Site Induction Form

Please complete this induction form before attending or commencing any work activities on site.

This form records that you have received and understood the relevant project health, safety, environmental and welfare information in accordance with the Construction Design and Management Regulations 2015 and site rules.

All workers, subcontractors, temporary workers and visitors must complete this induction before arriving on site.

If you experience any issues completing this form, please contact pd@evolutionsafetysolutions.co.uk.

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1. Personal Information

Full Name

Email Address

Mobile Telephone Number

Home Address

Date of Birth

Nationality

National Insurance Number

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2. Employment Information

Employer / Company Name

Your Job Role / Trade

—Please choose an option—Site ManagerSupervisorLabourerGroundworkerBricklayerJoiner / CarpenterElectricianPlumberRooferSteel ErectorDrylinerPainter & DecoratorPlant OperatorScaffolderDemolition OperativeM&E EngineerSurveyorArchitectEngineerVisitorCleanerDelivery DriverOther

If Other, Please Provide Details

Line Manager / Supervisor

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3. Project Information

Project Title

Project Address

Induction Completion Date

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4. Competency & Training Information

Please provide details of your competency cards, qualifications and relevant training.

Do You Hold a Valid CSCS / CPCS / NPORS / ECS Card?

—Please choose an option—YesNo

Card Type & Registration Number

Card Expiry Date

Relevant Qualifications & Training

Please include trade qualifications, plant training, PASMA, IPAF, asbestos awareness, first aid or other relevant training.

Have You Received Asbestos Awareness Training?

—Please choose an option—YesNo

Have You Received Manual Handling Training?

—Please choose an option—YesNo

Have You Received Working at Height Training?

—Please choose an option—YesNoN/A

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5. Medical Information

Please provide details of any medical conditions, allergies or medication which could affect your safety or emergency response arrangements whilst on site.

Medical Conditions / Allergies / Medication

Do You Require Any Reasonable Adjustments?

—Please choose an option—YesNo

If Yes, Please Provide Details

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6. Emergency Contact Information

Emergency Contact Name

Relationship to You

Emergency Contact Telephone Number

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7. Site Rules & Safety Information

Please confirm you have read, understood and will comply with the following site rules and safety arrangements.

Site Access & Egress Arrangements UnderstoodWelfare Facilities ExplainedEmergency Procedures UnderstoodFire Procedures UnderstoodFirst Aid Arrangements UnderstoodAccident & Near Miss Reporting Procedures UnderstoodPPE Requirements UnderstoodSite Traffic Management Rules UnderstoodRestricted Areas ExplainedAsbestos Procedures ExplainedEnvironmental Requirements ExplainedPermit to Work Requirements UnderstoodRAMS Requirements ExplainedHousekeeping Standards UnderstoodDrugs & Alcohol Policy UnderstoodSmoking / Vaping Rules Understood

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8. PPE Confirmation

Please confirm the PPE you have available and will use whilst on site.

Safety HelmetSafety FootwearHi-Visibility ClothingSafety GlovesEye ProtectionHearing ProtectionRespiratory ProtectionHarness / Fall ProtectionTask Specific PPEOther

If Other, Please Provide Details

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9. RAMS & Work Documentation

Have Suitable RAMS Been Provided for Your Work Activities?

—Please choose an option—YesNoN/A

Have You Read and Understood the RAMS?

—Please choose an option—YesNoN/A

Additional RAMS / Documentation Notes

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10. Vehicle & Plant Information

Will You Be Operating Plant or Vehicles on Site?

—Please choose an option—YesNo

If Yes, Please Provide Details

Vehicle Registration Number

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11. Competency Cards, Qualifications & Supporting Documents

Please upload copies of all relevant competency cards, qualifications, training certificates and supporting documentation relevant to the role being undertaken on site.

This must include a valid CSCS, CPCS, NPORS, ECS or equivalent competency card where applicable for the work activities being carried out.

Failure to provide suitable evidence of competence may result in refusal of site access.

Please upload clear copies or photographs of the following where applicable:

• CSCS / CPCS / NPORS / ECS Cards
• Trade Qualifications
• Plant Competency Certificates
• PASMA / IPAF Certificates
• Asbestos Awareness Training
• Working at Height Training
• Manual Handling Training
• Face Fit Certificates
• First Aid Certificates
• Other Relevant Competence Evidence

Upload CSCS / Competency Cards

Upload Qualifications & Training Certificates

Upload RAMS / Competency Supporting Documents

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12. Worker Declaration

Please confirm the following declarations.

I confirm the information provided is accurateI understand the site rules and emergency proceduresI will comply with site health & safety requirementsI will use suitable PPEI will report unsafe conditions, incidents and near missesI understand I may be removed from site for unsafe behaviour or breaches of site rules

Worker Signature (Type Full Name)

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13. Additional Comments

Additional Comments

Please enter N/A if you have no further comments.