Free permit to work form
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Free general permit to work form (PDF-ready). Covers hazard assessment, precautions, isolation, PPE, authorisation and close-out. Download free.
Commercial Director
Updated 3 May 2026
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What is a permit to work form?
A permit to work (PTW) is a formal written system used to control work activities that carry significant risk. The permit authorises specific people to carry out specific work at a specific location during a defined time period, after confirming that all identified hazards have been assessed and appropriate precautions are in place. It covers the work description, hazard assessment, precautions (isolation, barriers, signage, PPE, gas testing, ventilation), specialist permits required (hot work, confined space, working at heights), authorisation chain, time limits, extensions and formal close-out. The PTW system is a core component of workplace safety management and is required under Australian WHS regulations for high-risk work activities.
The permit creates a structured communication chain between the people requesting the work, the people authorising it and the people performing it. This ensures that everyone involved understands the hazards, the controls in place and the conditions under which the work may proceed. A well-managed PTW system prevents conflicting activities in the same area and provides a documented audit trail for regulators, clients and insurers.
WHS Regulations 2011, Part 4 mandates specific permit requirements for several high-risk work categories. Division 2 requires a confined space entry permit before any person enters a confined space, including atmospheric testing results and rescue arrangements. Division 4 addresses fall prevention obligations and references permits for working at heights where fall arrest systems are used. Division 5 covers demolition work notifications. Safe Work Australia Codes of Practice for confined spaces, falls and construction work all reference permit-to-work systems as a recognised control measure. Organisations that fail to implement a structured PTW system for high-risk activities risk enforcement action from the regulator, and the absence of documented permits significantly weakens the PCBU defence of having taken all reasonably practicable steps to manage risk.
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Benefits of using this permit to work form
- Systematic hazard control: ensures every significant hazard is identified, assessed and controlled before work begins.
- Clear authorisation: only authorised people can issue, accept and close out permits, creating accountability at every stage.
- Coordination of activities: prevents conflicting work activities in the same area (e.g. hot work near flammable materials).
- Regulatory compliance: demonstrates due diligence under WHS regulations for high-risk work activities.
- Time-bound control: permits have defined validity periods, ensuring conditions are reassessed if work takes longer than planned.
- Audit trail: completed and closed-out permits provide documented evidence for safety audits and incident investigations.
Benefits of digitising forms in MapTrack
When you move your checklists from paper to MapTrack, you get:
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- Build conditional logic (show or hide questions based on answers).
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- Electronic signatures.
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- Restrict permissions (who can view, complete or approve).
- Build forms with AI (describe what you need and MapTrack suggests the form).
- Escalate critical hazards instantly to safety managers via push notification.
- Maintain an auditable safety register that satisfies WHS regulator requests.
- Correlate incident trends across sites with built-in safety analytics.
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What to include in a permit to work form
This permit to work form covers 8 key areas:
- Permit details: permit number, date, valid from/to, site/location, area/zone, requested by, work description.
- Hazard assessment (P/F/N/A): working at heights, confined spaces, hot work, electrical hazards, excavation, hazardous substances, mobile plant, other.
- Precautions checklist (P/F/N/A): area isolated/barriered, lockout/tagout applied, gas testing completed, fire extinguisher available, PPE identified, adjacent workers notified, signage displayed, emergency plan reviewed.
- Specialist permits required: hot work, confined space, working at heights, electrical isolation, excavation, none.
- PPE required: hard hat, safety glasses, hi-vis, boots, gloves, harness, respiratory, hearing.
- Authorisation: requested by, issued by, accepted by with signatures and dates.
- Permit extension: extended to date/time, authorised by, conditions unchanged.
- Close-out: work complete, area restored, all personnel clear, closed by with date and signatures.
How to use this permit to work form
- Complete the permit details - permit number, date, validity period, site, area and work description.: Assign a unique permit number from your site register so the permit can be tracked and cross-referenced. Record the exact validity period with start and end dates and times. The work description should be specific enough that anyone reading the permit understands exactly what task is being performed, where and by whom. A vague description such as "maintenance work" is insufficient; instead write "replacement of the 415V isolator on switchboard SB-03 in the east substation".
