Site Induction Form

Welcome to a BuilderShield building site! To comply with OH&S and site safety procedures everyone on-site must complete this form. This includes; clients, subcontractors, inspectors, and suppliers. Thank you for taking the time to complete the form.

What BuilderShield site are you working on?

First Name

Last Name

Mobile Number

Date of Birth

Home Address (primary residence)

Email Address

Company / Contractor Name and Trade

Do you have any pre-existing injuries, medical conditions or allergies? (bee stings, nuts etc)

Emergency Contact Name

Emergency Contact Number

Upload a Photo of your White / Red Card

The Construction Induction Card is a mandatory requirement for all workers on construction sites.

I do not have my white/red card on me and agree to upload it when BuilderShield follows me up.

I have been made aware of the location the site signage and safety information including; Coordination Plan, Site Rules, Emergency Procedures, WorkCover if you are injured at work poster Yes, I am aware of the safety information

I have been made aware of BuilderShield OHS&E Plan Yes, I have been made aware of the OHSE site plan

I agree to report any injuries, incidents or near misses to BuilderShield Yes, I agree to report any incidents or hazards

Do you consent to the processing and storage of your data?

By completing and submitting the Site Induction form, you confirm that all information provided is accurate and up-to-date. BuilderShield is not liable for any inaccuracies or omissions. and you agree for BuilderShield to process and store your data on behalf of BuilderShield and agree to the Privacy Policy.

Signature