Safety Checklist Form Template

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Permit to Work Safety Checklist

Use our Checklist creator tool to create customised workplace safety documents. Learn more about Permit to Work Safety Checklist Template below
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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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Export to Word

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

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Important: The documents produced by this tool are templates only. They must be reviewed and approved by a competent person or your HSEQ representative prior to publication or circulation, in accordance with our Terms & Conditions.

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Risk Assessment Description:

This permit to work safety checklist template from Health & Safety Zone helps construction managers, supervisors and operatives ensure that all permit‑to‑work processes are carried out safely and in line with legal duties. It covers authorisation, competence, isolation, control measures, hazardous substances, PPE, emergency arrangements and the hand‑over of the permit after work is finished.

The checklist aligns with the Construction (Design and Management) Regulations 2015 and the Management of Health and Safety at Work Regulations 1999, as well as HSE Permit to Work guidance. By ticking each item you confirm that the required risk assessment, isolation plan and competency checks have been completed before work starts, and that the site is made safe before the permit is closed.

Use this checklist for:

  • Pre‑start checks – verify that the permit is valid, scope defined and all isolations are in place.
  • During work monitoring – ensure controls, PPE and emergency provisions remain effective.
  • Post‑work hand‑over – confirm the area is safe, equipment re‑energised correctly and the permit formally closed.

Each question is answered Yes, No or N/A; any No answer must be resolved before work proceeds or the permit is signed off.

Fully editable and shareable — customise the questions to your site, download as a PDF and share with your team.

Compliant with: Construction (Design and Management) Regulations 2015; Management of Health and Safety at Work Regulations 1999; HSE Permit to Work guidance.

Sample PDF Document Image:

Checks covered in this Construction Permit to Work Issuance and Execution checklist

This Construction Permit to Work Issuance and Execution safety checklist template covers 25 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
1Has a valid Permit to Work been issued for the specific task?
2Does the permit clearly define the scope of work and location?
3Is the permit signed by a competent issuer?
4Is the permit signed by the competent receiver/operator?
5Are all isolation requirements identified and documented on the permit?
6Have all energy sources (electrical, hydraulic, pneumatic, mechanical) been isolated as required?
7Is the isolation method verified as safe before work begins?
8Are lockout/tagout procedures applied and verified?
9Are the required control measures (barriers, signage, fire precautions) listed on the permit?
10Has a risk assessment been completed and referenced on the permit?
11Are all personnel involved trained and competent for the task and permit requirements?
12Is appropriate personal protective equipment (PPE) identified on the permit and available?
13Is the work area clear of unrelated personnel and hazards?
14Is site access and egress clear and unobstructed?
15Is adequate lighting provided for the work area?
16Is the weather condition suitable for the work as noted on the permit?
17Are exclusion zones and barriers established and signed as required?
18Are any hazardous substances to be used identified and controlled on the permit?
19Are emergency arrangements (first aid, rescue) documented on the permit?
20Is first aid provision and emergency contact details displayed on site?
21Are fire extinguishers or fire control measures positioned as required?
22Is a method for safe re‑energising recorded for after work completion?
23Has the work been completed as described in the permit?
24Has the site been inspected and made safe before signing off the permit?
25Has the permit been formally closed and returned to the issuer?

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 — a free account is all you need to download.

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?

You can build and preview a checklist without an account. To download the PDF you'll need a free account — it takes less than a minute, costs nothing, and also lets you 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.