Tailgate Safety Meeting Form

A tailgate safety meeting form is filled by those people attending short, informal safety meetings conducted on a periodic basis by supervisors about various job-related hazards and safe work practices. A tailgate meeting aims to inform the employees of dangers associated with a particular task and also advises them on the safe way to do the job.

By filling up these forms, workers can go through what they already know and are reminded of the precautions again and it helps to establish the supervisor’s credibility regarding his or her responsibilities for the safety of his employees. Tailgate safety meetings should have timely topics and since they are informal meetings, the supervisor encourages the employees to interact and get involved.

You can Download the Free Tailgate Safety Meeting Form form, customize it according to your needs and Print. Tailgate Safety Meeting Form is either in MS Word, Excel or in PDF.

Sample Tailgate Safety Meeting Form

Tailgate Safety Meeting Form

Download Tailgate Safety Meeting Form

General information

Meeting conducted by:Unit Date and time
Worksite location Type of work
                                                       Supervisor safety plan
Describe the work plan for your team.What are the equipment and tools needed?Initial hazard assessment:
Backing Fall protection Trenching and excavation
Confined spaces Utilities Lifting
Hazardous materials Hazardous atmosphere Noise exposure
Eye protection Uneven terrain
Describe adjustments to work plan.What are the equipment and tools provided?Onsite hazard assessment:
Supervisor safety plan (continued)
Traffic control:Other topics that raise concern:Describe adjustments to traffic control.Other topics addressed.














Names of attendees in the meeting:

Assignments of these attendees:

Team comments:

Post-operation evaluation of the topics discussed in the meeting:

Observations on the meeting:

Mention if any follow-up is needed.

Name and signature of supervisor:

Name and signature of team leader:

Category: Accounting Forms

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