Get Work Refusal Form - Fiasco Gelato

Filling out the Work Refusal Form is an important step in ensuring workplace safety. This guide provides clear and comprehensive instructions on how to complete the form online, empowering users to articulate their concerns effectively and ensure they are addressed.

Follow the steps to fill out the Work Refusal Form online.

1. Click ‘Get Form’ button to obtain the form and open it in the editor.
2. Enter the worker's name in the 'Team Member’s Name' field. This should be the full name of the individual reporting the work refusal. Next, fill in the 'Date' to indicate when the form is being completed.
3. Provide the 'Location of Refusal' where the incident occurred. Specify the exact area or site related to the concern raised.
4. Complete the 'Team Lead' field by noting the name of the individual responsible for overseeing the team member during the incident.
5. Record the 'Time Notified' to indicate when the team member communicated their refusal to work.
6. In the 'Describe Team Member’s Job Assignment' section, provide a brief description of the duties the worker was performing at the time of refusal.
7. In the 'Nature of Concern / Imminent Danger' section, clearly articulate the specific safety concerns that led to the work refusal.
8. Under the 'Supervisor' section, the Team Lead should indicate their response by checking one of the available options regarding the safety of the job.
9. If the job is deemed unsafe, the Team Lead should outline the 'Recommendations' for making the job safe, ensuring to follow institutional protocols.
10. Once the Team Lead's input is complete, the confirmed statement by the Team Member needs to be signed and dated to acknowledge their agreement or disagreement regarding the resolution of their concern.
11. If there is disagreement, proceed to Step 3, wherein the 'Safety Representative' will fill out any necessary details about notifications made to Health and Safety Officers and Managers.
12. Finalize the form by confirming all details are accurate and complete. Users may then save changes, download, print, or share the completed form as required.

Complete your Work Refusal Form online to ensure your safety concerns are properly documented and addressed.