KD-OH-SK-005
Skin Surveillance and Dermatitis Check Record
The skin surveillance record for one person: the substances and the check frequency from the COSHH assessment, each check with what was seen and what the person reported, the action, and the referral where something was found — a health record held apart from the site file.
2 pages · 94 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
- COSHH 2002 reg 11
- RIDDOR 2013 reg 8
- 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.
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