Templates

Customizable Microsoft Word examples of checklists, forms, plans, policies and more.

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Occupational health and safety starter kit: template package

BP035TMP

***This resource is current to May 2023.
For information on the latest OHS requirements, visit OHS website.***

This zip folder holds MS Word versions of templates and sample forms from the 'Occupational health and safety starter kit', which employers can adapt them to their organization's needs.

Note that the templates and sample forms are also available individually: see "Related resources" section below.

UPDATED: May 2023

Hazard assessment and control: a handbook for Alberta employers and workers: template package

BP018TMP

This zip package contains a formal hazard assessment and control report template, and a site-specific hazard assessment and control template. If you choose to use these templates, make sure you customize them to your work and work site. (Microsoft Word format.)

UPDATED: October 2023

Emergency response planning: template package

BP040TMP

These are Microsoft Word template versions of the sample forms in the "Emergency response planning: an occupational health and safety tool kit" pdf. Employers can customize these templates to suit their work site.

UPDATED: September 2024

Fuel and convenience store employer guide: template package

BP031TMP

***This resource describes new rules that came into effect in December 2024. Until March 30, 2025, work site parties can follow the new rules or the previous rules. (A resource explaining the previous rules is available here.) Starting on March 31, 2025, work site parties will need to comply with the new rules, which are explained in this resource.***

"This zip folder holds MS Word versions of the four templates from the "Fuel and convenience store employer guide: violence and harassment prevention plan". Employers can customize these templates to their work and work site. Note that the templates are also available individually: see "Related resources" section below.

UPDATED: March 2025

Working on ice: template package

BP043TMP

This zip package contains an ice cover inspection template and an ice cover profile template. Both are intended for use as described in the "Guide for building and working safely on ice covers in Alberta".If you choose to use these templates, make sure that you customize them to your work and work site. (Microsoft Word format.)

UPDATED: December 2024

Hazard assessment and control report (template)

TMP001-1

This is one example of a hazard assessment and control report template. If you choose to use this template, make sure you customize it to your work and work site. (Microsoft Word format.)

PUBLISHED: March 2023

Site-specific hazard assessment (template)

TMP001-2

This site-specific hazard assessment is part of the Hazard Assessment and Control handbook. If you choose to use this template, make sure you customize it to your work and work site. (Microsoft Word format.)

UPDATED: October 2023

Emergency response plan template

TMP002-1

This is one example of an emergency response plan. If you choose to use this template, make sure you customize it to suit your work site's emergency response planning requirements.

UPDATED: September 2024

Emergency contact list (template)

TMP002-2

This is an example of an emergency contact list template. If you choose to use this template, make sure you customize it to your work and work site.

PUBLISHED: September 2024

Emergency planning team list (template)

TMP002-3

This is one example of a document you can use to build your emergency response planning team. If you choose to use this template, make sure you customize it to your work site's emergency response planning requirements.

PUBLISHED:September 2024

Emergency response drill record (template)

TMP002-4

This is an example of an emergency response drill record template. If you choose to use this template, make sure you customize it to your work and work site.

PUBLISHED: September 2024

Emergency response planning checklist (template)

TMP002-5

This is an example of an emergency response planning checklist template. If you choose to use this template, make sure you customize it to your work and work site.

PUBLISHED: September 2024

Emergency response training summary record (template)

TMP002-6

This is an example of an emergency response training record template. If you choose to use this template, make sure you customize it to your work and work site.

PUBLISHED: September 2024

Work site inspection (template)

TMP003

This is an example of a work site inspection template. If you choose to use this template, make sure you customize it to your work and work site.

PUBLISHED: March 2023

Health and safety policy (sample)

TMP004

This is one example of a health and safety policy. If you choose to use this sample policy, make sure you customize it to your work and work site.

PUBLISHED: March 2023

Violence and harassment prevention plan (template)

TMP005

This is an example of a violence and harassment prevention plan template. If you choose to use this template, make sure you customize it to your work and work site. MS Word format.

PUBLISHED: March 2025

Health and safety committee terms of reference (sample)

TMP006

This is an example of health and safety committee terms of reference. If you choose to use this example, make sure you customize it to your work and work site.

