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System · 110 documentsPart of HVAC-Refrigeration OHS-WHS Industry Suite

Health Surveillance Record

Form · FORM-30008

  • Version 3

The Health Surveillance Record is used to monitor and document changes in workers' health due to exposure to specific substances. Levels of risk depend on the frequency, duration and level of exposure, and keeping accurate health surveillance records is the key to managing these exposures.

It records the worker's name, payroll or ID number and job title, the occupational exposure and hazards, the screening, vaccination and frequency of surveillance required, the examiner's recommendation, and the actions and follow up completed.

Written by SafetyDocs safety experts, who have been writing safety documents since 2004.

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Preview of the Health Surveillance Record

Health Surveillance Record

FormVersion 3

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What it covers

13 fields

  1. Location
  2. Workers Name
  3. Worker Payroll/ID Number
  4. Job Title
  5. Date
  6. Occupational Exposure
  7. Hazards
  8. Surveillance required
  9. Examiner's Recommendation
  10. Actions/Follow up Completed
  11. Screening
  12. Vaccination

and 1 more

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