Daily Safety Report Form

July 12, 2011

Daily safety report form is mainly used in large manufacturing units, factory plants or in such organization, where a large number of workers are employed. The safety officer usually prepares this report to update the security and safety measures in unit. The report contains details of safety measures, their execution, violation if any and other related actions.

Sample Daily Safety Report Form



General Information

Company Title_______________  Registration Number___________

Project Title___________  Project ID____________

person Preparing report: Name______________  Designation___________

Address___________  Phone____________ Email____________

Daily Safety Report Information


Date of Report___/___/___  Place of Report__________

Name of Supervisor____________

Total Number of Workers____________

Name of Contractor/Agency____________

Nature of Work/Project___________

Duration of Work: From___/___/____ To___/____/___
Name of those operations that require safety equipments____________________

List the safety equipment being used on site_________________

Name of those workers who are provided those equipments__________________

Any Injury/Accident Reported _____________

If yes, than provide details____________ Name of affected person/s______________

Primary health/Medicare facilities at worksite__________________

Signature______________  Date of report Submission___/____/___


Download Daily Safety Report Form in Word Format

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