- Assess hazards. Mark each hazard category as Present, Fail (requiring additional controls) or N/A.: Review every hazard category on the form: working at heights, confined spaces, hot work, electrical hazards, excavation, hazardous substances and mobile plant. Mark each as Present if the hazard exists and is controlled, Fail if additional controls are needed before work can proceed, or N/A if the category does not apply to this task. Any hazard marked Fail must have a corrective action completed and re-verified before the permit is issued.
- Work through the precautions checklist. Confirm isolation, lockout/tagout, gas testing, fire equipment, PPE, notification, signage and emergency plan. Mark P/F/N/A for each item.: Physically verify each precaution on site rather than ticking from memory or assumption. Confirm that isolation points are locked and tagged, that gas testing results are within safe limits, that a charged fire extinguisher is positioned within reach, that all affected workers and adjacent trades have been notified, and that the emergency plan for the work area is current and accessible. Record gas test readings where applicable, including the instrument ID, calibration date and the measured values for oxygen, LEL and toxic gases.
- Identify any specialist permits required (hot work, confined space, heights, electrical, excavation).: Determine whether the work triggers the need for a specialist permit in addition to the general permit to work. For example, any cutting, welding or grinding requires a hot work permit; entry into a space with restricted access and potential atmospheric hazards requires a confined space entry permit. Record the specialist permit numbers and confirm they are current and physically attached or cross-referenced. The general PTW should not be issued until all required specialist permits are also in place.
- Identify required PPE and confirm it is available.: List every item of personal protective equipment required for the task based on the hazard assessment. This may include hard hat, safety glasses, face shield, hearing protection, hi-vis vest, steel-cap boots, chemical-resistant gloves, fall arrest harness, respiratory protection or arc flash rated clothing. Physically confirm that each item is on site, in serviceable condition and correctly sized for the workers involved. Do not issue the permit if required PPE is missing or damaged.
- The requester, permit issuer and permit holder sign to authorise the work.: The authorisation chain creates clear accountability. The requester (the person or team who needs the work done) signs to confirm the scope. The permit issuer (typically the site supervisor or safety officer) signs to confirm all hazards are assessed and precautions are in place. The permit holder (the person who will supervise the work) signs to accept responsibility for following the conditions on the permit. Each signature must include the printed name, role, date and time.
- If work extends beyond the original validity period, complete the extension section with re-authorisation.: Before extending, re-assess whether conditions have changed since the original permit was issued. Check that isolation is still in place, gas test results are still valid, weather has not deteriorated, and no new hazards have been introduced. Record the new end time and have the extension authorised by the permit issuer. Most organisations limit permits to one extension; if conditions have materially changed, cancel the original permit and issue a new one rather than extending.
- When work is complete, close out the permit - confirm work is done, area is restored, all personnel are clear, and sign off.: Walk the work area to verify that all tools and materials have been removed, temporary barriers and signage have been taken down or left in place as required, isolation locks have been removed (only by the person who placed them), and the area is safe for normal operations to resume. Confirm that all personnel listed on the permit have left the work area. The permit holder and permit issuer both sign the close-out section with the date and time. File the completed permit in the site permit register.
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A new permit to work must be issued for each specific work activity, location and time period. The permit is valid only for the scope of work, location and duration described. A new permit is required when the work scope changes, when conditions change (e.g. weather, adjacent activities), when personnel change, or at the start of each new shift. If the work takes longer than planned, the permit can be extended once with re-authorisation, but a new permit should be issued if conditions have materially changed. The permit must be closed out as soon as the work is complete and the area is restored. Never allow work to proceed on an expired or closed permit.
Frequently asked questions
Applicable regulatory standards
This template aligns with the following regulations and standards:
- WHS Regulations 2011 - Part 4, Division 2 (confined spaces), Division 4 (falls), Division 5 (demolition work)
- WHS Regulations 2011 - Part 3.2 (general workplace management)
- Safe Work Australia - Code of Practice: Confined Spaces
- Safe Work Australia - Code of Practice: Managing the Risk of Falls at Workplaces
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