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PPE hazard assessment form

A PPE hazard assessment for a US workplace under OSHA 1910.132(d), done on a phone as you walk each area. For every area or task, tick the hazard sources you see, then record each body area (eyes and face, head, hands, feet, body, hearing, respiratory): whether there is a hazard, its source, the PPE selected and whether it was being worn. The form counts hazards found and PPE not worn. It ends with the written certification of hazard assessment and a training record. For routine checks of the PPE itself, use the PPE inspection checklist.

For safety managers, supervisors and consultants in kitchens, warehouses, plants, workshops and labs who need the written PPE hazard assessment and certification, and a record of who was trained.

Written for US OSHA rules. In Great Britain, regulation 6 of the PPE at Work Regulations 1992 asks for an assessment of PPE suitability before it is chosen: use the risk assessment template and the PPE inspection checklist.

  • Each area or task with a walk-through of the hazard sources in Appendix B
  • Eyes and face, head, hands, feet, body, hearing and respiratory: source and PPE selected
  • Whether the PPE was worn when seen, fit, communication and defective PPE checks
  • Written certification of hazard assessment: workplace, person certifying, dates
  • PPE training record with the 1910.132(f) topics, actions and two signatures
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What is a PPE hazard assessment certification?

A PPE hazard assessment is useful when each area is walked while the work is happening, every body area has an answer, and the PPE selected is checked against what people are actually wearing. The certification then rests on a real walk-through, not a template.

Last updated . Facts checked by the SiteSurvey team on 27 October 2026 against OSHA 29 CFR 1910.132, PPE general requirements (eCFR), OSHA Appendix B to Subpart I of Part 1910, hazard assessment and PPE selection (eCFR), The Personal Protective Equipment at Work Regulations 1992, regulation 6 and HSE: Extended scope of the PPE at Work Regulations.

How to do a PPE hazard assessment

Walk each area while the work is going on, so you see the real hazards and the PPE people actually wear.

  1. Set up the assessment

    Enter the employer, the workplace evaluated, who took part and whether PPE is provided at no cost.

  2. Walk each area

    Add each area or task, describe the work, tick the hazard sources you see and note the injury history. Film a Walk Cam walk-through if it helps.

  3. Go through each body area

    For eyes and face, head, hands, feet, body, hearing and respiratory, record whether there is a hazard, its source and the PPE selected, and whether it was worn when you saw the task.

  4. Check fit and communication

    Confirm the PPE fits each affected employee, that they were told the selection, and that no defective or damaged PPE is in use.

  5. Certify

    Fill in the certification: workplace evaluated, the date or dates of the assessment and the person certifying it was performed, then sign.

  6. Record training and actions

    Add each employee trained, the topics covered and whether they showed they understand. Add actions for any gaps and sign off.

What makes a PPE hazard assessment useful

Each area: hazard source and PPE selected for each body area, worn when seen

Catering kitchen, Columbus, 7 October: dish room, eyes and face, splash from topping up the degreaser dispenser and the pre-rinse spray. Selected: indirect-vent splash goggles. Seen: porter filling the dispenser without goggles. Goggles now hung at the dispenser and added to the opening checklist.

Fictional example. Record the actual evidence and approved arrangements for your job.

A common recording mistake

Ticking safety glasses for every area from the office, without seeing that the dish porters top up the degreaser from 5-gallon jugs.

What happens next

Re-walk an area whenever its tasks, equipment or chemicals change, and train anyone whose PPE changes before they start.

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Every question in the PPE hazard assessment template

A US workplace PPE hazard assessment under OSHA 29 CFR 1910.132(d): each area or task with a walk-through of hazard sources, hazards by body area (eyes and face, head, hands, feet, body, hearing, respiratory) with the source, the PPE selected and whether it was worn, fit and communication checks, the written certification of hazard assessment, the PPE training record under 1910.132(f) and actions. 5 sections and 97 questions. Follow-up questions and guidance appear only when an answer calls for them, so the person on site never sees the ones that do not apply.

Make it your own: every question is editable

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Add this form to a project in SiteSurvey and it fills in what the project already knows, so nobody on site retypes it and every form on the job uses the same names. Anything filled in can still be changed.

  • Project: the project name
  • Site address: the site address, from the space or the project
  • Client or owner: the project's customer

Workplace and assessment

  • ProjectShort answer

    Filled in from the project in SiteSurvey.

    Fills in from the project name
  • Site addressShort answer
    Fills in from the site address, from the space or the project
  • Client or ownerShort answer
    Fills in from the project's customer
  • Location (GPS)Short answer
  • Hazard assessment date*Date
  • Assessed by*Short answer
  • Employer*Short answer
  • Workplace evaluated*Short answer

    For example: Production kitchen and warehouse, 1200 Example Ave.

