HFORM19: Staff HSQEMS Acknowledgment Form¶
| Field | Details |
|---|---|
| Form Reference | HFORM19 |
| Version | 1.0 |
| Classification | CRGI Information |
| Form Owner | Sean Ashton, Operations Manager |
| Purpose | HSQEMS policy awareness acknowledgment per ISO 9001/14001/45001 Cl. 7.3 |
Document Control¶
| Version | Date | Author | Changes |
|---|---|---|---|
| 1.0 | 10/03/2026 | Sean Ashton | Initial release |
Purpose¶
This form documents staff acknowledgment of HSQEMS policies, procedures, and responsibilities in compliance with ISO 9001 Clause 7.3 (Awareness), ISO 14001 Clause 7.3 (Awareness), and ISO 45001 Clause 7.3 (Awareness). Electronic completion and signature are legally binding and equivalent to handwritten signatures.
1. Staff Information¶
| Field | Details |
|---|---|
| Full Legal Name | ________________ |
| Job Title/Role | ________________ |
| Email Address | ________________ |
| Start Date | ________________ |
| Department/Team | ________________ |
2. Required Reading — HSQEMS Policies¶
All staff must read and understand the following policies available at hsqems.crgi.uk
| Policy Reference | Policy Name | Summary |
|---|---|---|
| HPOL01 | HSQE Policy | Master policy — overall HSQEMS framework and commitments |
| HPOL02 | Quality Policy | Quality management commitments and objectives |
| HPOL03 | Environmental Policy | Environmental protection and sustainability |
| HPOL04 | Health & Safety Policy | Workplace safety, risk management, wellbeing |
| HPOL07 | Code of Conduct | Professional behaviour and ethical standards |
| HPOL15 | PPE Policy | Personal protective equipment requirements |
3. Policy Acknowledgment¶
By checking all boxes below, you confirm you have read, understood, and accept these policies:
☐ I have read and understood HPOL01 (HSQE Policy)
☐ I have read and understood HPOL02 (Quality Policy)
☐ I have read and understood HPOL03 (Environmental Policy)
☐ I have read and understood HPOL04 (Health & Safety Policy)
☐ I have read and understood HPOL07 (Code of Conduct)
☐ I have read and understood HPOL15 (PPE Policy)
☐ I have attended the HSQE induction briefing
☐ I have received and reviewed the staff safety handbook
☐ I understand my personal responsibilities for quality, environmental protection, and health & safety
☐ I understand the consequences of policy violations and non-compliance
4. Health & Safety Commitments¶
By checking all boxes below, you commit to the following H&S responsibilities:
☐ I will follow safe working practices and procedures at all times
☐ I will report all hazards and near-misses promptly using HFORM02
☐ I will use PPE as required per HPOL15 and HPROC15
☐ I will attend all required training and competency assessments
☐ I will participate in emergency drills and evacuation procedures
☐ I will comply with the drug and alcohol policy HPOL10
☐ I will complete and update DSE self-assessment HFORM11 as required
☐ I will report all incidents and injuries using HFORM03 immediately
5. Environmental Commitments¶
By checking all boxes below, you commit to environmental responsibility:
☐ I will minimise waste per HPROC17 (Waste Management)
☐ I will conserve energy and natural resources
☐ I will report environmental incidents immediately to management
☐ I will follow waste management and recycling procedures
☐ I will consider environmental impact in work activities and decisions
6. Quality Commitments¶
By checking all boxes below, you commit to quality and document control:
☐ I will follow all documented procedures per HPROC10 (Document Control)
☐ I will report non-conformities and quality issues promptly
☐ I will support continuous improvement initiatives
☐ I will maintain accurate and legible records and documentation
7. Legal Agreement¶
IMPORTANT LEGAL NOTICE — READ CAREFULLY BEFORE PROCEEDING
By electronically signing this form, you confirm the following legal statements:
☐ I have read and fully understood all policies, procedures, and information above. I acknowledge that I have had adequate time and opportunity to review all materials, ask questions, and seek clarification.
☐ I understand the sensitivity of client engineering data and intellectual property entrusted to CRGI Solutions. I confirm that I will maintain confidentiality of all client information, designs, calculations, and commercial data per HPOL01 and information security policies.
☐ I understand that violations of these policies may result in disciplinary action up to and including formal warnings, suspension, or termination of employment, depending on the severity and nature of the violation.
☐ I am personally responsible for compliance with all HSQEMS policies, procedures, and legal requirements. I cannot delegate this responsibility to others or claim ignorance of policy requirements.
☐ This agreement remains in effect for the duration of my engagement with CRGI Solutions and continues to apply after termination unless explicitly superseded by a written policy change notice.
☐ I agree to re-acknowledge updated policies if any HSQEMS policies are materially revised or updated during my employment. I understand that CRGI Solutions will provide notification of policy changes.
☐ I confirm that electronic acknowledgment (electronic signature) has the same legal force and effect as a handwritten signature. I understand this is a legally binding document.
☐ I am freely and voluntarily entering into this agreement without duress, coercion, or undue pressure. I have not been forced to sign and understand my rights to refuse or request clarification.
8. Electronic Signature & Date¶
| Field | Details |
|---|---|
| Full Legal Name (Electronic Signature) | ________________ |
| Date Signed | ________________ |
| Time Signed | ________________ |
IMPORTANT: Your electronic signature must match your full legal name above. This form is not valid if any required checkbox is unchecked.
9. Important Notes¶
CRITICAL REQUIREMENTS:
- ✓ ALL checkboxes in Sections 3, 4, 5, 6, and 7 must be checked for this form to be valid
- ✓ Electronic signature MUST match the Full Legal Name entered in Section 1
- ✓ Complete this form in one session — do not save and return later as this may compromise the legal integrity
- ✓ This is a legally binding document with the same legal status as a handwritten acknowledgment
- ✓ Retain a copy — you will receive electronic copy via email for your records
If you have questions or cannot in good conscience agree to any statements above, you must contact your Line Manager or Sean Ashton (Operations Manager) before signing.
10. Records & Retention¶
| Field | Details |
|---|---|
| Form Completed By (Name/Confirmation) | ________________ |
| Date Received by Operations | ________________ |
| Filed in Personnel Records | ☐ Yes Date: ________ |
| Registered in HREG06 | ☐ Yes - Date: ________ |
Related Documents¶
- ISO 9001 Clause 7.3: Awareness
- ISO 14001 Clause 7.3: Awareness
- ISO 45001 Clause 7.3: Awareness
- HPOL01: HSQE Policy (Master Policy)
- HPOL02: Quality Policy
- HPOL03: Environmental Policy
- HPOL04: Health & Safety Policy
- HPOL07: Code of Conduct
- HPOL10: Drug & Alcohol Policy
- HPOL15: PPE Policy
- HPROC09: Staff Induction Procedure
- HPROC10: Document Control Procedure
- HPROC15: PPE Procedure
- HPROC17: Waste Management Procedure
- HREG06: Training & Competency Register
- HFORM02: Hazard Report Form
- HFORM03: Incident Report Form
- HFORM11: DSE Self-Assessment Form
Classification: CRGI Information Document Control: This form must be completed by all new staff prior to commencing work and by existing staff upon policy updates. Retention: Retain original signed/acknowledged form in personnel file for duration of employment plus 7 years minimum in accordance with employment law and ISO compliance requirements. Legal Status: This form constitutes a binding agreement between the staff member and CRGI Solutions. Electronic completion and signature are legally valid.
END OF FORM