noun_Needs-Assessment_4202-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,, and

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.


Checklist PNPTemplates

EnglishUpdatedAs GaeilgeUpdated
Pre-Return to Work FormDownload PDF21/05/21Download PDF21/05/21
COVID-19 Response PlanDownload PDF30/07/21Download PDF04/08/21

Employer PNPEmployer Checklists



As GaeilgeUpdated
Checklist 1: Planning and PreparingDownload PDF 30/07/21Download PDF 04/08/21
Checklist 2: Infection Prevention and Control (IPC) MeasuresDownload PDF21/05/21Download PDF 21/05/21
Checklist 3: COVID-19 InductionDownload PDF 21/05/21Download PDF21/05/21
Checklist 4: Dealing with a Suspected Case of COVID-19Download PDF 21/05/21Download PDF21/05/21
Checklist 5: Cleaning and DisinfectionDownload PDF 21/05/21Download PDF 21/05/21
Checklist 8: VentilationDownload PDF 29/07/21Download PDF29/07/21
New DocumentChecklist 9: Returning to the OfficeDownload PDF12/08/21Download PDF09/09/21
New DocumentChecklist 10: Rapid Antigen Diagnostic Tests (RADTs) Download PDF12/08/21Download PDF09/09/21

Worker PNP

Worker Checklists

EnglishUpdatedAs GaeilgeUpdated
Checklist 6: WorkersDownload PDF21/05/21Download PDF21/05/21
New DocumentChecklist 10a: Rapid Antigen Diagnostic Tests (RADTs)Download PDF12/08/21Download PDF09/09/21

LWR1 PNGLead Worker Representative(s) Checklist

EnglishUpdatedAs GaeilgeUpdated
Checklist 7: Lead Worker Representative(s) ChecklistDownload PDF21/05/21Download PDF21/05/21
Lead Worker Representative Poster (A3)Download PDF10/03/21Download PDF22/04/21
Lead Worker Representative Poster (A4)Download PDF10/03/21Download PDF22/04/21

Note: The Work Safely Templates and Checklists 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.