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Qhse Induction Form

This document is a QHSE (Quality, Health, Safety, and Environment) induction form that outlines 13 safety topics that site visitors and workers must be briefed on. It includes topics such as use of personal protective equipment, safety in lifting operations, electrical safety, hazard identification and reporting, emergency response procedures, fire safety, defensive driving, and more. Workers and visitors must acknowledge receiving instruction on these topics by signing the form along with their instructor.

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CHRISTOPHER WEALTH
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613 views1 page

Qhse Induction Form

This document is a QHSE (Quality, Health, Safety, and Environment) induction form that outlines 13 safety topics that site visitors and workers must be briefed on. It includes topics such as use of personal protective equipment, safety in lifting operations, electrical safety, hazard identification and reporting, emergency response procedures, fire safety, defensive driving, and more. Workers and visitors must acknowledge receiving instruction on these topics by signing the form along with their instructor.

Uploaded by

CHRISTOPHER WEALTH
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd

Doc Ref No.

: CDPNL/HSE-IF/10-01

Issue date: JANUARY 4 2016


QHSE INDUCTION FORM Revision: 0000

S/N RESPONSE
TOPIC CONTENT (If topic discussed is
understood)
Tick
1 Welcome Brief Overview of site
Activities, and company
policies;
2 Use of Personal Protective Equipment Outline minimum
requirements per Task, types
and use of PPE. Importance
of PPE.
3 Safety in Lifting Operations Safe manual lifting posture

4 Electrical Safety & Energy Isolation Use proper electrical


precaution, use and care for
extension cords;
5 Restricted Activities – Smoking, Use of GSM Identify restricted areaswithin
the facility
6 House keeping Introduction to housekeeping,
importance, effect of poor
housekeeping, importance
good housekeeping.
7 Waste Management Types of wastes, effects of waste on
the environment, proper waste
management techniques.
8 Hazard Identification and Reporting Introduction to hazard,
identification, effects, mitigation,
9 Health Awareness and Emergency Response Introduce the Clinic andER
facilities and procedures in place

10 Work Hazard Management PTW System


Onsite Supervision and Control

11 Fire Intro to fire, causes of fire, Fire


Fighting Equipment, triangle of
fire, fire prevention;
12 Community Relations and Management Relate with Supervisors, ifin doubt.

13 Defensive driving Use of seat belt, speed limit, traffic


signs (road signs)
I acknowledge that I have received instructions explaining safe work procedures and practices on the
above listed topics.

Comments:
………………………………………………………………………………………………………
………………………………………………………………………………………………………
………………………………………………………………………………………………………
…………………… …………………………
Inductee Name Inductor Name
Phone Number ………………………………………
…………………… …………………………
Sign/Date Sign/Date

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