?

Designed for poison control within the home

Industrial Hygiene » Biosafety
Full text bloodborne pathogens programs and technical resources

Bloodborne Pathogens Reference and Training Manual [5457] ?

Workers tutorial with test and training forms on bloodborne pathogens

Industrial Hygiene » Confined Spaces
Technical resources related to confined space requirements

Confined Space Entry Program [pdf] [2744] ?

Example of safe work practice policies

Confined Space Program [pdf] [23325] ?

A sample draft written program

Confined Space Sample Entry Permit Forms [pdf] [22364] ?

Sample forms for a confined space entry program

Industrial Hygiene » Indoor Air
IAQ guides, checklists, fact sheets, sick building syndrome & more

IAQ Initial Assessment Form [36717] ?

A sample form for conducting an initial assessment of a potential indoor air quality problem

Industrial Hygiene » Labs
Chemical Hygiene Plans, standard operating procedures, lab safety programs, etc.

Controlled Substances Use in Research [16867] ?

Conducting research using controlled substances - forms, policies, regulations, etc.

Lab Safety Guidelines [26997] ?

Sample safety checklist for laboratories

Laboratory Safety Self-Inspections [904] ?

Chemistry lab safety inspection form and checklist

Industrial Hygiene » Noise
Hearing conservation programs, acoustics, hearing protection devices, etc.

Sound Level Survey Form [pdf] [31762] ?

A sample form for workplace sound level testing

Industrial Hygiene » Radiation
Radiation control programs, technical manuals, tutorials and more

Radiation Safety New Worker Form [pdf] [902] ?

Sample radiation safety form

Industrial Hygiene » Respirators
Respirator fit, full text of respiratory programs, etc.

OSHA Respiratory Standard; Medical Evaluation Questionnaire [7917] ?

OSHA requires the employee to fill out a medical questionnaire - sample template provided

Respiratory Protection Program [23323] ?

Includes sample forms & safety SOP's

Industrial Hygiene » Sampling
Technical guides on industrial hygiene air & noise sampling, monitoring, etc

IH Exposure Assessment Strategies [5897] ?

The steps in an industrial hygiene assessment model

OSHA » Process Safety
OSHA technical resources on process safety management

PSM Program Review Checklist [pdf] [32312] ?

Help determine employer compliance with the OSHA PSM standard

OSHA » Publications
OSHA fact Sheets, publications, online documents

OSHA Publications [2123] ?

Large variety of OSHA documents, fact sheets and forms

OSHA » Recordkeeping
OSHA recordkeeping guidelines, standards, fact sheets, etc.

Cal/OSHA Forms 300, 300A, 301 [8134] ?

Download the injury and illness forms

MI-Michigan MIOSHA Recording and Reporting Requirements [3937] ?

How to complete MIOSHA forms 300, 300A and 301

OR-OSHA Recordkeeping [7915] ?

Everything you need for OSHA recordkeeping in the State of Oregon

OSHA Forms [3548] ?

Download federal OSHA forms

OSHA » Safety Programs
OSHA technical resources on safety programs, including motor vehicle safety

OSHA Small Business Handbook [pdf] [27022] ?

Covers a wide variety of workplace safety program topics including self-inspections

OSHA » Violence
OSHA technical resources on violence in the workplace

Workplace Violence Prevention Guide [pdf] [9665] ?

A guide for employers

Property » Boilers
Boiler and pressure vessel safety materials

Sample Boiler Checklists, Logs, Informational Articles [35120] ?

Created by State government agencies responsible for boilers and pressure vessels

Property » Checklists
Fire safety inspection checklists

FHA Property Inspection Checklist [35445] ?

Minimum FHA property requirements

Fire Alarm sytem Inspection, Testing and Maintenance [35119] ?

Procedures for Inspecting, Testing, Maintaining Fire Alarm, Fire Sprinkler, and Smoke Management Systems

Workplace Fire Safety Checklist [26889] ?

For a fire safe workplace check these items routinely

Property » Sprinklers
Technical resources on fire sprinklers, halon, fire protection engineering

Sample Sprinkler Test Log [pdf] [21536] ?

Download a sample sprinkler test log

Property » Winter
Winter property protection precautions

Winter Preparation Facility Advice [pdf] [27179] ?

Protecting your facilities from winter storms

Regulations » Biosafety
Full text of biosafety standards, manuals and guidelines for US federal laws

Importation Permits for Etiologic Agents [1427] ?

Application forms and instructions to apply for importation permits for etiologic agents

Risk Mgt » Forms
Library of forms used by the risk management department, sample RFPs

General Contractor Safety Audit Form [pdf] [25620] ?

Form for the contractor to complete about jobsite safety program requirements

Safety » Boating-Marine
Resources on boating and marine safety

Vessel Safety Check (VSC) [pdf] [29073] ?

