HEALTH COMPLIANCE SLIP
Employee Name: [Your Name] | Date: [Month Day, Year] |
Employee ID: 50-123 | Position: Production Staff |
Dear [Your Name],
As part of our commitment to maintaining a safe and healthy workplace, we kindly request your confirmation of compliance with our company's health policies. Please check the appropriate boxes to indicate your compliance:
Compliance | Yes | No |
I have read and understand the company's health and safety policies. | ✓ | |
I follow proper hand hygiene practices, including regular handwashing. | | |
I participate in company-sponsored health screening and programs. | | |
I wear the required personal protective equipment (PPE). | | |
I report any safety concerns or incidents promptly. | | |
I received training and education on our company's health and safety. | | |
Your commitment to these policies is essential to ensure the health and safety of our entire team. If you have any questions or require clarification on any aspect of our health policies, please do not hesitate to reach out to our HR department.
By signing below, you acknowledge your compliance with our company's health policies:
____________________
[Your Name]
Date:
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