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North Carolina Office of State Human Resources
Safety Health and Workers Compensation DivisionReturn to Work Program Implementation Manual
for State Agencies and Universities
September 2017EXPLANATION
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How to fill out safety health and workers

How to fill out safety health and workers
01
To fill out a safety health and workers form, follow these steps:
02
Start by gathering all the necessary information about the health and safety measures at the workplace.
03
Ensure you have the relevant forms or templates to fill out. These forms can typically be obtained from the appropriate regulatory bodies or organizations.
04
Begin by providing general information about the workplace, such as its name, address, and contact details.
05
Proceed to fill out specific details about the safety measures in place, such as fire prevention protocols, hazardous materials handling procedures, and emergency evacuation plans.
06
Include information about the workers, their roles, responsibilities, and any specific training they have received.
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Ensure you accurately capture any incidents or accidents that have occurred in the workplace, including the steps taken for investigation, prevention, and reporting.
08
Review the completed form for accuracy and completeness, making any necessary corrections.
09
Obtain any required signatures or endorsements from relevant parties, such as management representatives or safety officers.
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Keep a copy of the filled-out form for records and submit the original to the appropriate authorities or keep it readily accessible in case of inspections or audits.
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Regularly review and update the safety health and workers form to reflect any changes or improvements in the workplace's safety measures.
Who needs safety health and workers?
01
Safety health and workers forms are required by various stakeholders involved in promoting and maintaining workplace safety. These may include:
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- Employees or workers: They benefit from these forms as they outline the safety measures in place and their respective responsibilities.
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- Trade unions or employee representatives: They may use these forms to ensure that the rights and safety of workers are protected.
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What is safety health and workers?
Safety health and workers refer to the regulations and practices in place to ensure the well-being and protection of employees in the workplace.
Who is required to file safety health and workers?
Employers are typically required to file safety health and workers reports.
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Safety health and workers reports can usually be filled out online or submitted in a physical form to the relevant authorities.
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The purpose of safety health and workers regulations is to create a safe and healthy work environment for employees.
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Information such as workplace incidents, safety training programs, and health and safety measures must be reported on safety health and workers.
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