Template

HAV Annual Screening Questionnaire for Occupational Health

by C-Tech Solutions Limited, from the Community

30+

This HAV annual screening questionnaire helps organizations identify symptoms of hand arm vibration syndrome among workers who use hand held or hand guided vibrating tools and machines. It covers common symptoms such as numbness, tingling, finger blanching in cold, pain, dexterity issues, and any changes since the last assessment. Use it to support occupational health monitoring, protect worker wellbeing, and inform follow up evaluations. Always seek professional advice to confirm suitability for your workplace and jurisdiction.

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Eliminate mistakes made by paper-based processes

Create and share professional reports instantly

Confirm accountability and compliance with a digital log

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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
Health Surveillance Questionnaire
Hand-arm vibration syndrome (HAVS): is a disorder which affects the blood vessels, nerves, muscles and joints of the hand, wrist and arm; can become severely disabling if ignored; and its best known form is vibration white finger (VWF) which can be triggered by cold or wet weather and can cause severe pain in the affected fingers. Signs to look out for in hand-arm vibration syndrome: tingling and numbness in the fingers; in the cold and wet, fingers go white, then blue, then red and are painful; you can't feel things with your fingers; pain, tingling or numbness in your H and S, wrists and arms; loss of strength in H and S.
by Drew Walls, from the Community
Downloads: 40+
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Template
Hand Arm Vibration Syndrome Toolbox Talk
Brief your team on Hand Arm Vibration Syndrome with a ready to use toolbox talk form. It explains what HAVS is, who is at risk, common vibrating tools, hazards and symptoms, UK exposure limits EAV and ELV, and employer duties under the Control of Vibration at Work Regulations 2005. Includes practical advice on tool choice, maintenance, grip and break schedules, plus an attendance sign off to document training.
by Matthew Oneill, from the Community
Downloads: 0
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Template
Health Questionnaire
A questionnaire to highlight any health concerns
by Scott Bundy, from the Community
Downloads: 40+
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Template
Hand Hygiene Questionnaire
This hand hygiene questionnaire template helps teams evaluate compliance with hand hygiene practices and strengthen infection control across healthcare settings. Use it to record audit details such as document number, audit title, date, and preparer, and to capture observations on hand hygiene opportunities and compliance. Ideal for hospitals, clinics, aged care, and allied health, the checklist supports routine audits, training, and continuous improvement of hygiene standards.
by Jill Hulin, from the Community
Downloads: 20+
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HAV Annual Screening Questionnaire for Occupational Health

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