  • Others who took partShort answer

    Supervisors, employees, safety committee.

  • PPE provided at no cost to employees, apart from the items 1910.132(h) excludes?*Yes or No

    For example, non-specialty safety-toe shoes and prescription safety glasses the employee may wear off the job site are excluded (1910.132(h)).

  • Any employee-owned PPE checked for adequacy, maintenance and sanitation?Yes or No

    1910.132(b). Answer Yes if none is used.

  • Next review of this assessmentDate

    Your own date: review when tasks, equipment or PPE change.

  • GuidancePPE hazard assessment (29 CFR 1910.132(d)). The employer assesses the workplace to find hazards that are present, or likely to be present, which need PPE. Where they are, the employer selects the PPE that protects against them and has each affected employee use it, tells each affected employee the selection, and selects PPE that properly fits each one. The assessment is verified by a written certification. Appendix B to Subpart I is non-mandatory guidance on how to do it: a walk-through survey, hazard sources, injury records, then selection.
  • GuidanceThe assessment and training duties in 1910.132(d) and (f) apply to eye and face, head, foot and hand protection and personal fall protection (1910.133, .135, .136, .138 and .140), not to respirators (1910.134) or electrical protective equipment (1910.137) (1910.132(g)). Hearing protection has its own rules in 1910.95. This form records hearing and respiratory hazards so the picture is complete.
  • GuidanceWorking in Great Britain? Regulation 6 of the Personal Protective Equipment at Work Regulations 1992 requires an assessment before choosing PPE: the risks not avoided by other means, the characteristics the PPE needs, a comparison with the PPE available, and compatibility with other PPE worn at the same time, reviewed when no longer valid or after a significant change. Since 6 April 2022 the duties also cover limb (b) workers. Hearing protection and RPE come under the noise and COSHH regulations.

Hazards and PPE by area or task

  • GuidanceWalk through each area, look for the sources of hazards, then for each body area record whether a hazard is present, its source and the PPE selected. Select PPE that gives more than the minimum protection needed, fit it to the user and explain its care and use (Appendix B).
  • Areas and tasks assessed
    Repeat for each entry. Each one asks:
    • Area or task*Short answer

      For example: Dish room, Fry station, Receiving dock.

    • Job titles and number of employeesShort answer
    • Work done here*Notes
    • Hazard sources seen on the walk-throughTick all that apply

      The sources Appendix B suggests looking for. Tick what you saw.

      • Moving machinery, tools or flying particles
      • High temperatures (burns, ignition)
      • Chemical exposures
      • Harmful dust
      • Light radiation (welding, cutting, furnaces, high-intensity lights)
      • Falling or dropped objects
      • Sharp objects (piercing feet, cutting hands)
      • Rolling or pinching objects (crushing feet)
      • Workplace layout and co-workers nearby
      • Electrical hazards
    • Injury and incident history for this areaNotes

      Appendix B suggests reviewing injury and accident data.

    • Walk-through of the areaWalk Cam video with voice-to-text

      Optional. Film a guided walk-round on the SiteSurvey app.

    • Eyes and face*Choose one

      Flying particles, molten metal, liquid chemicals, acids or caustic liquids, chemical gases or vapors, or injurious light radiation (1910.133(a)(1)).

      • Hazard found
      • No hazard found
      • Not checked
    • Eyes and face: source of the hazard*Short answer
      Shown when “Eyes and face” is “Hazard found”
    • Eyes and face: PPE selected*Short answer
      Shown when “Eyes and face” is “Hazard found”
    • Eyes and face: in use when seenChoose one
      • Worn as selected
      • Not worn or wrong PPE
      • Not seen in use
      Shown when “Eyes and face” is “Hazard found”
    • Head*Choose one

      Potential for injury from falling objects (1910.135(a)(1)).

      • Hazard found
      • No hazard found
      • Not checked
    • Head: source of the hazard*Short answer
      Shown when “Head” is “Hazard found”
    • Head: PPE selected*Short answer
      Shown when “Head” is “Hazard found”
    • Head: in use when seenChoose one
      • Worn as selected
      • Not worn or wrong PPE
      • Not seen in use
      Shown when “Head” is “Hazard found”
    • Hands*Choose one

      Skin absorption of harmful substances, severe cuts or lacerations, severe abrasions, punctures, chemical or thermal burns, harmful temperature extremes (1910.138(a)).

      • Hazard found
      • No hazard found
      • Not checked
    • Hands: source of the hazard*Short answer
      Shown when “Hands” is “Hazard found”
    • Hands: PPE selected*Short answer
      Shown when “Hands” is “Hazard found”
    • Hands: in use when seenChoose one
      • Worn as selected
      • Not worn or wrong PPE
      • Not seen in use
      Shown when “Hands” is “Hazard found”
    • Feet*Choose one

      Falling or rolling objects, objects piercing the sole, or electrical hazards (1910.136(a)).

