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Working at Heights Permit Template and Example Format

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This working at heights template is free to use and makes the job of preparing for working at heights safe and reliable - and managing the permit to work approval process easy.

The permit PDF example you see to the right comes pre-built with all the fields you need to safely prepare a working at heights permit and share it with other personnel for digital signoff before engaging in working at height like: automated ID, location, (Y/N) risk assessment questions, dropdown of fail restrain system used, rescue method sketch, photos, additional questions, and many more.

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What is a Working at Heights Permit?

A Working at Heights Permit ensures that the necessary precautions have been taken including an assessment of the fall restraints used and other height controls. Properly managing the permit approval process ensures a number of certified parties and safety personnel have had the chance to assess and approve the circumstances.

Before you proceed with working at a dangerous height, make sure that all the safety checks are done, the expert approves the precautions, and you've completed your permit to work at height.

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Preview this Working at Heights Permit below and see how having a digital template works for yourself and your team to be mindful in working at heights. Click around and experiment with this permit now.

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How can a permit to work make working at heights safer?

Working at heights is an extremely risky activity in the industries. Falling while working at heights is a leading cause of death and serious injury around the world. In Australia alone, the statistics between 1 January 2003 and 31 December 2015 are sobering:

359 workers were killed following a fall from a height—11% of all workers killed over this period.
Half of these falls involved falling three metres or less.
The greatest number of fatalities involved falling from roofs (59), ladders (54), vehicles (27) and horses (33).
Workers aged 45 years and over made up 65% of those who died.
The construction industry accounted for 37% of falls-related fatalities.

Preparing a working at heights permit to work is one of the most reliable ways to decrease the likelihood of these tragic events taking place. Completing and managing the approvals of these permits can be the difference between a safe day on the job and a terrible fall.

What are the critical sections in any Working at Heights Permit format?

There are required key sections in a Working at Heights Permit, but the template itself differs across countries, regions, industries, or even company preferences. However, these are key sections you should include in your permit:

Key permit details such as the permit number (necessary to keep track of all your permits), date & time issued, the specific location of the work, and the detailed description of work to be done
Information of the worker doing the high-risk task at heights
Risk assessment, hazard identification, and safety measures (including equipment and PPE to be used) section that fully outlines all the potential risks/hazards the worker may face including environmental conditions.
Inspection checklist/results of the scaffolding/ladders if applicable, safe access and points, and warning signs.

When is a permit required?

Not all workers are required to attain a Working at Heights Permit, in fact it should be clear that a permit to work at heights is issued per task or per job. It's not like a permanent certification where you can work on heights at anytime. It should differ per task, because fall protections, equipment checks, and risk assessments differ per job.

Remember, it's only the trained and competent workers who work at high-risk tasks involving heights who are issued a job-specific permit to work at heights.

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This electronic Permit was generated with Dashpivot

This working at heights permit example is especially for industries that often have to work at heights, protecting their workers from fall and slip hazards, and many more. It's powered by Dashpivot software, with these convenient features to use:

Edit or add permit fields with simple drag-and-drop functionality.
Access and use your working at heights permit on laptop, computer, mobile or tablet.
Take and add supporting attachments to your permit in the office or on site.
Format your completed permits into register view or workflow view at the click of a button.
Automate the approval process of permits with smart notifications and digital signoff
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