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Safety Declaration Form for the United Kingdom

Safety Declaration Form Template for England and Wales

A Safety Declaration Form is a legally binding document under English and Welsh law that establishes an individual's acknowledgment and understanding of workplace safety requirements, risks, and procedures. It serves as both a record of safety training completion and a formal commitment to following established safety protocols. The document incorporates requirements from the Health and Safety at Work Act 1974 and related regulations, providing organizations with documentation of their due diligence in safety matters.

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What is a Safety Declaration Form?

The Safety Declaration Form is a critical document used in workplace environments where health and safety considerations are paramount. It is designed to comply with English and Welsh health and safety legislation, particularly the Health and Safety at Work Act 1974 and associated regulations. This document serves multiple purposes: it confirms that workers have received appropriate safety training, understand workplace risks, and agree to follow safety procedures. The form also provides organizations with documented evidence of their compliance with safety regulations and their duty of care to employees.

What sections should be included in a Safety Declaration Form?

1. Personal Information: Individual's details including name, position, employee ID

2. Health and Safety Training Acknowledgment: Confirmation of safety training received

3. Risk Understanding: Declaration of understanding workplace risks

4. Safety Rules Compliance: Agreement to follow safety procedures

5. Emergency Procedures: Confirmation of understanding emergency protocols

6. Signature and Date: Legal confirmation of declarations made

What sections are optional to include in a Safety Declaration Form?

1. Specific Equipment Authorization: Additional section for roles requiring specialized equipment operation and safety protocols

2. Medical Declaration: Declaration of health conditions relevant to workplace safety in high-risk environments

3. Site-Specific Rules: Additional safety requirements specific to particular locations for multi-site operations

What schedules should be included in a Safety Declaration Form?

1. Safety Training Record: Detailed list of completed safety courses and certifications

2. Risk Assessment Summary: Overview of relevant workplace hazards and control measures

3. Emergency Contact Information: List of medical and emergency contact details

4. PPE Requirements List: Detailed list of required personal protective equipment for the specific role

Authors

Alex Denne

Head of Growth (Open Source Law) @ Ƶ | 3 x UCL-Certified in Contract Law & Drafting | 4+ Years Managing 1M+ Legal Documents | Serial Founder & Legal AI Author

Jurisdiction

England and Wales

Publisher

Ƶ

Document Type

Declaration Form

Cost

Free to use
Relevant legal definitions

























Clauses












Industries

Health and Safety at Work etc. Act 1974: The cornerstone of British health and safety law that sets out general duties of employers and employees. This is the primary legislation governing workplace safety in England and Wales.

Management of Health and Safety at Work Regulations 1999: Key regulations that detail requirements for risk assessments and health and safety arrangements in the workplace. Essential for safety declaration compliance.

Data Protection Act 2018 and UK GDPR: Legislation governing the handling of personal information and data protection requirements in safety declarations and related documentation.

Personal Protective Equipment at Work Regulations 1992: Regulations specifying requirements for personal protective equipment in the workplace, including assessment, maintenance, and proper use.

Manual Handling Operations Regulations 1992: Legislation covering the movement of objects by human effort, including risk assessments for lifting, lowering, carrying, pushing, and pulling.

Workplace (Health, Safety and Welfare) Regulations 1992: Regulations governing workplace conditions including ventilation, temperature, lighting, cleanliness, room dimensions, and workstations.

Control of Substances Hazardous to Health Regulations 2002: Known as COSHH, these regulations control exposure to hazardous substances in the workplace through risk assessment and control measures.

Reporting of Injuries, Diseases and Dangerous Occurrences Regulations 2013: Known as RIDDOR, these regulations mandate the reporting of workplace accidents, diseases and dangerous occurrences to the relevant authorities.

Construction (Design and Management) Regulations 2015: Industry-specific regulations for construction projects, defining legal duties for safe operation of construction sites.

Electricity at Work Regulations 1989: Specific regulations governing electrical safety in the workplace, including maintenance and safe working practices.

Work at Height Regulations 2005: Regulations covering all work activities where there is a risk of falling from height, including requirements for planning, supervision and safety equipment.

Teams

Employer, Employee, Start Date, Job Title, Department, Location, Probationary Period, Notice Period, Salary, Overtime, Vacation Pay, Statutory Holidays, Benefits, Bonus, Expenses, Working Hours, Rest Breaks,  Leaves of Absence, Confidentiality, Intellectual Property, Non-Solicitation, Non-Competition, Code of Conduct, Termination,  Severance Pay, Governing Law, Entire Agreemen

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