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KD-POL-001
Health and Safety Policy
The written policy HSWA s.2(3) requires at five or more employees — drafted statement of intent signed by the person responsibility stops with, the organisation named person by person, six guided arrangement sections, and the brought-to-notice record.
2 pages · 59 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
- HSWA 1974 ss.2(3) and 2(2)(a)
- MHSWR 1999 regs 3 and 5
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.