PUBLISHED: March 2023

Worker orientation record (template)

TMP007-1

This is an example of a worker orientation record template. If you choose to use this template, make sure you customize it to your work and work site.

PUBLISHED: March 2023

Worker training record (template)

TMP007-2

This is an example of a worker training record template. If you choose to use this template, make sure you customize it to your work and work site.

PUBLISHED: March 2023

Incident investigation report (template)

TMP008

This is an example of an incident investigation report template. If you choose to use this template, make sure you customize it to your work and work site.

PUBLISHED: May 2023

Illness or injury record (template)

TMP009

This is an example of an illness or injury record template. If you choose to use this template, make sure you customize it to your work and work site.

UPDATED: March 31, 2023

Retail fuel and convenience stores staff training record (template)

TMP010-1

This is an example of a staff training record template for fuel and convenience stores. If you choose to use this template, make sure you customize it to your work and work site.

PUBLISHED: June 2018

Retail fuel and convenience stores video surveillance testing log (template)

TMP010-2

This is an example of a video surveillance testing log template for fuel and convenience stores. If you choose to use this template, make sure you customize it to your work and work site.

PUBLISHED: June 2018

Personal Emergency Transmitter Testing Log (template)

TMP010-3

This is an example of a personal emergency transmitter testing log template. If you choose to use this template, make sure you customize it to your work and work site.

PUBLISHED: June 2018

Retail fuel and convenience stores action plan (template)

TMP010-4

This is an example of a template that fuel and convenience store employers can use to create an action plan. If you choose to use this template, make sure to customize it for your work and work site.

PUBLISHED: June 2018

Fall protection plan (template)

TMP011

This template provides an example of a fall protection plan, and can be customized for use on work sites.

PUBLISHED: March 2023

Working Alone – Questions for Employers to Consider

TMP012

This list of sample questions is intended to help employers identify what steps they can take to ensure the safety of their workers who work alone.

PUBLISHED: March 2023

Excavation/Trench Safety Checklist

TMP013

This resource is one example of a safety checklist that could be used at an excavation work site. If you choose to use this checklist, make sure to customize it to your own work site.

PUBLISHED: June 2023

Ice cover inspection (template)

TMP014-1

A template to help assess if a floating ice surface is safe for work. The template is intended for use as described in the"Guide for building and working safely on ice covers in Alberta".
If you choose to use this template, make sure you customize it to your work and work site. (Microsoft Word format.)

UPDATED: December 2024

Ice cover profile (template)

TMP014-2

A template for recording the details of ice covers, such as measurements, colour, and location. The template is intended for use as described in the "Guide for building and working safely on ice covers in Alberta". If you choose to use this template, make sure you customize it to your work and work site. (Microsoft Word format.)

UPDATED: December 2024

Handbook of Occupational Hazards and Controls for Healthcare Administrative Workers: Knowledge and Skills Assessment Verification Checklist

HC003

***This resource is current to 2011.
For information on the latest OHS requirements, visit OHS website.***

Knowledge and Skills Assessment for Administrative Workers – Verification Checklist for Preceptors or Self-assessment.

PUBLISHED: January 2011

Handbook of Occupational Hazards and Controls for Community Clinics and Doctors’ Offices: Knowledge and Skills Assessment Verification Checklist

HC005

***This resource is current to January 2011.
For information on the latest OHS requirements, visit OHS website.***

Knowledge and Skills Assessment for Personnel in Community Clinics and Doctors' Offices – Verification Checklist for Preceptors or Self-assessment.

PUBLISHED: January 2011

Handbook of Occupational Hazards and Controls for Personnel in Continuing Care Facilities: Knowledge and Skills Assessment Verification Checklist

HC007

***This resource is current to January 2011.
For information on the latest OHS requirements, visit OHS website.***

Knowledge and Skills Assessment for Caregivers in Continuing Care Facilities – Verification Checklist for Preceptors or Self-assessment.

PUBLISHED: January 2011

Handbook of Occupational Hazards and Controls for Dental Workers: Knowledge and Skills Assessment Verification Checklist

HC009

***This resource is current to July 2008.
For information on the latest OHS requirements, visit OHS website.***

Knowledge and Skills Assessment for Dental Workers – Verification Checklist for Preceptors or Self-assessment.

PUBLISHED: July 2008

Handbook of Occupational Hazards and Controls for Personnel in Diagnostic Imaging and Nuclear Medicine: Knowledge and Skills Assessment Verification Checklist

HC011

***This resource is current to January 2011.
For information on the latest OHS requirements, visit OHS website.***

Knowledge and Skills Assessment Personnel in Diagnostic Imaging and Nuclear Medicine – Verification Checklist for Preceptors or Self-assessment.

PUBLISHED: January 2011

Handbook of Occupational Hazards and Controls for Homecare Providers: Knowledge and Skills Assessment Verification Checklist

HC013

***This resource is current to January 2011.
For information on the latest OHS requirements, visit OHS website.***

Knowledge and Skills Assessment Homecare Workers – Verification Checklist for Preceptors or Self-assessment.

PUBLISHED: January 2011

Handbook of Occupational Hazards and Controls for Laboratory Workers: Knowledge and Skills Assessment Verification Checklist

HC015

***This resource is current to January 2011.
For information on the latest OHS requirements, visit OHS website.***

Knowledge and Skills Assessment for Laboratory Workers - Verification Checklist for Preceptors or Self-assessment.

PUBLISHED: January 2011

Handbook of Occupational Hazards and Controls for Medical and Surgical Staff: Knowledge and Skills Assessment Verification Checklist

HC017

***This resource is current to January 2011.
For information on the latest OHS requirements, visit OHS website.***

Knowledge and Skills Assessment for Medical and Surgical Staff –Verification Checklist for Preceptors or Self-assessment.

PUBLISHED: January 2011

Handbook of Occupational Hazards and Controls for Medical Emergency Response Personnel: Knowledge and Skills Assessment Verification Checklist

HC019

***This resource is current to January 2011.
For information on the latest OHS requirements, visit OHS website.***

Knowledge and Skills Assessment for Emergency Response Personnel – Verification Checklist for Preceptors or Self-assessment.

PUBLISHED: January 2011

Handbook of Occupational Hazards and Controls for Mental Health Workers: Knowledge and Skills Assessment Verification Checklist

HC021

***This resource is current to January 2011.
For information on the latest OHS requirements, visit OHS website.***

Knowledge and Skills Assessment for Mental Health Workers – Verification Checklist for Preceptors or Self-assessment.

PUBLISHED: January 2011

Handbook of Occupational Hazards and Controls for Pharmacy Workers: Knowledge and Skills Assessment Verification Checklist

HC023

***This resource is current to January 2011.
For information on the latest OHS requirements, visit OHS website.***

Knowledge and Skills Assessment for Pharmacy Workers - Verification Checklist for Preceptors or Self-assessment.

PUBLISHED: January 2011

Handbook of Occupational Hazards and Controls for Physiotherapy, Occupational Therapy, and Respiratory Therapy Personnel: Knowledge and Skills Assessment Verification Checklist

HC025

***This resource is current to January 2011.
For information on the latest OHS requirements, visit OHS website.***

Knowledge and Skills Assessment PTs, OTs, RTs – Verification Checklist for Preceptors or Self-assessment.

PUBLISHED: January 2011

Handbook of Occupational Hazards and Controls for Public Health Workers: Knowledge and Skills Assessment Verification Checklist

HC027

***This resource is current to January 2011.
For information on the latest OHS requirements, visit OHS website.***

Knowledge and Skills Assessment for Public Health Workers – Verification Checklist for Preceptors or Self-assessment.

PUBLISHED: January 2011.

Handbook of Occupational Hazards and Controls for Staff in Central Processing: Knowledge and Skills Assessment Verification Checklist

HC029

***This resource is current to January 2011.
For information on the latest OHS requirements, visit OHS website.***

Knowledge and Skills Assessment for Personnel in Central Processing – Verification Checklist for Preceptors or Self-assessment.

PUBLISHED: January 2011