Cushman & Wakefield Induction Form – Docusafe

Back to Docusafe

Cushman & Wakefield Induction Form

To be completed by all Cushman & Wakefield

"*" indicates required fields

First Name*

Last Name*

Company (Full Name please - no abbreviations)*

Date of Induction*

MM slash DD slash YYYY

Phone Number*

Email*

Do you have any medical condition, allergy or phobia which could potentially affect your safety while working?*

Yes

Should your condition occur, are there particular actions, knowledge or resources you require?

Emergency Contact Name 1 [Who do we contact if you are involved in an accident/incident?]

First Name*

First Name *

Last Name*

Last Name *

Phone Number*

Phone Number *

I wish to confirm that I attended a Safety Induction Training Course. Guidance was given in relation to the following matters. Tick to indicate subjects discussed.

Consent*

Company Procedures*

Consent*

Lock out/ Tag out arrangement*

Consent*

Accident Reporting Procedures*

Consent*

Specific Safety Rules*

Consent*

Emergency Procedures*

Consent*

Welfare Facilities*

Consent*

PPE requirements*

Consent*

Exclusion zone requirements*

Consent*

HouseKeeping Arrangements*

Consent*

Permits required on-site*

Consent*

Disciplinary Procedure*

Consent*

Alcohol & Drug Policy*

Consent*

Safety Observations*

Consent*

Particular Risks*

Consent*

By clicking the submit button I confirm that I have completed and understood the Subcontractor Induction Programme. I agree to abide by site safety rules at all times. I am aware that any breach of site rules will result in a safety violation being issued to me. I understand that safety violations may lead to dismissal from site. **

Do you agree to abide by the site rules and to wear the correct PPE at all times?*

Yes

Are you a ‘Young Person – under 18 years of age’?*

Yes

Safe Pass Number

Manual Handling Training Complete?*

Yes

Training Certificate Available?*

Yes

Signature Person A