PPE Clothing Request Form Template
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PPE Clothing Request Form

Please complete this PPE Clothing Request Form, selecting from the available options where applicable. Your accurate and detailed information is essential for us to meet your protective clothing needs effectively.

  1. Requestor Information

Name:

[Your Name]

Job Title/Position:

[Your Job Title]

Department/Area:

[Your Department Name/Work Area]

  1. Type of PPE Clothing Needed

PPE Clothing Requested (Select from list):

  • Safety Vests

  • Flame-resistant Overalls

  • Chemical-resistant Suits

Intended Use:

For handling and experimenting with hazardous chemicals.

  1. Size and Quantity

Sizes (Select from list):

  • S

  • M

  • L

  • XL

  • XXL

Quantity:

  1. Work Environment and Hazards

Work Environment Description:

Indoor laboratory with chemical exposure.

Hazards (Select from list):

  • Chemical Exposure

  • Fire Risks

  • Electrical Hazards

  1. Previous PPE Clothing Use

Previously Used PPE Clothing:

Standard lab coats, basic safety glasses.

Feedback/Issues with Previous PPE:

Lab coats insufficient for spill protection; glasses lack adequate side protection.

  1. Urgency and Justification

Urgency (Select one):

  • High

  • Medium

  • Low

Explain the Urgency:

Needed for upcoming project in two weeks.

Justification for Request

Enhanced protection is required for handling high-concentration chemicals.

  1. Approval and Processing

Managerial Approval:

_______________

[Manager’s name] 

[Date]

Submitted by:

                              

[Your Name]

[Your Job Title]

[Your Company Name]

Thank you for completing the PPE Clothing Request Form.

Your safety is our priority, and we strive to provide the necessary protective clothing promptly.

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