Questionnaire - FasterDraft

Lone Worker Policy

Scope of Policy
- General Information
- Contact Information
- Safety Measures
- Miscellaneous
Complete the Document
- Format & Signatures

General Information

Indicate full name of the employer who adopts this policy:
Provide the employer's business registration number:
Select the date on which this policy is being adopted:

Contact Information

Indicate full name of the supervisor within the organisation responsible for implementation of this policy:
Provide the supervisor's contact working telephone number:
Indicate full name of the health and safety manager within the organisation:

!
If there is no separate position of the Health & Safety manager within your organisation, full name of the HR manager should be provided instead.
Provide the health and safety manager's contact working telephone number:

Safety Measures

Describe in detail the forms and circumstances in which lone working takes place within the organisation:
List the specific activities and tasks that lone workers carry out within the organisation:
List all specific locations where lone working takes place within the organisation:
List all specific hazards that lone workers may face while carrying out their work:
List all high-risk activities that must not be carried out by lone workers within the organisation:

Miscellaneous

List all communication methods and means available to lone workers for maintaining contact with managers and colleagues:
Are lone workers required to follow specific check-in procedures at regular intervals?
- No
- Yes
Specify the regular intervals at which all lone workers must complete their required check-ins:

Do you want to add a signature?
- Yes
- No
Add signature:

Select a template's format:

PDF

DOCX

Back

You can skip answers for the questions.
Skipped answers will appear as blank part in the text of the final document. You can fill them in at later stage.

Back

Skip

You can skip answers for the questions.
Skipped answers will appear as blank part in the text of the final document. You can fill them in at later stage.

General Information

Indicate full name of the employer who adopts this policy:

Provide the employer's business registration number:

Select the date on which this policy is being adopted:

Contact Information

Indicate full name of the supervisor within the organisation responsible for implementation of this policy:

Provide the supervisor's contact working telephone number:

Indicate full name of the health and safety manager within the organisation:

Provide the health and safety manager's contact working telephone number:

Safety Measures

Describe in detail the forms and circumstances in which lone working takes place within the organisation:

List the specific activities and tasks that lone workers carry out within the organisation:

List all specific locations where lone working takes place within the organisation:

List all specific hazards that lone workers may face while carrying out their work:

List all high-risk activities that must not be carried out by lone workers within the organisation:

Miscellaneous

List all communication methods and means available to lone workers for maintaining contact with managers and colleagues:

Are lone workers required to follow specific check-in procedures at regular intervals?

Specify the regular intervals at which all lone workers must complete their required check-ins:

Do you want to add a signature?

Add signature:

Select a template's format: