Free Permit to Work Template (UK, HSE-Aligned)

If you manage high-risk work on UK construction or maintenance sites, you almost certainly need a permit-to-work (PTW) system. The problem is knowing where to start. Most contractors understand the concept. What they want is a solid template they can put into use on Monday morning — so there is one below, followed by a walkthrough of why each part is there.

This guide walks through every section a good permit to work template should contain, explains why each part matters, and describes what an HSE-aligned form looks like in practice. PermitPad is building a digital permit to work with guided fields and automatic audit trails — join the waitlist to try it when it launches.

This guide covers UK requirements and references HSE guidance. Legislation and standards may differ in other jurisdictions.

What is a permit to work template?

A permit to work template is a pre-formatted form used to authorise and control high-risk work on site. It is not a risk assessment, though it references one. It is not a method statement. It is a controlled document that records who is doing what, where, when, and under what safety conditions. If you are new to PTW systems, our permit-to-work system guide covers the fundamentals.

HSE guidance document HSG250 describes a permit-to-work system as "a formal recorded process used to control work which is identified as potentially hazardous." The template is the form that system runs on.

There is no official HSE permit form to download. HSG250 says the form "should be designed by the company issuing the permit, taking into account individual site conditions and requirements" — and then lists the essential elements every form should cover. The template below is built on that list.

A single generic PTW template can cover multiple work types — hot work, confined space entry, electrical isolation, working at height — or you can use separate templates for each. Many contractors start with one general-purpose template and add specialist versions later. To see one filled in end to end, read our permit to work example.

Printable permit to work template

Copy this into a Word or Google document, or print the page. Every row maps to one of the thirteen "essential elements of a permit-to-work form" in HSG250's Figure 1 — HSG250 says that "if the permit you use does not cover these areas it is unlikely to be fully achieving its purpose." HSG250 also says "signatures on permit-to-work forms should be dated and timed", so every signature row below has a date and time.

PERMIT TO WORK

#	Section	Fill in
1	Permit title / type (general, hot work, confined space, electrical, height, excavation)
2	Permit number · Cross-reference to other permits or isolation certificates for the same plant or area	No. ______ · Linked: ______
3	Job location (building, level, room, grid reference)
4	Plant or equipment being worked on (ID / tag number)
5	Description of work and its limits — what is and is not covered by this permit
6	Hazards — including hazards left in place (residual) and hazards the work creates
7	Precautions and emergency actions — isolations, barriers, gas tests, fire watch, PPE, rescue arrangements. Isolations signed by the person who made them	Isolated by: ______ Date/time: ______
8	Protective equipment required (including PPE)
9	Issue — issuing authority confirms isolations made and precautions taken. Valid from / to (date and time). Second signature from a permit authoriser for high-hazard work	Issued by: ______ Date/time: ______ Valid until: ______
10	Acceptance — the person in charge of the work confirms they understand the work, hazards and precautions, and have briefed everyone working under the permit	Accepted by: ______ Date/time: ______
11	Extension / shift handover — checks made that plant remains safe; new people briefed; new expiry time	Handed to: ______ Date/time: ______ New expiry: ______
12	Hand-back — work complete (person in charge of the work) · plant ready for testing and recommissioning (issuing authority)	Work complete: ______ Plant ready: ______ Date/time: ______
13	Cancellation — work tested and plant satisfactorily recommissioned	Cancelled by: ______ Date/time: ______

How to use it:

• One permit, one job, one location. HSG250 describes the permit as a document that "authorises certain people to carry out specific work at a specific site at a certain time".
• Complete rows 1-9 before work starts, at the job, not in the office.
• Nobody signs row 9 for their own work. HSG250: "a person should not issue a permit to themself."
• Rows 12 and 13 are separate on purpose. Work finished is not the same as plant safely back in service.

For a filled-in example of this form on a real job, read our permit to work example. For the detail behind each element, see our guide to what every permit must record.

What the template should include

In plain terms, the thirteen elements above group into six sections. Here is what each one covers and why it matters.

Section 1: Permit identification

Every permit needs basic administrative information:

• Permit number — sequential numbering makes filing and auditing straightforward
• Date and time of issue
• Valid from / valid to — HSG250's audit checklist asks: "Do permits clearly specify a time limit for expiry or renewal?" Open-ended permits defeat the purpose of the system.
• Permit type — hot work, confined space, electrical, height, general high-risk, or other
• Site and specific location — "Building A" is not enough. "Building A, basement plant room, south wall" is better.

Section 2: Description of work

A clear, plain-language description of the task being carried out and the equipment being used. This section should be specific enough that anyone reading the permit understands what is happening without needing to ask.

Section 3: Hazard identification

This section links the permit to the relevant risk assessment and identifies location-specific hazards. Typical items include:

• Presence of combustible or flammable materials
• Confined or enclosed spaces
• Live electrical systems or buried services
• Work at height with fall risks
• Other workers or members of the public in the area
• Environmental conditions (weather, ventilation, lighting)

The hazard identification should be completed fresh for each permit, not copied from a previous one. Conditions change.