Checklist to be completed by a US Coast Guard approved Vessel Examiner

Safety » Construction
Workplace safety and health resources for construction hazards

Construction Jobsite Loss Control Survey [26060] ?

Checklist of safety items that should be observed at construction job sites

Daily Pre-Job Safety Briefing Form [pdf] [20616] ?

Includes a job/hazard assessment section

Safety » Cranes-Hoists
Crane and hoist safety program materials

Climbing Frame Inspection Form [pdf] [40428] ?

A sample checklist

Manlift Pre-Use Inspection Form [pdf] [30240] ?

To be used prior to use

Overhead Crane Pre-Use Inspection Checklist [pdf] [30239] ?

To be used prior to use

Safety » Equipment
Safety materials on industrial robots, woodworking machinery, machine shops, etc

Advantages and Disadvantages of Automating with Industrial Robots [27053] ?

How to choose the right industrial robot

Daily Inspection Report: Front End Wheel Loader [pdf] [28991] ?

Sample checklist and form

Safety Inspection Report: Bucket Truck (Cherry Picker) [pdf] [28986] ?

Sample checklist and form

Safety » Excavations
Resources on excavation and trenching safety requirements

Trenching & Excavation Competent Person Checklist [30214] ?

To evaluate the competent person within the scope of the excavation and trenching standard

Trenching & Excavation Operations Checklists [30215] ?

Guidelines and sample checklists

Safety » Fall Protection
Falls from elevations and fall protection safety resources

Fall-Arrest System Checklist [pdf] [30217] ?

To be used at the jobsite

Ontario, Canada: Work at Height Checklist [pdf] [40134] ?

For tasks above 5 feet (1.5m)

Safety » Forklifts
Forklift safety program materials

Forklift Safety Checklist [pdf] [35801] ?

Example of a forklift operator's daily safety inspection check-off list

Forklift Safety Program [pdf] [23322] ?

Text of a safety program for forklifts includes forklift safety forms

Safety » Ladders-Platforms
Ladder and work platform safety

Portable Ladder Safety Checklist [27058] ?

Checklist for portable ladder safety

Safety » Medical Devices
FDA regulatory guidance for manufacturers of medical devices

Can Inspection Time Be Reduced?: Developing a HACCP Plan [25397] ?

The experience of a medical device company

Safety » Office Safety
Checklists, office safety programs, training materials, home offices, etc.

Office Safety Analysis [18951] ?

Office general safe work practices

Safety » Playgrounds
Playground safety information

Playground Inspections [17606] ?

Worksheets, forms, checklists, etc. for playground inspections

Playground Recreation Injuries [12517] ?

Legal rights of the injured child

Sample Safety Checklist for Active Play Areas [19571] ?

Checklist for safety equipment and location hazards

Safety » PPE
Workplace Personal Protective Equipment (PPE) Programs

PPE Program Forms [35290] ?

Assessment and documentation forms for personal protective equipment programs

Safety » Sports
Sports injury prevention

Locker Room Safety Checklist [pdf] [15954] ?

Practices for locker room safety

Safety » Swimming
Pool and spa safety - drowning prevention

Scientific Diving Safety [22286] ?

A written manual

Safety » Tools
Safety fact sheets and tips on the safe use of hand and power tools

Abrasive Wheel Equipment Grinders Checklist [39450] ?

A safety checklist for abrasive wheel grinders

Machine Shop Safe Work Practices [26730] ?

Safety guidance

Safety » Welding
Bulletins, guidance on safety in welding

Hot Work Permit Tips [pdf] [3334] ?

Requirements for safe practices

Hot Work Welding and Cutting Safety Policy [19360] ?

Example of a policy in use at a major univeristy

Safety Mgt » Accidents
Accident investigation programs, job safey analyses, etc.

Accident Investigation Report [15580] ?

A sample form

Incident / Hazard Report [doc] [36718] ?

A sample report for internal use only

Job Hazard Analysis FAQ [8334] ?

Basics of job hazard analysis process with sample forms

Supervising Accident Repeaters [18783] ?

Sample guidance

Supervisor's Accident Report [pdf] [26819] ?

A sample form

Safety Mgt » Audits
Regulatory compliance self-inspections, program audits, self-evaluations

Assessing Safety and Health Management Programs [pdf] [23112] ?

Self-management self-assessment

CA-California Safety Program Self Audit [27043] ?

A form to compare your existing safety program to minimum required elements

Contractor Safety Audit [pdf] [30213] ?

A program audit for construction contractors

IIPP Checklist [doc] [36734] ?

Used to audit a California Injury and Illness Prevention Program

Ontario Canada: Workwell Core Health and Safety Audit [pdf] [25105] ?

