Skip to main content
MapTrack
Skip to download form

Free permit to work form

Free general permit to work form (PDF-ready). Covers hazard assessment, precautions, isolation, PPE, authorisation and close-out. Download free.

Updated 28 Sept 2026

Permit to Work Form

General permit to work: complete before commencing any high-risk work activity

Your logo here
0 of 30 checks

Checklist

1Working at heights
2Confined spaces
3Hot work (welding, cutting, grinding)
4Electrical hazards
5Excavation
6Hazardous substances
7Mobile plant / lifting
8Other: _______________

Isolation and energy control

9Plant and equipment isolated at all energy sources
10Lockout / tagout applied and personal locks fitted
11Stored energy released (pressure, electrical, gravity, springs)
12Isolation verified by test (try-start / zero-energy check)
13Lines, pipes or vessels drained, vented, purged or blanked

Work area and atmosphere

14Work area isolated, barricaded and access controlled
15Warning signs and permit displayed at the work area
16Atmospheric testing completed (oxygen, LEL, toxic gases)
17Continuous or periodic gas monitoring arranged where required
18Ventilation adequate or mechanical ventilation in place
19Adjacent areas and combustibles cleared or protected

PPE and fire precautions

20PPE identified, available and fit for the task
21Specialist permits obtained (hot work, confined space, heights)
22Fire extinguisher and fire watch in place for hot work
23Tools and equipment inspected, tagged and fit for use

People, communication and emergency

24Workers competent, trained and inducted for the task
25SWMS or safe work procedure reviewed with all workers
26Adjacent workers and affected parties notified
27Communication method established (radio, standby person)
28Emergency procedures, rescue plan and first aid confirmed
29Access and egress routes clear and emergency contacts known
30Spill containment and waste handling arrangements in place

Authorisation

Requested by (signature)

Print name

Date

Issued by (signature)

Print name

Date

Accepted by, permit holder (signature)

Print name

Date

Close-Out Signatures

Permit issuer (signature)

Print name

Date

Permit holder (signature)

Print name

Date

How to use: download the PDF, print or complete digitally on any device.

  • PDF format, ready to print or fill on screen
  • Use as-is or customise to suit your operation
  • Go digital in MapTrack for photos, reminders and audit trails

Download formats

  • Permit to work form PDF

    PDF: Print-ready permit covering hazard assessment, precautions, isolation, PPE, authorisation and close-out.

  • Permit to work form XLSX

    XLSX: Editable Excel workbook with the same hazard and precaution sections and pass/fail and notes columns.

Two ways to use it

Use in MapTrack →

Download the free PDF

PDFXLSX

Use it digitally instead

Unlimited users

These same 30 checks, already built.

G2 rating 4.9 out of 5Capterra rating 5.0 out of 5
  • Scan the asset’s QR tag with any phone
  • Submitted forms can trigger alerts
  • Photos on fails, audit-ready records
  • Export responses, PDF reports with your logo

Free trial. No credit card needed.

Trusted by teams across Australia and New Zealand

We respect your privacy. Unsubscribe anytime.

These templates are free general guides provided as-is. They do not constitute legal, safety or compliance advice. You are responsible for ensuring any form meets your specific workplace obligations, industry standards and applicable regulations.

Don't just download it - use it live. Start a free workspace with this permit to work form already built, so your crew can run it from a phone.

Jarrod Milford

Jarrod Milford

Co-Founder & Commercial Director

Updated 28 September 2026
Also see:Compliance and inspections →Best inspection software →MapTrack vs SafetyCulture →

Key takeaways

  • The MapTrack permit to work form contains 30 checks across 4 sections. Sections covered: Isolation and energy control, Work area and atmosphere, PPE and fire precautions, People, communication and emergency.
  • A permit authorises specific work, in a specific place, for a specific period, and names who issued it, who accepted it and who cancelled it.
  • The permit is not the control. It is the record that the controls were checked, applied and confirmed before work started.
  • A permit expires. Extending one without re-checking conditions leaves the paperwork in place even though the controls may have changed.
  • The model WHS Regulations set specific duties for confined spaces, work at height and demolition, and the permit is where those checks are recorded.

Enter your email below to download this permit to work form as a ready-to-use PDF.

