MSD prevention project summary

Printable form including prompts users to insert the following information:

  • Name of project 
  • project participants
  • date issue raised 
  • date to follow up 
  • date issue assessed 
  • date closed
  • Issue (state the problem that was identified)

Description of the MSD hazard control/improvement

A table containing before and after columns, with room to add before and after intervention photos. Includes spaces to fill in the MSD hazards identified and root causes, and MSD hazard controls implemented and results from evaluation. 

Modified from Part 3B: MSD Prevention Toolbox - Beyond the Basics. Developed by Occupational Health and Safety Council of Ontario (OHSCO)

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MSD prevention project summary (1 page PDF)