PPE issue record form template

5 minute read • 1 December 2024
£ 9
(and you get 12 months access)

Our PPE Issue Record Form template documents the issuance of personal protective equipment, ensuring compliance with safety regulations and employee protection.

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PPE issue record form

Name:  
Department:  

The personal protective equipment (PPE) listed below is issued to you in accordance with the Management of the Health and Safety at Work Regulations 1999 and the Personal Protective Equipment at Work Regulations 1992.

It is your responsibility to:

  • wear and use the provided PPE in the circumstances where a need for it has been identified by the Company and in accordance with the manufacturer's instructions

  • inspect their issued PPE daily before use

  • immediately report any damage or defects to the equipment to the issuer for maintenance or replacement

  • not misuse or damage any PPE provided

  • inform the issuer of any problems in the use of the PPE

PPE issued Issue date (if known) PPE usage training given (where required) Employees Signature
       
       
       
       
       
       
       
       
       
       

It is the Managers/Supervisors responsibility to:

  • ensure that staff are trained in the correct use of PPE, the risks that it protects against, the purpose of the equipment and actions to be taken to ensure that it remains in an efficient state, properly working and in good repair

  • provide adequate storage facilities so that PPE can be kept in an efficient state and will not contaminate employees' personal items

  • replace any damaged or worn PPE where necessary and update the PPE issue record accordingly

  • take all reasonable steps to ensure that issued PPE is properly used

  • monitor use and continued suitability of PPE

Signed (Manager/Supervisor):  
Print name:  
Date:  

Restricted before purchase.

Restricted before purchase.

Version: [1.0]

Issue date: [date]

What is this for?

The PPE Issue Record Form is a tool designed to systematically document the issuance of Personal Protective Equipment (PPE) to employees.

This form captures essential details such as the type of PPE, date of issue, and recipient information.

Its purpose is to maintain an organised record of PPE distribution, ensuring accountability, compliance with safety protocols, and the overall well-being of employees within the workplace.

ppe issue record form template
  • Personal Protective Equipment at Work Regulations 1992: Specifies the legal requirements for the provision and use of PPE in the workplace.

  • Health and Safety at Work Act 1974: Imposes a general duty on employers to ensure the health, safety, and welfare of employees, including the provision and record-keeping of PPE.

  • Management of Health and Safety at Work Regulations 1999: Requires employers to assess and manage risks to employees' health and safety, encompassing the use and documentation of PPE.

  • Equality Act 2010: Ensures that the provision of PPE and associated records are handled without discrimination based on protected characteristics.

  • Data Protection Act 2018 (incorporating GDPR): Mandates the handling of personal data within PPE issue record forms in compliance with data protection principles.

Documentation sequence

Previous
Policies
PPE policy

Our PPE Policy outlines guidelines to safeguard employees, ensuring they have appropriate protective gear for their roles and tasks.

This
PPE issue record form template

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