Can I use electronic signatures for this form?

Yes. Electronic signatures are legally effective under the ESIGN Act (15 U.S.C. §7001) and UETA in most states if intent, consent, attribution, and retention requirements are met.

Does OSHA accept digital records and forms?

OSHA recognizes electronic records when they are maintained and available; ensure audit trails and unalterable logs to support inspections and inquiries.

How long must exposure-related records be kept?

Maintain exposure records for 30 years per 29 CFR §1910.1020. Injury logs follow the five-year rule under 29 CFR §1904.33.

What if an SDS is not available for a product?

Document attempts to obtain the SDS, use supplier contact records, and perform a precautionary assessment; note that lack of SDS does not remove employer responsibility to protect workers.

Who should sign and approve the assessment?

The trained assessor signs to certify the evaluation, the supervisor acknowledges implementation, and affected employees should be briefed and record receipt.

How do I update an existing assessment?

Amend the form with new SDS dates, control changes, and re-sign with dates. Keep previous versions archived to preserve the audit trail.

Electronic Signature
Templates
Miscellaneous
Workplace Safety Coshh Form

Workplace Safety Coshh Form

This template is fully customizable. Edit the text, fill out the fields, and send it for signature. Give it a try!

Workplace Safety COSHH Form and Service Agreement

Agreement Recitals

WHEREAS, Client Name: engages Service Provider Name: to perform workplace hazardous substance assessments, controls and related services;

WHEREAS, the parties desire to document the assessment of hazardous substances used at Client premises and to set out responsibilities for control measures, training, monitoring and associated services; and

WHEREAS, the parties agree that this COSHH assessment and any related services provided by the Service Provider will be performed in accordance with applicable health and safety standards and the terms set forth below effective as of Effective Date: .

Scope of Work

Services to be provided (describe all assessment and control activities)

COSHH Assessment Details

Substance / Product Name Supplier / Manufacturer Location of Use / Storage

Quantity / Concentration

Hazardous Components / Ingredients (list)

Routes of Exposure (check all that apply) Inhalation Skin contact Eye contact Ingestion

Control Measures and PPE

Engineering Controls (ventilation, extraction, containment) Personal Protective Equipment (PPE) required

Handling, Storage & Disposal

Safe Handling Procedures Storage Requirements Waste Disposal Method

Emergency Procedures

First Aid Measures Spill / Leak Response

Training & Monitoring

Training Requirements

Health Surveillance Required? Yes No

Risk Rating & Review

Residual Risk (select) Low Medium High

Next Review Date

Payment Terms

Total Fee: . Payment Schedule:

Late Payment Fee: . Invoices are due within days of invoice.

Term and Termination

Term Commencement Date: . Term End Date (if any): .

Either party may terminate for convenience upon written notice of days. Termination for material breach may be immediate if the breaching party fails to remedy the breach within a reasonable specified period.

Confidentiality

Each party shall keep confidential all non-public information disclosed in connection with this assessment and shall not disclose such information except as required by law. Confidentiality obligations shall continue for a period of years following termination.

Governing Law & Entire Agreement

This agreement and any associated assessments shall be governed by the laws of Jurisdiction: . This document constitutes the entire agreement between the parties with respect to the subject matter and supersedes all prior understandings and agreements.

Assessor Certification

I certify that I have conducted the assessment described above to the best of my knowledge and that the control measures recommended are reasonably practicable to reduce risk to personnel.

Assessor Name Assessor Position Assessment Date

Authorisation

The undersigned hereby acknowledge and agree that they have authority to bind their respective organizations to the terms set forth in this COSHH assessment and service agreement.

Client Printed Name:

By:

Date:

Service Provider Printed Name:

By:

Date:

What the Workplace Safety Coshh Form Is and why it matters

The Workplace Safety Coshh Form documents assessment and control measures for hazardous substances used or produced at work. Although COSHH is a UK-origin term, the form template helps U.S. employers record chemical identity, exposure pathways, control measures, and monitoring results consistent with OSHA Hazard Communication requirements (29 CFR 1910.1200) and Safety Data Sheet (SDS) information. It centralizes evidence of risk assessment, PPE, training, and review dates so employers can demonstrate due diligence and maintain a searchable compliance record.

Why completing a Coshh-style workplace form adds value

A clear assessment form reduces exposure risk, documents controls and training, and creates an auditable record for inspections, incident investigations, and insurance or regulatory review.

Who typically completes and signs this form

Employers and safety personnel complete the form to identify hazards and assign controls before tasks commence.

EHS or safety manager — Oversees hazard evaluation, selects controls, and certifies compliance responsibilities.
Supervisors and line managers — Implement controls, ensure training, and confirm the assessment applies to daily tasks.
Contractors and technicians — Complete task-specific sections and acknowledge PPE, monitoring, and operating limits.

Supervisors, trained assessors, and affected employees may all review and sign; retained records support audits and incident response.

Step-by-step: completing the Workplace Safety Coshh Form

Follow these sequential actions to create a defensible assessment that aligns controls with documented hazards.

01

Gather SDS: Collect the current Safety Data Sheet for every substance used in the task.
02

Describe the task: Note location, duration, process steps, and personnel exposure points.
03

Assess exposure: Compare tasks to OELs, PELs, or recommended limits and record estimated exposure levels.
04

Assign controls: Specify engineering controls, work practices, and PPE; set review and monitoring dates.

Core sections to include in a professional COSHH-style form

A complete form groups identity, hazard evidence, exposure estimates, controls, monitoring, and administrative details for clarity and traceability.