A manual of instructions on how to conduct a point-assessed safety program audit

Safety and Health Management Program Assessment Worksheet [pdf] [25031] ?

Scoring worksheet for evaluating a worksite safety program

Safety and Health Program Checklist [26551] ?

Analyze how your safety and health program measures up

Safety Inspections - Hazard Assessments [39587] ?

A risk assessment system

Safety Management Evaluation Audit [pdf] [28993] ?

Format for evaluating a company's safety program using a point system

Safety Program Audit Checklist [pdf] [38840] ?

Also includes safety committee self-evaluation materials

Safety Program Evaluation Checklist [16638] ?

Safety program audit checklist used by Cal/OSHA for VPP

Safety Mgt » Bulletins
Safety bulletins & tool box talks for workplace, home, personal & off-the-job

Safety Meeting Outline Topics [1554] ?

Employee training bulletins

Safety Mgt » Checklists
Safety self-inspections, self-evaluation checklists, yes/no questions

Automotive Services Safety Inspection Checklist [pdf] [18877] ?

Download a general safety checklist for automotive services

Chemical Safety Checklists - Laboratories [27877] ?

Use these forms to document periodic lab inspections for safety purposes

First Aid Checklist [26243] ?

Checklist for a comprehensive first aid kit

Garage / Shop Safety Checklist [pdf] [18952] ?

A repair garage / shop safety inspection checklist form

Hazardous Waste Inspection Checklists [29059] ?

Santa Clara, California designed forms

Health Services Inspection Checklists [pdf] [29020] ?

Checklists of potential safety hazards in medical facilities

Ladder Inspection Checklist [26669] ?

General safety checklist for all types of ladders

Manufacturing Facility Safety Analysis [18956] ?

Manufacturing safety checklist

Municipal Maintenance Yard Inspection Checklist [pdf] [18786] ?

Checklist to inspect job yards

NV-Nevada CAPP Element Audit Checklists [16843] ?

For Nevada's Chemical Accident Prevention Program (CAPP) - Program Guidance

Office Safety Analysis [18955] ?

Office safety checklist

Office Safety Inspection Checklist [pdf] [26099] ?

Form designed to be used monthly

Older Consumer Home Safety Checklist [pdf] [27696] ?

Home safety checklist for older consumers

OSHA Construction Safety Checklist [pdf] [27183] ?

Sample job site inspection form to ascertain compliance with OSHA requirements

Safety Checklists [25126] ?

Modify these documents to meet site-specific hazards

Safety Guidelines for the Home Work Space [9145] ?

Sample safety checklist for home-based telecommuters

Safety Inspection Checklists [40796] ?

A variety of safety inspection checklists

Safety Inspection Checklists [27278] ?

Office Safety Checklist, Laboratory Safety Checklist, Shop Safety Checklist

Scaffolding Safety Inspection Checklist [pdf] [35800] ?

An example checklist

Self Inspection Checklists [pdf] [38841] ?

For property, premises liability, workers compensation, auto, etc

Self-Inspection Safety Checklist for Exterior of Facilities [pdf] [31982] ?

For worship centers, schools and related facilities

Tractor/PTO Safety Guidance [16835] ?

Tractor/Power Take Off (PTO) training guidance

Warehouse and Dock Safety Analysis [pdf] [18953] ?

Warehouse safety checklist

Warehouse Workplace Inspection Form [26558] ?

Example of a form

Worker Safety Checklist [40926] ?

A workplace safety inspection checklist

Workplace Housekeeping Checklist [18957] ?

Use the following checklist as a general workplace guide

Safety Mgt » Committees
Safety committees, safety teams, etc.

Best Practice Safety Committees [pdf] [18775] ?

Provides guidance for safety committees

Safety Mgt » Forms
Forms used by safety departments

Accident Investigation Form [pdf] [20126] ?

A sample form in English

Accident Witness Statement [doc] [35939] ?

Sample form to be used by employees who witness accidents on the job

Alternate Entry Procedure/Reclassification Form [doc] [31735] ?

For use for confined spaces requirements

Biosafety Forms [14059] ?

Series of forms used in a biosafety program of a major university

CA-California School IPM Forms [24863] ?

Sample pesticide application warning signs, information sheet for parents, etc.

Campus Safety Forms [14064] ?

Download forms used by the safety department of a major university

Code of Safe Practices - Construction [pdf] [26804] ?

A list of general construction safety rules

Confined Space Entry Permit Form [pdf] [28914] ?

A sample blank entry form on confined space entry

Contractor Safety Assessment Form [pdf] [25311] ?

An example of one firm's safety requirements for construction contractors

Department of Occupational Health & Safety Forms [14061] ?

Download forms in use by a major university

Driver and Risk Management Forms [20918] ?

