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AF FORM 55 Employee Safety and Health Record
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af55.pdf

Form Instructions

INSTRUCTIONS : EMPLOYEE SAFETY AND HEALTH RECORD (AF FORM 55)

An AF Form 55 is a United States Air Force form is used for documenting the completion of initial and recurring safety training. The for serves as an employee safety and and health record, to be kept in the workplace and update the training as necessary.
The AF Form 55 is available on the United States Air Force documentation website or can be supplied through the chain of command.
The first section of the AF Form 55 is to be filled out by the workplace supervising authority.

1. The officer in charge of the workplace must identify themselves on the AF Form 55.

2. Boxes 1 through 3 must state the name of the supervising officer, their social security number, and their organization or workplace identifier.

3. Boxes 4 and 5 must identify the occupation series and duty of the supervising official. In these boxes, provide the official title used in your organization and provide the specific duty type you are assigned to supervise.

4. In box 6, the supervising officer must list the hazards that are associated with the job tasks or work areas involved in their assigned duties. List all hazards, both minimal and severe, indicating how likely the hazards may be encountered.

5. Use box 7 to indicate any occupational health examinations that may be required for the duties served in the workplace. Such exams may not be required in all duty types, in which case you may leave box 7 blank.

6. The next section provides a checklist for all mandatory safety items to be briefed by the supervisor to all on duty in the workplace.

7. As you inform your crew of the hazards and safety precautions to be taken, you must check off the boxes as necessary.

8. Continue checking off the boxes and keep the AF Form 998 in the workplace and continue to update the form as additional training is accomplished.

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