Identification

Full chemical name, CAS number, product code, supplier contact, and SDS version to ensure exact substance tracking.

Hazard summary

Key SDS hazard statements, routes of exposure, and physical properties that inform risk and emergency steps.

Exposure assessment

Estimated exposure concentration, task duration, frequency, and comparison to OSHA/ACGIH limits or other OELs.

Control measures

Engineering, administrative, and PPE measures with clear responsibilities for implementation and maintenance.

Monitoring and review

Air monitoring plan, medical surveillance triggers, review frequency, and responsible person for reassessment.

Signatures and training

Spaces for assessor sign-off, supervisor acknowledgment, employee briefings, and date stamps for legal traceability.

Essential fields to capture on the form

Employer name: Company legal name

Work location: Site or facility address

Substance ID: Chemical name or product code

SDS date: MM/DD/YYYY

Control summary: Engineering and PPE listed

Assessor signature: Name, role, and date

Where completed forms should go and who receives them

Establish a simple routing path so completed assessments are stored, reviewed, and acted on by the right parties.

Safety file: Primary copy retained in the centralized safety management folder.
Supervisor copy: Supervisor keeps a task-level copy for daily checks.
HR or records: Employee exposure or training items filed with HR as required.
EHS archive: EHS team stores final assessment and monitoring data for audits.

How to set up an online workflow for the form

Configure fields and notifications to ensure consistent completion, sign-off, and retention across locations.

Field	Configuration
Signature capture	Require signer name, role, and date
Conditional fields	Show monitoring fields only if exposure exceeds threshold
SDS attachment	Attach latest SDS PDF to each form
Reviewer alert	Email notification to EHS on submission

Delivery options and integrations for digital completion

Choose platforms that support PDF/Word import, mobile completion, audit trails, and common integrations for records management.

File formats: PDF, DOCX, and HTML supported
Integrations: Salesforce, Microsoft 365, Google Workspace
Authentication: Email, SMS code, and SSO options

Key timing: reviews, incident updates, and recordkeeping rules

Observe review intervals, post-incident reassessments, and legally required retention windows to remain compliant.

Initial assessment:

Before introducing a new substance or process

Periodic review:

At least annually or after process changes

After incident:

Immediately reassess following spills, exposures, or near misses

OSHA injury records:

Retain injury logs for 5 years (29 CFR §1904.33)

Exposure records:

Retain for 30 years (29 CFR §1910.1020)

Milestones from assessment to archival

Track each milestone so responsibilities and dates are clear throughout the document lifecycle.

01

Assessment completed

Record assessor, findings, and effective date for controls.

02

Control implementation

Document installation or procedural changes and responsible parties.

03

Training delivered

Log employee briefings and competency checks after controls are applied.

04

Periodic reassessment

Schedule formal review and any exposure monitoring required.

Common mistakes to avoid when preparing the form

Using outdated SDS versions or missing the SDS date causes incorrect control selection and regulatory gaps.
Vague controls like 'use ventilation' without specifications leave implementation and enforcement unclear.
Failing to record exposure frequency or duration undermines the assessment and future monitoring decisions.
Not capturing signatures, dates, or reviewer roles weakens auditability and may invite regulatory scrutiny.

Potential consequences of incomplete or inaccurate assessments

Regulatory citation: OSHA enforcement actions possible

Fines and penalties: Monetary penalties and corrective orders

Worker harm: Increased exposure and health incidents

Workers' compensation: Higher claims and premiums

Legal liability: Civil suits for negligence

Record gaps: Loss of defense in investigations

Representative eSignature pricing and capability comparison

Vendor pricing and core capabilities vary; signNow is listed first for direct comparison. Verify plan details with each provider before procurement.

	signNow	DocuSign	Adobe Sign	PandaDoc	HelloSign
Starting Price	$8/user/mo	$15/user/mo	$14/user/mo	$19/user/mo	$15/user/mo
Free Trial	7-day free trial	Varies by vendor	Varies by vendor	Varies by vendor	Varies by vendor
Bulk Send	Yes	Yes	Yes	Yes	No
Audit Trail	Yes	Yes	Yes	Yes	Yes
HIPAA Compliant	Yes	Yes	Yes	No	No
Envelope Cap	No envelope cap	100 envelopes/user/year	Varies by plan	Varies by plan	Varies by plan

Frequently asked questions about using the Workplace Safety Coshh Form

Answers to common questions about legal validity, e-signatures, record retention, and practical handling of missing SDS information.

Need help? Contact support

Can I use electronic signatures for this form?
Yes. Electronic signatures are legally effective under the ESIGN Act (15 U.S.C. §7001) and UETA in most states if intent, consent, attribution, and retention requirements are met.
Does OSHA accept digital records and forms?
OSHA recognizes electronic records when they are maintained and available; ensure audit trails and unalterable logs to support inspections and inquiries.
How long must exposure-related records be kept?
Maintain exposure records for 30 years per 29 CFR §1910.1020. Injury logs follow the five-year rule under 29 CFR §1904.33.
What if an SDS is not available for a product?
Document attempts to obtain the SDS, use supplier contact records, and perform a precautionary assessment; note that lack of SDS does not remove employer responsibility to protect workers.
Who should sign and approve the assessment?
The trained assessor signs to certify the evaluation, the supervisor acknowledges implementation, and affected employees should be briefed and record receipt.
How do I update an existing assessment?
Amend the form with new SDS dates, control changes, and re-sign with dates. Keep previous versions archived to preserve the audit trail.

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