Employee Confirmation of Receipt of

Health & Safety Policy Handbook

Section A

Name ________________________________

Department / Location _____________________________________

Please read the notes below and then sign this form.

We at “company name” have formulated a Health and Safety at Work Policy. This letter is to inform you that the sections of the policy that affect all of our employees are contained in this safety handbook.

Section B

I have read the “company name” Employee Safety Handbook and understand, accept and will comply with its contents so forming part of my contract of employment. I will keep myself aware of its contents and any updates which are made known to me

Employee Signature _______________________________________