      • Hazard found
      • No hazard found
      • Not checked
    • Feet: source of the hazard*Short answer
      Shown when “Feet” is “Hazard found”
    • Feet: PPE selected*Short answer
      Shown when “Feet” is “Hazard found”
    • Feet: in use when seenChoose one
      • Worn as selected
      • Not worn or wrong PPE
      • Not seen in use
      Shown when “Feet” is “Hazard found”
    • Body (protective clothing)*Choose one

      For example: hot liquids and splashes, chemicals, cold stores, traffic.

      • Hazard found
      • No hazard found
      • Not checked
    • Body (protective clothing): source of the hazard*Short answer
      Shown when “Body (protective clothing)” is “Hazard found”
    • Body (protective clothing): PPE selected*Short answer
      Shown when “Body (protective clothing)” is “Hazard found”
    • Body (protective clothing): in use when seenChoose one
      • Worn as selected
      • Not worn or wrong PPE
      • Not seen in use
      Shown when “Body (protective clothing)” is “Hazard found”
    • Hearing*Choose one

      Hearing protection follows 1910.95 (noise monitoring and the hearing conservation program), not this certification.

      • Hazard found
      • No hazard found
      • Not checked
    • Hearing: source of the hazard*Short answer
      Shown when “Hearing” is “Hazard found”
    • Hearing: PPE selected*Short answer
      Shown when “Hearing” is “Hazard found”
    • Hearing: in use when seenChoose one
      • Worn as selected
      • Not worn or wrong PPE
      • Not seen in use
      Shown when “Hearing” is “Hazard found”
    • Respiratory*Choose one

      Respirators follow 1910.134 (written respiratory protection program), not this certification.

      • Hazard found
      • No hazard found
      • Not checked
    • Respiratory: source of the hazard*Short answer
      Shown when “Respiratory” is “Hazard found”
    • Respiratory: PPE selected*Short answer
      Shown when “Respiratory” is “Hazard found”
    • Respiratory: in use when seenChoose one
      • Worn as selected
      • Not worn or wrong PPE
      • Not seen in use
      Shown when “Respiratory” is “Hazard found”
    • CheckHearing hazard: measure the noise and follow 1910.95 (hearing conservation program at or above 85 dBA TWA).
      Shown when “Hearing” is “Hazard found”
    • CheckRespiratory hazard: respirator use follows a written respiratory protection program under 1910.134.
      Shown when “Respiratory” is “Hazard found”
    • Selected PPE fits each affected employee?*Yes or No

      1910.132(d)(1)(iii).

    • Selection told to each affected employee?*Yes or No

      1910.132(d)(1)(ii).

    • Any defective or damaged PPE found in use?*Yes or No

      Defective or damaged PPE is not used (1910.132(e)).

    • What was defective and what was done*Notes
      Shown when “Any defective or damaged PPE found in use?” is Yes
    • Photos of the hazards and PPEPhotos
    • s_foundWorked out by the form
    • s_not_wornWorked out by the form
    • s_not_checkedWorked out by the form
    • s_otherWorked out by the form
    • Area resultWorked out by the form
  • Areas or tasks assessedWorked out by the form
  • Hazards foundWorked out by the form
  • PPE not worn or wrong when seenWorked out by the form
  • Fit, communication or defective PPE problemsWorked out by the form
  • Body areas not checkedWorked out by the form

Certification of hazard assessment

  • GuidanceCertification of hazard assessment (29 CFR 1910.132(d)(2)). This document is the employer's written certification that the workplace hazard assessment recorded here has been performed. It names the workplace evaluated, the person certifying that the evaluation was performed and the date or dates of the assessment. It records that the assessment was done; it does not certify that any PPE or workplace complies.
  • Workplace evaluated*Short answer
  • Date or dates of the hazard assessment*Short answer

    For example: 6 and 7 October 2026.

  • Person certifying that the evaluation was performed*Short answer
  • RoleShort answer
  • I certify that the workplace hazard assessment in this document was performed.*Yes or No
  • Signature of the person certifying*Signature
  • cert_flagWorked out by the form

PPE training

  • GuidanceEach employee required to use PPE is trained in when and what PPE is needed, how to put it on, take it off, adjust and wear it, its limitations, and its care, maintenance, useful life and disposal, and shows they understand before doing the work. Retrain when changes or gaps make earlier training out of date (1910.132(f)).
  • Employees trained
    Repeat for each entry. Each one asks:
    • Employee (name or ID)*Short answer
    • Area or taskShort answer
    • PPE they useShort answer
    • Trained on*Date
    • Training covered*Tick all that apply

      1910.132(f)(1).