Used by construction, mining and field service teams

Saunders InternationalMineral ResourcesSupagasHacer GroupMetro TunnelUltrabuilt

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 model WHS Regulations make a permit mandatory for confined space entry and list permit systems as a control for some other hazards, such as falls.

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.

The model WHS Regulations require a permit in one case outright: regulation 67 says a PCBU must not direct a worker to enter a confined space to carry out work unless it has issued a confined space entry permit for the work. The permit must be in writing, completed by a competent person, and name the space, the people permitted to enter, the time period and the risk control measures, with space to acknowledge that the work is complete and everyone has left. The Safe Work Australia Confined spaces Code of Practice says the permit should list control measures such as atmospheric testing, and any specialist emergency rescue equipment required. Part 4.4 (Falls) lists permit systems among its examples of a safe system of work, and the Safe Work Australia model Code of Practice on falls gives an example: requiring permits for access to areas where restraint or fall arrest systems are used. Part 4.6 (Demolition work) requires written notice to the regulator at least 5 days before certain demolition work starts; that is a notice, not a permit. Safe Work Australia Codes of Practice for confined spaces, falls and construction work all reference permit-to-work systems as a recognised control measure. A permit does not replace the controls themselves: HSE guidance on permit-to-work systems says the issue of a permit does not, by itself, make a job safe.

Learn more about compliance and inspections in MapTrack.

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:

  • Field users can easily scan a QR code to complete a form on mobile. Unlimited users.
  • Email the right people when a form is submitted, with an automation you set up.
  • File every completed form against the asset, location or person it covers.
  • Download any completed form as a PDF, with failed answers listed at the top.
  • Fill in forms offline; they upload when the device is back online.
  • Build conditional logic (show or hide questions based on answers).
  • Take pictures or attach photos. Not possible with a paper-based form.
  • Electronic signatures.
  • Edit forms later without reprinting.
  • Set who can view, fill in or edit forms with user roles.
  • Upload a paper form (PDF, Word, Excel or a photo) and MapTrack's AI builds a digital version for you to check.
  • Email safety managers when a hazard report is submitted, with an automation you set up.
  • Keep every hazard and incident report against the site it came from, with photos.
  • Turn a hazard report into a corrective-action work order with its own review step.

Book a demo to see how MapTrack handles checklists.

Try MapTrack free for 30 days

Full access to every feature. No credit card required. Per-asset pricing so you scale as your fleet grows.

Start free trial
  • No credit card required
  • 30 days free trial
  • Cancel anytime

1-2 days/week saved

“Bloody amazing! We used to spend 1-2 days a week tracking and managing our generators alone.”
Saunders International

Steve McAllister

Asset Coordinator, Saunders International

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

  1. 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".
  2. 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.
  3. 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.
  4. 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.
  5. 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.
  6. 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.
  7. 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.
  8. 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.

In MapTrack, you can digitise safety inspections and compliance forms. Each submission is stored as a timestamped PDF against the asset record.

Get the free templateEnter your email above to download the full permit to work form as a PDF.Back to download form

How often should you complete this checklist?

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

A permit to work (PTW) is a formal written document that 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 is used for work activities that carry significant risk and require additional controls beyond standard operating procedures. Common examples include hot work, confined space entry, working at heights, electrical isolation, excavation and work involving hazardous substances. The permit system ensures that hazards are systematically identified, controls are implemented, and work is formally authorised and closed out.

A permit to work should be issued by a competent person who has the authority, knowledge and experience to assess the hazards and verify that all precautions are in place. This is typically the site supervisor, safety officer or a specifically trained permit issuer nominated by the PCBU. The issuer must physically inspect the work area and confirm controls before signing. In many organisations, permit issuer training is a formal requirement and a register of authorised issuers is maintained on site.

A permit to work is valid only for the specific scope of work, location and time period stated on the permit. Most general permits are issued for a single shift or a defined number of hours. The permit expires at the stated end time and must be closed out or extended before that time. A new permit is required when conditions change, when different personnel take over, or at the start of each new shift. Never allow work to continue on an expired permit.

Yes. The PDF and Excel versions are free to download: the PDF prints ready to fill in, and the Excel version can be completed on a computer. No MapTrack account is required. If you want to run permits digitally, MapTrack can hold this form as a mobile form: each completed permit logs who submitted it and when, can be downloaded as a PDF with your logo, and responses export to CSV.

