KD-HTM-AP-001
Authorised Person and Competent Person Appointment Record
The written appointment of an Authorised Person or Competent Person for one engineering discipline in a healthcare building: the role, the systems and premises covered, the limits, the Authorising Engineer's assessment it rests on, the duties acknowledged, and the signatures of the Designated Person appointing and the person accepting — the HTM 00 role model on one sheet.
2 pages · 47 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
- Electricity at Work Regulations 1989 regs 12, 13, 14 and 16
- MHSWR 1999 reg 5
Guidance and standards relied on
These are not law. HSE guidance carries no statutory force in itself, British Standards and NASC technical guidance are industry documents, and the Joint Code of Practice is an insurers' code. They are what the document is built to — and where a court would look for the standard of the reasonable contractor.
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.
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