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Health & safety

Permit to Work template

Record the task, hazards, isolations and issue or close-out signatures for controlled work. Use it within your site’s authorised permit procedure; a downloaded sheet is not permission to start a hazardous task.

Blank printable PDF: Classic style with the JobForms badge. No sign-up needed.

What's on this sheet

JobForms

Permit to Work

Blank sheet
Job ref: __________

Job details

Job No.

Short answer

Job type

Choose one

□ Hot work□ Electrical isolation□ Confined space□ Work at height□ Roof access□ General

Client

Short answer

Site details

Site / address

Short answer

Site contact

Short answer

Contact phone

Phone

Permit

Permit no.

Short answer

Work to be done

Notes

Valid from / to

Short answer

Precautions in place

Yes / No / N/A · notes on No

Area isolated / locked off□ Yes　□ No　□ N/A
Risk assessment reviewed□ Yes　□ No　□ N/A
Fire extinguisher at hand□ Yes　□ No　□ N/A
Permit holder briefed□ Yes　□ No　□ N/A
PPE in use□ Yes　□ No　□ N/A
Area barriered / signed□ Yes　□ No　□ N/A

Isolations (what and where)

Notes

Close out

Closing checks

Yes / No / N/A · notes on No

Work complete□ Yes　□ No　□ N/A
Isolations removed□ Yes　□ No　□ N/A
Area left safe and clean□ Yes　□ No　□ N/A
Fire watch done (hot work)□ Yes　□ No　□ N/A

Time on site

Date

Date

Start

Time

Finish

Time

Duration

Visit duration

Sign off

Issued by

Short answer

Issuer signature

Signature

Issuer signature

Accepted by

Short answer

Holder signature

Signature

Holder signature

Closed by

Short answer

Close-out signature

Signature

Close-out signature

Classic printable sheet · Powered by JobForms

Who uses it

Health & Safety teams and UK businesses keeping a clear visit or check record. Simple permit to work: task, hazards, isolations, issue and close-out signatures.

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Common questions

Is this health & safety sheet a certificate?

Tailor the record to the actual task and use your site’s authorised safety procedures. A template does not replace a competent assessment.

Can I print it or fill it on my phone?

Download the blank Classic PDF without signing up, or fill a copy in guest mode on your phone. Photos and signatures are available when filling digitally.

What is included on the Free plan?

Free includes Classic PDFs with the JobForms badge, up to 3 custom templates, 20 jobs per calendar month and 1 shared form. Other PDF styles and custom PDF branding are paid features.

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