PPE hazard assessment form
OSHA requires employers to assess the workplace for hazards that require PPE and to certify that assessment in writing: who did it, when, and for which work area. This form is that assessment and certification on one page: walk the area, identify the hazards, select the PPE, sign it.
PPE hazard assessment form
Company: ____________
Jobsite: ____________
Date: ____________
Assessment details
| Work area / task assessed: ____________ | N/A · Action | |
| Assessed by: ____________ | N/A · Action | |
| Date of assessment: ____________ | N/A · Action |
Head, eyes, face, hearing
| Falling or flying objects, overhead work: hard hat required? | N/A · Action | |
| Impact, dust, chemical splash, radiant light (welding): safety glasses, goggles, or face shield? | N/A · Action | |
| Noise you must raise your voice over: hearing protection? | N/A · Action |
Hands, body, feet
| Cuts, abrasion, chemicals, vibration: which glove type? | N/A · Action | |
| Sparks, splash, weather, visibility: FR clothing, apron, high-vis class? | N/A · Action | |
| Rolling or falling material, punctures: safety-toe footwear? | N/A · Action |
Respiratory and fall
| Dust, silica, fumes, vapors: respirator needed (triggers the respiratory protection program)? | N/A · Action | |
| Work at height without guardrails: personal fall arrest? | N/A · Action |
Written certification
| PPE selected and listed for this area: ____________ | N/A · Action | |
| Workers trained on the PPE selected (what, when, how, limits, care) | N/A · Action | |
| This document certifies the workplace hazard assessment: signature ____________ date ____________ | N/A · Action |
Completed by: ____________________
Signature: ____________________
tailgatedocs.com · Free printable form. Not legal advice; adapt to your jobsite.
Common questions
▸Is a written PPE hazard assessment required?
Yes. OSHA requires the employer to assess the workplace for hazards requiring PPE and to verify the assessment through a written certification identifying the workplace, the person certifying, and the date. This form is built to be that certification.
▸How often should it be redone?
Reassess when the work, equipment, or materials change, and review it periodically. A new task or a new site is the practical trigger; the certification should reflect the work actually being done.
The PPE assessment feeds your JHA and written program. Generate the documents reviewers ask for in minutes.
Forms record what happened on the job; the JHA, safety plan, or written program is what a GC, prequal portal, or inspector asks to see. Generate a verified, job-specific one in minutes.