Template

Permit to Work at Height

by Stephen Dawson, from the Community

10+

This Permit to Work at Height template guides supervisors and contractors through planning and authorization of work at height. It covers equipment suitability and inspection, fall-arrest systems, edge protection, PPE, barriers, and overhead service checks. The form captures approvals, issue, acceptance, clearance, and closure to ensure work is controlled from start to finish. Use it to confirm competent persons, record work details, apply site-specific conditions, and maintain compliance with safe systems of work.

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About author

Community

This community page makes available free workplace checklists and templates created by other users within the SafetyCulture community. SafetyCulture has re-published this content and where possible, has credited the original author. SafetyCulture has not verified the accuracy, reliability or suitability of any community content. You agree that your use of any of this content is in accordance with SafetyCulture’s Terms and Conditions.

Template
Work at Height Permit to Work
Use this permit to plan and control work at height. The template captures site and contractor details, scope of work, and required control measures such as barriers, access limitations, ladder condition, plant setup, falling object protection, weather checks, housekeeping, and RAMS attachments. It documents authorization by an approved person, acceptance by the competent person, time extensions, and final completion and closure to ensure the area is left safe and equipment returned to service.
by Luke Penrose, from the Community
Downloads: 10+
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Template
Safe Sound Services Permit to Work Form
Use this comprehensive Permit to Work form to authorize and control high‑risk activities and maintain safe working conditions. The template covers hot works, work at height, work on plant and machinery, confined spaces, electrical works, flammable and hazardous substances, and asbestos. It prompts for authorization details, scope of work, validity periods, and essential risk controls such as isolation, ventilation, barriers, LOTO, PPE, and fire watch. The form supports documentation like RAMS, MSDS, schematic drawings, and asbestos registers, helping contractors and site controllers implement safe systems of work across projects and facilities.
by Dave Foy, from the Community
Downloads: 10+
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Template
Safety Work Permit Template
This safety work permit template helps you control high risk work by formalizing request, review, and authorization. It guides supervisors and permit authorities through documenting the work activity, identifying high risk tasks such as hot work, confined space, excavation, plant isolation, work at heights, and live electrical work, and confirming risk assessments and controls are in place. Capture names, dates, approvals, and signatures, register the permit, and communicate scope and supervision requirements. Use it to verify controls before start of work, monitor hazards during the job, and close out with final sign off.
by Mohamed Elhassan, from the Community
Downloads: 10+
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Template
Hospital Permit To Work Template
This Permit To Work template helps hospitals authorize and control contractor and maintenance activities. It captures permit details, contractor and competent person information, work scope and location, and RAMS submission and approval. It links associated high risk permits including hot works, working at height, confined spaces, isolated and live equipment. The form includes approvals, declarations, signatures, and clear acceptance of responsibilities. It guides permit clearance and closure, and verifies completion, safety, and any fire stopping measures such as sleeves, collars, covers, and sealants. Security checks confirm permits returned and closed.
by Stephen Dawson, from the Community
Downloads: 10+
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Permit to Work at Height

With SafetyCulture you can

Digitize team workflows

Reduce manual errors

Create and share inspection reports

About author

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Work at Height Permit to Work

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