Safety Checklist Form Template

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Lone Working Self-Assessment Safety Checklist

Use our Checklist creator tool to create customised workplace safety documents. Learn more about Lone Working Self-Assessment Safety Checklist Template below

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Safety Checklist Creator

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Create a Safety Checklist in 4 Easy Steps: Complete the checklist details below, add or edit the questions, add your logo and sign-off, then export a professional, print-ready PDF with Yes / No / N/A tick-boxes and a comments space.

Checklist Details

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Checklist Questions

Every question is included by default. Untick any you want to leave out, or delete the ones you don't need.

Click Add Question to add your own custom checks. Click a row to edit its wording, and drag to reorder.

The Yes / No / N/A tick-boxes and comments space are added automatically on the exported PDF or Word document.

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Print-ready PDF with Yes / No / N/A tick-boxes and a comments space.

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An editable Word (.doc) version with Yes / No / N/A tick-boxes and a comments space.

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A spreadsheet version for digital tracking and filtering.

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Risk Assessment Description:

This universal checklist assists employers in fulfilling their legal duties for lone workers across all sectors. It aligns with the Management of Health and Safety at Work Regulations 1999 and the HSE lone working guidance (INDG 73), providing a clear framework to identify, assess and control risks when an employee works alone.

It covers the ten safety dimensions required by modern health‑and‑safety management: planning and permits; competence and supervision; work environment and site conditions; task‑specific hazards; plant, equipment and tools; hazardous substances; personal protective equipment; collective safety measures; emergency and welfare provisions; and completion‑record‑keeping. Each dimension is addressed with a closed Yes/No/N/A question to ensure comprehensive risk management. The checklist is designed to be industry‑agnostic, suitable for offices, factories, warehouses, retail outlets and care settings.

Use this checklist to:

Conduct a pre‑task risk assessment for lone‑working activities.
Verify that monitoring, communication and emergency procedures are in place.
Confirm post‑task review, incident recording and site clean‑up.

It should be reviewed regularly and updated whenever work conditions change, new hazards are identified or organisational procedures are revised.

Compliant with: Management of Health and Safety at Work Regulations 1999; HSE lone working guidance (INDG 73); and any relevant sector‑specific standards.

Sample PDF Document Image:

Checks covered in this Lone Working Self-Assessment checklist

This Lone Working Self-Assessment safety checklist template covers 22 checks. Customise the questions to your workplace, then download a professional, print-ready PDF with Yes / No / N/A tick-boxes and a comments space.

#	Checklist item
1	Has a specific risk assessment for lone working been completed and reviewed?
2	Is the lone working activity included in the general workplace risk assessment?
3	Are any necessary permits or authorisations (e.g., hot‑work, confined‑space) obtained before the lone worker starts?
4	Is a method statement or safe system of work for the lone working task documented and approved?
5	Are all lone workers trained and competent to work alone for the tasks they will perform?
6	Has each lone worker received a task‑specific briefing on hazards and controls?
7	Is a designated supervisor or responsible person identified and reachable for the lone worker?
8	Is there a clear system for regular check‑ins or monitoring (e.g., phone, lone‑worker device)?
9	Is the work location free from immediate hazards such as slip, trip or fall risks?
10	Is adequate lighting and ventilation provided for the lone worker’s area?
11	Are environmental conditions (e.g., weather, temperature) suitable for lone work?
12	Are task‑specific hazards (e.g., manual handling, exposure to substances) identified and controlled?
13	Is any equipment or tool to be used by the lone worker inspected, maintained and suitable for solitary use?
14	Are guards, safety devices and interlocks on equipment functional and in place?
15	Are any hazardous substances being used covered by COSHH assessments and safe‑handling procedures?
16	Is appropriate personal protective equipment provided, serviceable and being worn?
17	Is any required respiratory protective equipment face‑fit tested and maintained?
18	Are any collective safety measures such as barriers, signage or exclusion zones in place to protect the lone worker?
19	Are emergency contact details and first‑aid provisions readily available to the lone worker?
20	Has a clear rescue or emergency response plan for lone workers been communicated?
21	Is the completion of the lone‑working task recorded and any incidents logged?
22	Has the work area been left clean, tidy and any temporary controls removed after the task?

Frequently asked questions

Are these safety checklist templates really free to download?

Yes — completely free. Customise any checklist to your workplace and download a professional, print-ready PDF in minutes. No paywall, and no signup required for guests.

What format do the safety checklists download in?

Checklists download as a professional PDF, ready to print and complete on-site — each question has clear Yes / No / N/A tick-boxes and a comments space. You choose portrait or landscape at download. Word and spreadsheet formats are being added.

Can I customise the checklist questions to my workplace?

Yes — fully. Add your own questions, edit or remove any of the pre-written ones, and reorder them to suit your site, task or inspection before you download.

Are the safety checklists suitable for UK workplaces?

Yes. The checklists are written around UK health and safety good practice and HSE guidance, and are suitable for inspections, audits, toolbox checks and routine workplace monitoring.

Do I need an account to use the checklist templates?

No — guests can build and download a checklist for free without signing up. Register a free account if you want to save checklists to your dashboard and edit them later.

Can I add my company logo and branding to the checklist?

Yes — add your company logo, colours and details on Standard and Pro plans, so the exported checklist carries your own branding. Guests and Free downloads carry Health & Safety Zone branding.

How do I complete the checklist once it is downloaded?

The exported checklist is a blank, ready-to-use document: print it and tick Yes, No or N/A against each question and write any comments in the notes space, then sign and date it in the sign-off section.

What types of safety checklist can I create?

We are building specialist checklists across a wide range of subjects and industries — fire safety, workplace inspections, equipment and machinery checks, site inductions, vehicle checks, PPE, first aid and more. Browse by category to find the right one.

How often should safety checklists be completed?

It depends on the activity and your risk assessment — many checks are daily, weekly or monthly, while others are done before each task or shift. Completed, dated checklists provide a useful record of your monitoring.

Are the checklists a substitute for a risk assessment?

No. A checklist is a monitoring and inspection tool that complements your risk assessments and method statements — it helps confirm that controls are in place and working. Use them alongside your risk assessments.