Volunteering Bank
Health & Safety Questionnaire
1. Health & Safety
Does your organisation have a written Health & Safety Policy, if ‘yes’ please attach?
If ‘no’, please give reason:
Will the student receive an induction and other safety related training, including use of
vehicles, plant and equipment, necessary to undertake the placement safely?
Is your organisation registered with:
a) the Health and Safety Executive?
b) the Local Authority Environmental Health Department?
2. Insurance
Is Employer Liability Insurance held?
If yes:
Company with whom policy is held:
Policy Number:
Expiry Date:
Level of Cover: £
Is Public Liability Insurance held?
If yes:
Company with whom policy is held:
Policy Number:
Expiry Date:
Level of Cover: £
3. Risk Assessment
Have you carried out a risk assessment of your work practices that includes the work to
be undertaken by the student?
Have suitable and sufficient controls been implemented as a consequence of that risk
assessment?
Are risk assessments reviewed regularly eg: annually or after any significant change
whichever is sooner?
4. Accidents and Incidents
Is there a formal procedure for reporting and recording accidents and incidents in
accordance with the Reporting of Injuries, Diseases and Dangerous Occurrences
Regulations 1989 (RIDDOR)?
Will your organisation report to the University all accidents or incidents involving the
placement student?
Have you emergency procedures in place to deal with imminent danger/s eg fire?
Will you report to the University any sickness involving the student volunteer, which may
be attributable to the work being undertaken?
5. Work Involving People Under 18 Years or Vulnerable Adults*
Will you inform the student if they will need a DBS check?
Yes
No
Yes
No
Yes
No
Yes
No
Yes
No
* A vulnerable adult is a person over 18 who has a physical or mental illness or disability which affects their ability to
protect themselves from abuse.
I understand, acknowledge and intend that putting an ‘X’ in the box below and sending this document
electronically, shall have the same effect as if I had signed the document.