Forms/Checklists and Healthcare
Find everything you need, from information on safe handling of chemicals and emergency preparedness, to preventing slips and falls and weather-related precautions. All are downloadable for easy sharing with teammates as you work with Accident Fund to create a culture of safety. Link
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- Certification of Safety-Related PPE
- Declination of Treatment (locked)
- Developing a Safety Program Checklist ADM 6001
- Electrical Grounding Safety Tips
- Employee Accident Investigation Report (locked)
- Employee Report of Injury – form C-64
- Employee Report of Injury – form C-64 No Dependency
- Eye and Face Protection Checklist
- Fire Protection Checklist
- First-Aid Checklist
- Fork Truck Certification Card
- Fork Truck Safety Checklist
- Guide to Building a Safety Program ADM 1100
- Guide to Heat Stress Prevention
- Hazard Communication Checklist
- Housekeeping Checklist
- Incident Investigation Report Form
- Ladder and Scaffold Safety Checklist
- Medical Authorization Report (locked)
- OSHA 300 Log
- Personal Protective Equipment Assessment Worksheet
- Personal Protective Equipment Hazard Assessment Log
- Personal Protective Equipment Hazard Training Certification Log
- Portable Ladder Inspection Checklist
- PPE – Foot Safety Checklist
- PPE – Training Log
- PPE Checklist
- Respirator Checklist
- Respirator Fit Test Worksheet
- S.A.F.E Housekeeping Guide
- Safety Checklist
- Safety Program Checklist
- Sample Company Notice to Physician (locked)
- Slip and Fall Prevention Safety Checklist
- Slips, Trips and Falls Checklist
- Worksafe Checklist ADM 6000
- Your Guide to Building a Return to Work Program