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Safe Work Method Statement (SWMS)

High-risk construction work procedure and risk control record

Company logo

PAGE 1 OF 2

Project Details

Project name

Site address

Principal contractor

SWMS prepared by

Date prepared

Revision number

High-Risk Work Type

Select all that apply

Work Steps, Hazards & Controls

List each work step in sequence. Identify hazards for each step, assign a risk rating (H = High, M = Medium, L = Low), and describe the control measures to manage each risk.

Step #	Work activity / step	Hazards identified	Risk (H/M/L)	Control measures	Responsible person
1
2
3
4
5
6
7
8

SWMS - Page 2 of 2

Project

Date

Work Steps (continued)

Step #	Work activity / step	Hazards identified	Risk (H/M/L)	Control measures	Responsible person
9
10
11
12

Emergency Procedures

Worker Sign-On Register

All workers involved in the high-risk work must sign on before starting. By signing, each worker confirms they have read, understood and agree to follow this SWMS.

Name	Company	Signature	Date

Declaration

All workers listed above confirm they have read, understood and agree to follow this SWMS. Work must not commence until all relevant workers have signed on. If site conditions change, this SWMS must be reviewed and updated before work continues.

Prepared by

Signature

Print name

Position

Date

Approved by

Signature

Print name

Position

Date