Section 4: Precautions and controls checklist

This is the most important section. It lists the specific precautions that must be in place before work begins:

• Relevant risk assessment reviewed and briefed to the work team
• Area inspected by the permit issuer
• Isolation or lock-out/tag-out completed where required
• Barriers, signage, or exclusion zones established
• Correct PPE identified and available
• Emergency equipment in place (fire extinguisher, rescue kit, first aid)
• Fire detection or alarm systems isolated if necessary (with notification)
• Atmospheric monitoring completed where applicable
• Affected personnel and neighbouring trades notified

Each item should be individually confirmed — not bulk-ticked. A checklist where every box is marked in the same pen stroke, at the same angle, suggests nobody actually checked anything. For a ready-made starting point, see our universal PTW checklist.

Section 5: Authorisation signatures

HSG250's model form (Figure 1) has at least two signatures before work starts, at elements 9 and 10, alongside the isolation sign-off at element 7 and, for high-hazard work, a permit authoriser:

• Issuing authority (permit issuer) — signs the Issue section (element 9), "confirming that isolations have been made and precautions taken, except where these can only be taken during the work." This should be someone with the competence and authority to make that judgement.
• Performing authority (the person in charge of the work) — signs the Acceptance section (element 10), "confirming understanding of work to be done, hazards involved and precautions required", and that the permit information has been explained to everyone working under it.

Before those, the people who carried out the precautions — for example the isolating authority — "should sign that precautions have been taken" (element 7; the "Isolated by" row in the template above).

The issue and acceptance signatures are the backbone of the system: the person issuing confirms the area is safe, and the person accepting confirms they understand it. HSG250 adds that "a person should not issue a permit to themself", and that where the potential for harm is particularly high a second person — the permit authoriser — should see the permit before issue.

Section 6: Close-out and handback

When the work is finished, the permit must be formally closed. The close-out section records:

• Work completed or suspended
• Area inspected and left in a safe condition
• Isolations removed or systems re-energised
• Fire watch completed for the required period (if applicable)
• Fire detection and alarm systems re-activated
• Permit signed off by the performing authority and the issuer

A permit without a close-out is incomplete, and on paper it is an easy step to miss — the work gets done, everyone moves on, and nobody signs off the permit. HSG250 asks three questions at hand-back: has the work been completed, has the plant been returned to a safe condition ("in particular by removing isolations"), and has the person in control of the area acknowledged it is back under their control? It creates gaps in your audit trail that are difficult to explain during an inspection.

Common mistakes with PTW templates

Too generic. A template that tries to cover every scenario with vague wording ends up covering none of them well. HSG250 notes that "separate permit forms may be required for different tasks, such as hot work and entry into confined spaces". If your team regularly does hot work and confined space entry, consider having dedicated templates for each — our complete guide to permit types covers when each one applies.

No time limit. Permits valid "until further notice" are not real permits. Many sites limit validity to a single shift; where a permit does run longer, HSG250 expects "a formal handover procedure for use when a permit is issued for a period longer than one shift".

Checklist treated as a formality. If the checklist is not actually driving behaviour — if people tick the boxes after the work is done rather than before — the system has failed. Training and regular audits are the fix.

Single-signature permits. A permit signed only by the person doing the work provides no independent check — HSG250 is explicit that nobody should issue a permit to themselves.

HSE references

• HSG250 — Guidance on permit-to-work systems (HSE, first edition 2005). Figure 1 (essential elements of a permit form), paragraphs 11-12, 24, 26, 48-49, Appendix 3. Written for the petroleum, chemical and allied industries; it is guidance, not law, but it is the standard UK reference for PTW design.
• Management of Health and Safety at Work Regulations 1999, regulation 3 — the duty to make "a suitable and sufficient assessment" of risks, which the permit references. These Regulations cover England, Wales and Scotland; in Northern Ireland, regulation 3 of the Management of Health and Safety at Work Regulations (Northern Ireland) 2000 sets the same duty.
• L101 — Safe work in confined spaces (HSE Approved Code of Practice, third edition 2014).

Paper or digital?

Paper permit to work books are inexpensive, widely sold by safety suppliers, and they work. But they have well-known limitations: permits go missing, handwriting is illegible, close-outs get forgotten, and retrieving records for an audit means rifling through a box of carbon copies.

Our guide to digital permits covers why UK contractors are making the switch. A digital permit to work solves these problems. Structured fields replace free-text scrawl, mandatory steps cannot be skipped, signatures are time-stamped, and every permit is stored and searchable instantly.

PermitPad is building a digital permit to work system designed for small UK contractors. It will follow the same section structure described above — identification, hazards, checklist, signatures, close-out — with guided fields on any phone or tablet. Join the waitlist to be first in line when it launches.

Specific permit templates

For detailed, type-specific templates with section-by-section walkthroughs:

• Hot work permit template — welding, cutting, grinding, and brazing permits
• Confined space permit template — gas testing, rescue plans, and atmospheric monitoring
• Working at height permit template — scaffold inspection, fall protection, and fragile-roof work
• Electrical isolation permit template — lock-out/tag-out and isolation verification
• Cold work permit template — non-hot work isolation, mechanical tasks, and maintenance with low ignition risk

If you need a quick printable checklist for today's work, our free safety checklist generator builds one based on your selected work types.