      • When PPE is necessary
      • What PPE is necessary
      • How to put on, take off, adjust and wear it
      • Its limitations
      • Care, maintenance, useful life and disposal
    • Showed they understand the training and can use the PPE properly?*Yes or No

      Before being allowed to do work that needs PPE (1910.132(f)(2)).

    • Retraining needed becauseTick all that apply

      1910.132(f)(3).

      • Workplace changes made the training out of date
      • PPE changes made the training out of date
      • Employee has not kept the understanding or skill
      • None
    • t_gapsWorked out by the form
    • t_flagWorked out by the form
  • Employees recordedWorked out by the form
  • Training topics missedWorked out by the form
  • Not shown or retraining neededWorked out by the form
  • p1_flagsWorked out by the form

Result, actions and sign-off

  • Items needing actionWorked out by the form
  • ResultWorked out by the form
  • Actions
    Repeat for each action. Each one asks:
    • Action*Notes
    • PriorityChoose one
      • Now: before the task continues
      • This week
      • Within 30 days
      • Before the next review
    • Who will do it*Short answer
    • Due byDate
    • Status*Choose one
      • Open
      • In progress
      • Done, checked
    • Photo when donePhotos
      Shown when “Status” is “Done, checked”
  • Actions still openWorked out by the form
  • Decision*Choose one
    • Assessment complete: PPE selected and in use
    • Complete: actions to finish
    • Reassess: hazards or areas not covered
  • Next check or re-inspection dateDate
  • Summary for the clientNotes
  • Assessor nameShort answer
  • Assessor signature*Signature
  • Employer representative nameShort answer
  • Employer representative signatureSignature

See it filled in

A completed PPE hazard assessment report, made by SiteSurvey from a fictional site visit: every answer, the photos, the guidance that applied and the sign-off, ready to send as a PDF.

See completed form (PDF) ↗

PPE hazard assessment FAQs

What does OSHA require in a PPE hazard assessment?

The employer assesses the workplace to find hazards that are present, or likely to be present, which need PPE. Where there are such hazards, the employer selects the PPE that protects against them and has each affected employee use it, communicates the selection to each affected employee and selects PPE that properly fits each one (1910.132(d)(1)).

Source: OSHA 29 CFR 1910.132, PPE general requirements (eCFR).

Is Appendix B mandatory?

No. Appendix B to Subpart I is non-mandatory guidance. It suggests a walk-through survey looking at sources of motion, high temperatures, chemicals, harmful dust, light radiation, falling objects, sharp objects, rolling or pinching objects, workplace layout and electrical hazards, and a review of injury records, then selecting PPE and fitting it to the user. The form lists these sources for the walk-through.

Source: OSHA Appendix B to Subpart I of Part 1910, hazard assessment and PPE selection (eCFR).

Does the certification cover hearing protection and respirators?

No. The assessment and training rules in 1910.132(d) and (f) apply to eye and face, head, foot and hand protection and personal fall protection, not to respirators (1910.134) or electrical protective equipment (1910.137). Hearing protection follows 1910.95. The form records hearing and respiratory hazards so the picture is complete, and points to the hearing conservation program and respiratory protection program.

Source: OSHA 29 CFR 1910.132, PPE general requirements (eCFR).

What training does 1910.132 require?

Each employee required to use PPE is trained in when PPE is necessary, what PPE is necessary, how to put it on, take it off, adjust and wear it, its limitations, and its care, maintenance, useful life and disposal. They show they understand before doing work that needs PPE, and are retrained when changes or gaps make earlier training out of date (1910.132(f)).

Source: OSHA 29 CFR 1910.132, PPE general requirements (eCFR).

Does the employer pay for PPE?

Generally yes: PPE used to comply with Part 1910 is provided at no cost to employees. 1910.132(h) lists exceptions, such as non-specialty safety-toe footwear and prescription safety eyewear the employee may wear off the job site, everyday clothing and ordinary weather gear. The form asks the question; it records your assessment and does not make you compliant.

Source: OSHA 29 CFR 1910.132, PPE general requirements (eCFR).

Can I use this form in the UK?

Not as it stands: it follows US OSHA rules. In Great Britain, regulation 6 of the PPE at Work Regulations 1992 requires an assessment before choosing PPE: the risks not avoided by other means, the characteristics the PPE needs, a comparison with what is available and compatibility with other PPE worn at the same time. HSE says the duties have covered limb (b) workers since 6 April 2022, and that PPE for noise and hazardous substances comes under other regulations.

Sources: The Personal Protective Equipment at Work Regulations 1992, regulation 6 and HSE: Extended scope of the PPE at Work Regulations.

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