KD-ASB-EH-005
Asbestos Worker Exposure and Health Record Index
The employer's 40-year index of asbestos exposure: one line per person per job with the work category, the plan of work, the RPE and fit-test reference, the air monitoring record or the reason none was needed, and where the health record and the medical certificate are held — holding no clinical detail.
2 pages · 197 fillable fields · works in Adobe Reader, Preview, Chrome, or on a phone — or complete it online in your browser and download the finished document.
Page 1 of 2 — click to enlarge
Read all 2 pages first — watermarked sample, no email Before you submit: the checklist
Statutory basis, cited on the form
- CAR 2012 reg 19
- CAR 2012 reg 22
- Data Protection Act 2018 and UK GDPR
What it is not
It is not a completed document and it is not health and safety advice. You must adapt it to your site and have a competent person complete and sign it off. See why we don't say "compliant".
Format
AcroForm fillable PDF. Every field has a tooltip. Tab order follows the reading order. Works on desktop and mobile, in Adobe and non-Adobe readers.
This revision was prepared against legislation current at 10 August 2026. Revision A0. Check kubitdocs.com/revisions for the current revision before use.
More in Asbestos management
5 documents