COVID-19 Templates, Checklists and Posters

These checklists and templates have been prepared to help employers, business owners and managers to get their business up and running again and to inform workers about what they need to do to help prevent the spread of Covid-19 in the workplace.

They have been drafted based on the Government’s Work Safely Protocol and should be read in conjunction with the Work Safety Protocol. Employers and workers must work together to keep workplaces safe. These checklists will help you to do that.

Further information can be found at gov.ie, hse.ie, hpsc.ie and hsa.ie

Note: The templates and checklists below have been revised in line with the Work Safely Protocol which was published on the 20th Nov 2020.  The Protocol sets down the minimum measures required in every place of work to prevent the spread of COVID-19 and to facilitate the re-opening of workplaces following temporary closures and the ongoing safe operation of those workplaces.

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Templates

EnglishUpdatedAs Gaeilge
Pre-Return to Work FormPDFpdf_icon30/11/20PDFpdf_icon
COVID-19 Response PlanPDFpdf_icon30/11/20PDFpdf_icon

Employer Checklists

EnglishUpdatedAs Gaeilge
Checklist 1: Planning and PreparingPDFpdf_icon30/11/20PDFpdf_icon
Checklist 2: Infection Prevention and Control (IPC) MeasuresPDFpdf_icon30/11/20PDFpdf_icon
Checklist 3: COVID-19 InductionPDF pdf_icon30/11/20PDFpdf_icon
Checklist 4: Dealing with a Suspected Case of COVID-19PDF pdf_icon30/11/20PDFpdf_icon
Checklist 5: Cleaning and DisinfectionPDF pdf_icon30/11/20PDFpdf_icon

Employee Checklist

EnglishUpdatedAs Gaeilge
Checklist 6: WorkersPDFpdf_icon30/11/20PDFpdf_icon

Lead Worker Representative(s) Checklist

EnglishUpdatedAs Gaeilge
Checklist 7: Lead Worker Representative(s) ChecklistPDFpdf_icon30/11/20PDFpdf_icon
Lead Worker Representative Poster (A3)PDFpdf_iconPDFpdf_icon
Lead Worker Representative Poster (A4)PDFpdf_iconPDFpdf_icon

Note: The Return to Work checklists and plan are now interactive fillable forms designed using Adobe Acrobat. It is recommended that users use the Adobe Acrobat Reader DC to open and edit the fillable forms.

If you are using an Android or Apple device we recommend you download the Adobe Acrobat Reader from the Google Play or Apple App Store to view and edit the fillable forms.