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PPE Hazard Assessment Form

Walk the area, tick the hazard sources you found, then record the hazards and the PPE selected for each body part. The document builds itself as you type and prints clean on one Letter page. It carries the four things 29 CFR 1910.132(d)(2) requires a written hazard assessment to identify. Nothing you type is sent to our servers.

Required element of the written certification — 1910.132(d)(2).
Required element — 1910.132(d)(2).
Reassess whenever equipment, processes or accident records change (App. B).

Nothing you type is sent to our servers. A draft is kept in this browser until you clear it.

Template for informational purposes only. This document must be reviewed and adapted by a competent or qualified person for your specific jobsite, equipment, and applicable federal, state, and local requirements. It does not constitute legal, engineering, or safety advice and does not by itself establish compliance with OSHA or any other standard. SteelToeTools assumes no liability for its use. Nothing you type is sent to our servers.

How to use this form

  1. 1
    Walk the area before you type anything. Appendix B is explicit: the assessment starts with a walk-through survey of the area in question, looking for the ten sources of hazards listed in step 2 of this form, plus a review of the injury and accident records for that area.
  2. 2
    Scope it to one area, process or job. The certification has to identify the workplace evaluated, so a document that says “entire facility” is weak. One per weld shop, per line, per crew.
  3. 3
    Name the hazard, then the PPE. “Flying particles from grinding” → “ANSI Z87.1 safety glasses with side shields, plus a face shield when using the 9-inch grinder.” A body part with no hazard is marked Not required — that is a finding too.
  4. 4
    Sign, date and keep it. Print or save the PDF, sign as the person certifying the evaluation, and file it with your PPE program. Redo it when the equipment, the process or the accident record changes.

What 1910.132 requires

PPE hazard assessment requirements and where they come from
RequirementSource
Assess the workplace to determine if hazards are present, or likely to be present, which necessitate PPE1910.132(d)(1)
Select and require each affected employee to use the PPE that protects against those hazards1910.132(d)(1)(i)
Communicate the selection decisions to each affected employee1910.132(d)(1)(ii)
Select PPE that properly fits each affected employee1910.132(d)(1)(iii)
Verify the assessment through a written certification identifying the workplace evaluated, the person certifying it, the date(s), and identifying the document as a certification of hazard assessment1910.132(d)(2)
Train each employee who must use PPE: when it is necessary, what is necessary, how to don, doff, adjust and wear it, its limitations, and its care, maintenance, useful life and disposal — with competency demonstrated before the work1910.132(f)
Ten sources of hazards to observe during the walk-through survey, plus review of injury and accident data1910 Subpart I App. B, §1
Reassess the workplace as necessary — new equipment or processes, accident records, suitability of the PPE already selected1910 Subpart I App. B, “Reassessment of hazards”
Construction: PPE required wherever workers are exposed to hazardous conditions, of safe design and fitting each employee — but no equivalent written certification clause1926.28(a); 1926.95(a), (c)

Hearing protection (1910.95), respirators (1910.134) and fall protection each have their own standards, with their own program, monitoring or fit-testing duties. Recording them here keeps the picture complete; it does not satisfy those standards. Federal OSHA is the floor — State Plan states may require more.

Frequently asked questions

29 CFR 1910.132(d)(1) requires the employer to assess the workplace to determine if hazards are present, or likely to be present, which necessitate PPE; then to select and require the right PPE, communicate the selection to each affected employee, and select PPE that properly fits each affected employee.

The assessment itself is a workplace evaluation; what must be written is the verification. 1910.132(d)(2) requires a written certification that identifies the workplace evaluated, the person certifying that the evaluation has been performed, the date(s) of the hazard assessment, and that identifies the document as a certification of hazard assessment. This form produces exactly those four elements.

Subpart I Appendix B lists the sources to observe: motion, high temperatures, chemical exposures, harmful dust, light radiation, falling or dropped objects, sharp objects, rolling or pinching objects, workplace layout and the location of co-workers, and electrical hazards. Injury and accident records should be reviewed at the same time to find problem areas.

OSHA does not set a format. The certification has to identify the workplace evaluated, so the practical approach is one assessment per work area, process or job classification where the hazards are the same, rather than one generic document for an entire site. Note on the form which tasks it covers.

There is no fixed interval in the standard. Appendix B puts the duty on the employer to reassess as necessary — new equipment or processes, a change in the work, a review of accident records, or a finding that the PPE selected is not suitable. Many employers add an annual review on top of those triggers; record whichever date you set.

The form lets you record them so the picture is complete, but they are governed by their own standards. Hearing protection follows 29 CFR 1910.95, which requires noise monitoring and a hearing conservation program at an 85 dBA 8-hour TWA. Respirators follow 29 CFR 1910.134, which requires a written respiratory protection program, medical evaluation and fit testing — a line on this form is not a substitute for either.

Not by 29 CFR 1926 Subpart E. Construction requires the employer to require appropriate PPE wherever workers are exposed to hazardous conditions (1926.28(a)) and, under 1926.95(c), that PPE be of safe design and fit each affected employee — but it has no clause equivalent to 1910.132(d)(2). Many general contractors and owners require the document contractually anyway, and it is good practice.

No. The document records an assessment someone still has to perform on site, and the standard also requires that the PPE be provided, that it fit, and that employees be trained under 1910.132(f) before doing work requiring PPE. Have a competent person review the completed form and keep it with your PPE program.

Sources & references

Content checked against these sources — last reviewed August 27, 2026.

By — Editorial team of SteelToeTools.com (published by LSEA SAS) Updated v1