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APPENDIX Montgomery County Government, Risk Management Division 1 Millennium Plaza, Suite 111 Clarksville, TN 37040 Phone: 9316485715MONTGOMERY COUNTY GOVERNMENT ONTHEJOB INJURY DECLINATION FORM decline
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Start by collecting all the necessary information about the job that needs to be filled out on the safety and health on-form-job.
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Determine the appropriate safety controls and measures that need to be implemented to mitigate the identified hazards.
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Clearly document and communicate the safety and health requirements to the relevant workers or employees.
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Who needs safety and health on-form-job?

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Anyone who is responsible for managing or supervising job tasks that involve potential hazards or risks.
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Organizations or companies that prioritize the well-being and safety of their employees and strive to maintain a strong safety culture.
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Safety and health on-form-job refers to the practices, regulations, and documentation required to ensure the workplace is safe and that health standards are maintained while work is being performed.
Employers in certain industries, particularly those with higher risks of workplace injuries and illnesses, are typically required to file safety and health on-form-job documentation.
To fill out a safety and health on-form-job, one must gather relevant data about workplace conditions, training records, incident reports, and employee safety measures, then record this information accurately on the designated forms.
The purpose of safety and health on-form-job is to promote workplace safety, ensure compliance with regulations, monitor health and safety practices, and prevent occupational injuries and illnesses.
Information that must be reported includes details on workplace hazards, safety protocols, employee training, incident logs, and compliance measures related to safety and health standards.
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