Farm Safety Induction Record

Business Name: [Insert Business Name] Farm Location: [Insert Property Address] Date of Induction: [DD/MM/YYYY]

Worker Details

Full Name: [Insert Worker Full Name] Role/Job Title: [Insert Role] Employment Type: [Employee / Contractor / Volunteer / Labour Hire] Company (if applicable): [Insert Company Name] Previous Farm Experience (Years): [Insert Number]

Induction Details

Inductor Name: [Insert Name of Person conducting induction] Start Time: [Insert Time] Finish Time: [Insert Time]

Section 1: General Farm Information

1. Have you been given a tour of the farm boundaries and key operational areas? [ ] Yes [ ] No
2. Have you been shown the location of amenities (toilets, meal areas, first aid)? [ ] Yes [ ] No
3. Do you understand the farm working hours and break times? [ ] Yes [ ] No
4. Are you aware of the process for reporting injuries, near misses, and hazards? [ ] Yes [ ] No

Section 2: Hazards and Risks

5. Have you been informed of the specific hazards on this property (e.g., dams, uneven terrain, livestock)? [ ] Yes [ ] No
6. Do you understand the rules regarding interaction with animals? [ ] Yes [ ] No
7. Are you aware of the location of hazardous chemicals and the requirement to read Safety Data Sheets (SDS) before use? [ ] Yes [ ] No

Section 3: Machinery and Equipment

8. Have you been instructed on the safe operation of the machinery you will use? [ ] Yes [ ] No
9. Do you understand the requirement to wear seatbelts on tractors and roll-over protection on quad bikes? [ ] Yes [ ] No
10. Have you checked your licence details for high-risk work (if applicable)? [ ] Yes [ ] N/A

Section 4: Personal Protective Equipment (PPE)

11. Have you been issued with the following PPE? [ ] Helmet [ ] High visibility vest [ ] Safety boots [ ] Gloves [ ] Eye protection [ ] Hearing protection [ ] Sun protection

Section 5: Emergency Procedures

12. Have you been shown the location of fire extinguishers and fire blankets? [ ] Yes [ ] No
13. Do you know the designated emergency muster point? [ ] Yes [ ] No
14. Do you know the emergency contact numbers (000, supervisor, local hospital)? [ ] Yes [ ] No

Declarations

Worker Declaration: I confirm that I have participated in this safety induction. I understand the information provided and I agree to follow all safety rules and procedures while working on this property. I understand that I must stop work if I believe it is unsafe.

Worker Signature: __________________________ Date: __________________________

Inductor Declaration: I confirm that I have provided the above worker with a full safety induction covering all the points listed above. I have answered all questions to the best of my ability.

Inductor Signature: __________________________ Date: __________________________

Review Date (if applicable): [Insert Date for Refresher]