Legal Templates
Safety Declaration Form

Safety Declaration Form for Australia

Safety Declaration Form Template for Australia

A Safety Declaration Form is a legally binding document used in Australian workplaces to formally record an individual's acknowledgment and understanding of workplace safety requirements, risks, and responsibilities. The document complies with the Work Health and Safety Act 2011 and related state-specific legislation, serving as evidence of safety briefing and awareness. It includes declarations about understanding workplace hazards, emergency procedures, safety protocols, and personal protective equipment requirements, while also capturing important personal and workplace information for record-keeping purposes.

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What is a Safety Declaration Form?

The Safety Declaration Form is a fundamental workplace safety document required under Australian workplace health and safety legislation, including the Work Health and Safety Act 2011 and state-specific regulations. This document is typically used when onboarding new employees, contractors, or visitors to a workplace, or when implementing new safety procedures. It serves multiple purposes: documenting an individual's acknowledgment of safety requirements, confirming their understanding of workplace hazards and safety procedures, and providing evidence of safety compliance for audit purposes. The form includes personal information, workplace details, safety acknowledgments, and specific declarations regarding understanding of safety procedures and requirements. It plays a crucial role in risk management and legal compliance, while also promoting a safety-first culture in Australian workplaces.

What sections should be included in a Safety Declaration Form?

1. Declarant Details: Personal information of the person making the declaration, including full name, position, and contact details

2. Workplace Information: Details of the workplace or site to which the declaration applies

3. Health and Safety Acknowledgment: Statement acknowledging understanding of workplace health and safety policies and procedures

4. Safety Responsibilities: Declaration of understanding personal responsibilities regarding workplace safety

5. Risk Awareness: Acknowledgment of workplace hazards and risks specific to the role or site

6. Emergency Procedures: Confirmation of understanding emergency protocols and procedures

7. Incident Reporting: Acknowledgment of incident reporting requirements and procedures

8. PPE Requirements: Declaration of understanding and compliance with Personal Protective Equipment requirements

9. Training Confirmation: Confirmation of safety training completion and currency

10. Declaration and Signature: Formal declaration of truth and accuracy, with signature block and date

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

1. Medical Information: Optional section for declaring relevant medical conditions that might affect workplace safety

2. Specific Competencies: Section for declaring specific safety-related competencies or licenses for specialized roles

3. Vehicle Operation: For workplaces requiring operation of vehicles or machinery, declaration of licenses and competencies

4. Working at Heights: Additional declarations for roles involving working at heights

5. Confined Spaces: Specific declarations for work in confined spaces

6. Hazardous Materials: Declarations related to handling hazardous materials

7. Remote Work: Additional safety declarations for remote or isolated work situations

What schedules should be included in a Safety Declaration Form?

1. Schedule A - Site-Specific Hazards: List of specific hazards identified at the workplace or site

2. Schedule B - Emergency Contacts: List of emergency contacts and procedures specific to the workplace

3. Schedule C - PPE Requirements: Detailed list of required Personal Protective Equipment for different activities

4. Appendix 1 - Safety Training Matrix: Matrix showing required safety training for different roles and activities

5. Appendix 2 - Incident Reporting Procedures: Detailed procedures for reporting various types of incidents

6. Appendix 3 - Risk Assessment Guidelines: Guidelines for conducting personal risk assessments before tasks

Authors

Alex Denne

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

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Jurisdiction

Australia

Publisher

Genie AI

Document Type

Declaration Form

Sector

Cost

Free to use
Relevant legal definitions
Workplace
Hazard
Risk
PPE (Personal Protective Equipment)
Safety Incident
Near Miss
Emergency Procedure
WHS (Work Health and Safety)
Declarant
Supervisor
Safety Officer
Competent Person
Safe Work Method Statement
Control Measure
High Risk Work
Safety Data Sheet
Notifiable Incident
First Aid Officer
Emergency Response Plan
Designated Work Area
Safety Equipment
Risk Assessment
Safety Protocol
Incident Report
Safety Induction
Site Rules
Critical Safety Information
Safety Representative
Dangerous Goods
Hazardous Substances
Relevant Industries

Construction

Mining

Manufacturing

Healthcare

Transport and Logistics

Agriculture

Energy and Utilities

Education

Retail

Hospitality

Professional Services

Industrial Services

Warehousing

Maritime

Aviation

Relevant Teams

Health and Safety

Operations

Maintenance

Production

Logistics

Field Services

Quality Assurance

Facilities Management

Human Resources

Security

Engineering

Construction

Manufacturing

Warehouse Operations

Relevant Roles

General Manager

Site Supervisor

Safety Manager

Machine Operator

Construction Worker

Maintenance Technician

Project Manager

Factory Worker

Warehouse Staff

Driver

Field Service Technician

Laboratory Technician

Office Administrator

Contractor

Visitor

Apprentice

Tradesperson

Engineer

Site Inspector

Healthcare Worker

Industries
Work Health and Safety Act 2011 (Cth): Primary federal legislation governing workplace health and safety in Australia, setting out the main duties of care for employers and workers
Work Health and Safety Regulations 2011: Detailed regulations supporting the WHS Act, providing specific requirements for workplace safety procedures and declarations
Privacy Act 1988 (Cth): Governs the collection, use, and storage of personal information in safety declarations and related documentation
Safety, Rehabilitation and Compensation Act 1988: Regulates worker's compensation and rehabilitation, relevant for safety declarations and incident reporting
Fair Work Act 2009: Contains provisions relating to workplace rights and safety responsibilities, including the right to a safe workplace
State-specific WHS Laws: Relevant state-based workplace health and safety legislation that may have additional requirements for safety declarations
Industry-Specific Safety Regulations: Depending on the industry, there may be additional safety regulations (e.g., mining, construction, maritime) that affect safety declarations
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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