The model WHS Regulations require a permit in one case outright: a PCBU must not direct a worker to enter a confined space to carry out work unless it has issued a confined space entry permit (regulation 67). They also list permit systems among the ways to control a fall risk (regulation 79) and to control access to automatically energised plant such as industrial robots (regulation 222). Certain demolition work needs written notice to the regulator at least 5 days before it starts (regulation 142), which is a notice, not a permit. Your own site procedures set the other jobs that need one.

A general permit to work covers the overall authorisation for a work activity, including hazard assessment, precautions and close-out. Specialist permits such as hot work permits, confined space entry permits and working at heights permits address the specific hazards and controls for those high-risk activities in greater detail. On most sites, a specialist permit is issued alongside the general permit and both must be in place before work can begin. The general permit references the specialist permit numbers to create a linked audit trail.

Applicable regulatory standards

This template is a starting point. Check the current requirements that apply to your equipment, work and location. The template alone does not establish compliance.

  • Model WHS Regulations - Part 4.3 (Confined spaces), Part 4.4 (Falls), Part 4.6 (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

Check the current source

Permit to work form preview

Permit to work form template preview showing fields and layout

The numbers behind this permit to work form

Every figure below is sourced and dated, so you can quote it in a toolbox talk, a budget case or a board paper without having to chase the original report.

Embed this free template on your website

Run an industry blog, trade association site, or training resource? Drop a preview of this free permit to work form straight into your page. The snippet is self-contained, needs no scripts, and links readers back to the full free template.

<div style="max-width:480px;font-family:system-ui,-apple-system,'Segoe UI',Roboto,sans-serif;border:1px solid #E5E7EB;border-radius:12px;padding:20px;background:#ffffff;">
  <p style="font-size:12px;font-weight:700;letter-spacing:0.05em;text-transform:uppercase;color:#071D49;margin:0;">Free template</p>
  <p style="font-size:18px;font-weight:700;color:#071D49;margin:6px 0 0;">Permit to work form</p>
  <ul style="margin:12px 0 0;padding-left:18px;color:#374151;font-size:14px;line-height:1.6;">
    <li style="margin:4px 0;">Permit details: permit number, date, valid from/to, site/location, area/zone, requested by, work description.</li>
    <li style="margin:4px 0;">Hazard assessment (P/F/N/A): working at heights, confined spaces, hot work, electrical hazards, excavation, hazardous substances, mobile plant, other.</li>
    <li style="margin:4px 0;">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.</li>
    <li style="margin:4px 0;">Specialist permits required: hot work, confined space, working at heights, electrical isolation, excavation, none.</li>
    <li style="margin:4px 0;">PPE required: hard hat, safety glasses, hi-vis, boots, gloves, harness, respiratory, hearing.</li>
    <li style="margin:4px 0;">Authorisation: requested by, issued by, accepted by with signatures and dates.</li>
  </ul>
  <p style="font-size:13px;color:#6B7280;margin:14px 0 0;padding-top:12px;border-top:1px solid #E5E7EB;">Free <a href="https://www.maptrack.com/templates/permit-to-work-form" style="color:#071D49;font-weight:600;text-decoration:none;">Permit to work form</a> by MapTrack</p>
</div>

Free to reuse, including commercially. This template is published under a Creative Commons Attribution 4.0 licence. Copy it, adapt it, put it on your own site or in your own docs. All we ask is that you credit MapTrack with a link back to this page. The snippet above already includes that credit, so if you use it as-is you’re covered.

Cite this template

Writing about this topic? You’re welcome to quote this checklist. Here’s the wording to use so your readers can find the original.

The MapTrack permit to work form contains 30 checks across 4 sections.

Short attribution
MapTrack Permit to work form, https://www.maptrack.com/templates/permit-to-work-form
Reference list
MapTrack. (2026). Permit to work form [Checklist template]. Retrieved from https://www.maptrack.com/templates/permit-to-work-form

Free to reuse with credit under a Creative Commons Attribution 4.0 licence. If you’d rather link straight to it, the page is https://www.maptrack.com/templates/permit-to-work-form.

Need to digitise safety inspections and compliance forms?

Register every asset in MapTrack, attach digital forms, and get a complete history of every inspection, service and compliance record.

Start free trialBook a demo

Compliance and inspections · All templates · Pricing · Book a demo