Includes general incident reports, vehicle use agreement, camp accident form, etc

EHS Forms [24907] ?

Examples of environmental safety and health forms in use at a major university

Employee Health and Safety Attitude Survey [26803] ?

Form to survey employee perceptions of safety at their workplace

Forms for Injury & Illness Prevention Program [14055] ?

Environmental health and safety forms

General Safety Rules [24231] ?

Issued to provide a safe and healthy working environment

Helpful Tools [17436] ?

Sample safety policy statements, program check-up form, sample program for small business, etc.

Incident Reporting Procedures Form [pdf] [22185] ?

Sample form to be used when there are injuries

Industrial Hygiene Forms [26313] ?

IH forms related to air sampling, noise surveys, heat stress and various IH surveys

Job Hazard Analysis [30182] ?

Booklet and sample form

Job Hazard Analysis Form [35293] ?

Includes instructions

Job Hazard Analysis Materials [18782] ?

OSHA materials on the subject

MSHA Forms [28181] ?

Mine Safety and Health Administration - Download the forms and online filing

MSHA Forms & On-Line Filing [8668] ?

Download forms or use on-line

New Employee Safety Orientation Form [pdf] [36750] ?

Example in use at a major university

NH-New Hampshire Safety Summary Form [22508] ?

Annual form that must be filed to the state by January 1 every other year

OSHA Compliance Self-Inspection Checklist [pdf] [35164] ?

A sample checklist

OSHA Online Complaint Form [23931] ?

Notice of Alleged Safety or Health Hazards

OSHA Recordkeeping Forms [21072] ?

Download OSHA 300 forms

OSHA Worker Complaint Form [21073] ?

File a complaint online or download the OSHA complaint form

OSHA-7 Form Notice of Alleged Safety and Health Hazards [pdf] [28177] ?

Download the form and the instructions

Physical Demands Assessment Form [pdf] [25106] ?

Form used to evaluate the physical demands of workplace tasks(pdf)

Radiological Safety Forms [21826] ?

In use by a majory university

Safety Department Forms [25157] ?

Environmental, fire and life, laboratory, occupational, radiation safety forms

Safety Forms [7965] ?

Series of approx 50 safety forms

Safety Forms - Biological Research Lab [14035] ?

Download forms related to biological materials, radioactive materials, & other miscellaneous forms

Safety Forms Index [14038] ?

Forms for biological safety, fire safety, lab safety, radiation safety, etc.

Safety Management Forms [35645] ?

A series of sample safety program forms for audits, meetings, workplace incidents, checklists

Safety Program Forms [22414] ?

Download a variety of safety forms, audits, etc

Sample Confined Space Entry Permits [pdf] [31734] ?

For use for confined spaces requirements

Sample JSA [pdf] [20128] ?

Download sample form for Job Safety Analysis

SDS Form Checklist [pdf] [22042] ?

Minimum Information for a Safety Data Sheet SDS

SOP Development Form for Hazardous Material [doc] [22018] ?

Standard operating procedures guidelines and template for hazardous materials

Student Laboratory Safety Contract [16100] ?

Sample form for students to sign indicating their acceptance of science classroom safety rules

Traffic Crash Report Forms by State [36653] ?

Traffic crash report forms and any code sheets applicable to that state form

Vehicular Accident Investigation Form [26244] ?

Sample form for auto accidents

Safety Mgt » Industries
Safety and health hazards & controls in specific industries

Bakery Operation Safety [29058] ?

Safety advice specific to the bakery industry

Safety Mgt » Injury Codes
Sample injury code tables and related information

Safety Mgt » Safety Programs
Full text of over 30 workplace safety and health programs & manuals

Biological Laboratory Safety Survey Form [doc] [28884] ?

Standardized reporting format for a laboratory safety inspection

Contractor Safety Manual - University [pdf] [22582] ?

Construction safety requirements of a major university

Health and Safety Program Guide [pdf] [24789] ?

Use this guide to create and enhance your safety and health program

Safety / Loss Control Program Materials [15600] ?

Sample safety checklists, forms, programs and manuals

Safety Policies and Procedures [3304] ?

Asbestos, biosafety, committees, occupational health, radiation safety, water quality

Safety Mgt » Software
Download demos and software related to workplace safety

MSHA Online Forms Advisor [10332] ?

Designed to help those involved in the mining industry fulfill their filing requirements

Security » School Security
Guides for schools to prevent violence - checklists, sample policies

School Security Safety Assessment Form [pdf] [22623] ?

Example of an assessment form to ensure a safer school environment

State Government » NH-New Hampshire
Access to state agencies and laws for the state of New Hampshire

Safety Summary Form - New Hampshire [17236] ?

Access to the form required to be filed biennially to the state Department of Labor - New Hampshire



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