PPE issue record form template

Purpose of this record

This record confirms the personal protective equipment (PPE) issued to the employee and, where required, the instruction and training provided in its correct use. PPE should only be relied upon where a risk assessment identifies that it is required and other reasonably practicable measures do not adequately control the risk.

The Company will provide suitable PPE where required for the employee's work. PPE will be selected to provide appropriate protection against the identified risks, be suitable for the work being undertaken and, where relevant, be compatible with other PPE being worn.

The PPE requirements should be determined by the relevant risk assessment and may include, for example:

• Head protection – safety helmets, bump caps and other protective headwear.
• Eye and face protection – safety glasses, goggles, face shields and welding visors.
• Hearing protection – ear defenders, earmuffs and earplugs.
• Respiratory protection – disposable respirator masks, reusable respirators, half-mask or full-face respirators and suitable filters.
• Hand protection – protective gloves, cut-resistant gloves, chemical-resistant gloves, heat-resistant gloves and other task-specific gloves.
• Foot protection – safety boots, safety shoes, protective footwear, metatarsal protection and specialist footwear where required.
• Body protection – coveralls, protective clothing, aprons, chemical-resistant clothing, high-visibility clothing and other protective garments.
• Fall protection – safety harnesses, lanyards and other fall-arrest or restraint equipment where required.
• Other specialist PPE – task-specific equipment identified through risk assessment, such as welding protection, chainsaw protective clothing or specialist respiratory equipment.

Employee responsibilities

By signing this record, the employee confirms that they understand their responsibilities in relation to the PPE issued to them. Employees must:

• wear and use the PPE provided whenever required by the relevant risk assessment, safe system of work, Company instruction or manufacturer's guidance;
• use PPE only for the purpose for which it has been provided and in accordance with any instructions or training given;
• inspect PPE before use and, where appropriate, carry out any required checks during use;
• take reasonable care of issued PPE and not intentionally misuse, damage or alter it;
• report any loss, damage, defect, contamination or deterioration of PPE as soon as reasonably practicable;
• report any difficulty, discomfort or other problem