You are required to complete this induction prior to working on site. You only need to complete it once for this site.

Site Supervisor (required) *

Date of Entry *

Time of Entry *

Hours

Minutes

Contact Number (required) *

Enter Job Number or Street Address Here (required) *

Is this a GROUP or INDIVIDUAL induction? (required) *

GroupIndividual

Where a group induction is occuring, what is the name of the person conducting it? (required)

Employer/Company (required) *

Signature (required) *

Do you have a current White Card? (required) *

YesNo

View the site specific Safety Management Plan via the folder link here

I have SWMS in place for undertaking any High Risk Construction Work. (required) *

YesNoIf No, do not start. Contact supervisor Not sure what High Risk Construction Work is?

Please refer to the definitions in this link

I have identified any site specific hazards and have controls in place as required. (required) *

YesNoIf not safe or unsure, do not start. Contact supervisor

I am trained and competent to perform the task required. (required) *

YesNoIf not safe or unsure, do not start. Contact supervisor

I am aware of the site’s emergency procedures? (required) *

YesNoIf no, refer Safety Management Plan, posted information or contact supervisor.

I have access to a first aid kit and a worker trained in first aid? (required) *

YesNoIf no, refer Safety Management Plan, posted information or contact supervisor.

I am aware of any site specific rules / procedures? (required) *

YesNoIf no, refer Safety Management Plan, posted information or contact supervisor

Procedures for reporting incidents, injuries understood? (required) *

YesNoIf no, refer Safety Management Plan, posted information or contact supervisor

I have the correct PPE for undertaking my job? (required) *

YesNoIf not safe or unsure, do not start. Contact supervisor

My tools are tested and tagged, guarded and maintained? (required) *

YesNoIf No, do not use. Make good

Safety Data Sheets are available for hazardous chemicals? (required) *

YesNoIf No, do not use substance. Contact supervisor

I acknowledge that I am not permitted to alter scaffolding > 4.0 M unless certificated. (required) *

YesNoIf scaffold requires altering / not safe, contact supervisor

I am aware of the sites amenities (Toilet, water etc.) (required) *

YesNoIf not safe or unsure, do not start. Contact supervisor

I understand I am responsible for cleaning up my own rubbish & leaving the workplace in a safe condition (required) *

YesNo

All participants are to provide their name, employer / company name and signature.
NOTE: Where more than one person is participating please complete additional signature fields.

Number of signatoriesPlease input number of people needing to sign below

Full Name (required) *

Employer/company (required) *

Signature *

Full Name

Employer/company

Signature

Full Name

Employer/company

Signature

Full Name

Employer/company

Signature

Full Name

Employer/company

Signature

Full Name

Employer/company

Signature

Full Name

Employer/company

Signature

Full Name

Employer/company

Signature

Full Name

Employer/company

Signature

Full Name

Employer/company

Signature

Contractor Induction