LEARNER HEALTH & SAFETY IN THE WORKPLACE LEARNER HEALTH AND SAFETYFirst NameLast NameAchievement Training Tutor Name:AddressAddress Line 1Address Line 2CityPostcode Employer's nameHas your employer completed a Health & Safety induction and risk assessment with you? Yes NoComments (e.g. date, name of assessor, etc.)Did the induction take into account your age and experience and do you now feel that you have a good understanding of any risks in your workplace? YesPlease note: If you do not believe you have a full understanding of the risks that apply to you in your workplace you will not be able to complete this form. All Health and Safety training should be carried out during the initial period of your employment. Please speak to your employer regarding any risks you are not aware of and then re-attempt this form.Comments Is your employer aware of any special needs you have, such as any disability or health condition? Yes NoCommentsFollowing the induction, are there any restrictions on your normal work? These could include areas where you cannot go, equipment you should not use or procedures you should not carry out without supervision or further training.If there are restrictions for health and safety reasons, is your supervisor aware of them? Yes NoCommentsDo you know who is responsible for you when you are at work? Yes NoWhat is their name?Do you know if your employer will be giving you any further instruction or ongoing training on health and safety matters? Yes NoComments If you need protective clothing or equipment for your job, has this been supplied and have you been shown how to use it properly? Yes NoCommentsHas your employer informed you about the legal requirement of normal working hours? Yes NoCommentsLearner Signature Sign Here DateSubmit Form
