Employee name: __________________________

Date: ______________

1. Go over your company's health and safety policy, explaining the employee's role and responsibilities under it.

2. Show the employee the operation\'s previous year\'s safety statistics, as well as the employee's individual safety record.

3. Communicate the current year's safety goals. Ask the employee what he or she can do to contribute to reaching these goals.

4. Ask the employee to explain the potential safety hazards associated with his or her particular job and how to handle those hazards effectively.

5. Ask whether the employee works safely at home, and whether there are areas of home safety that could be promoted at work.

6. Ask if the employee is involved in any committees and if he or she has an interest in becoming involved in efforts such as the Joint Health & Safety Committee.

7. Ask if there are safety issues in the operation the employee would like to discuss.

8. Ask the employee if there's anything else he or she would like to discuss.

9. Ask the employee to sign a form acknowledging that you had this discussion and that the employee is committed to working safely in accordance with company rules and procedures and with the aim of achieving the company's safety goals.

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