An educational library of workplace documents — purpose, who completes them, when they are used, typical fields, common mistakes and how they connect. Linked to workplace safety, workplace training, occupations, industries and employment documents. Informational only — template examples, not legal advice or official documents; employers remain responsible and using a document does not guarantee compliance.
What a health surveillance record is
A health surveillance record documents that ongoing checks linked to a specific workplace exposure — such as noise, vibration, certain substances or skin contact — have been carried out for a worker, and the high-level outcome the employer is entitled to keep. Detailed clinical information is usually held confidentially by the health professional.
This page is an educational overview with a simplified example. It is not an official template, not jurisdiction-specific and not legal advice — the employer decides, on competent advice, where surveillance is needed.
Purpose
- Record that surveillance linked to an exposure has taken place.
- Track the worker, the exposure and the dates of checks.
- Capture the high-level outcome the employer may hold.
- Support early action where a problem is identified.
Who completes it
- An occupational health professional carries out the clinical part.
- The employer keeps a high-level record, not the clinical detail.
- The employer decides, on advice, where surveillance applies.
- Confidential health information is handled separately.
When it is used
- When a worker is exposed to a hazard that calls for surveillance.
- At intervals advised by the occupational health professional.
- When the exposure or the worker’s circumstances change.
- When a problem is identified that needs follow-up.
Typical fields
- Worker name and the exposure surveillance relates to.
- Dates of checks and the next check due.
- High-level outcome (e.g. fit, fit with advice).
- Any restriction or follow-up the employer needs to act on.
- The provider carrying out the clinical assessment.
- Example fields only — adapt to the exposure and competent advice.
Common mistakes
- Holding detailed clinical data the employer should not keep.
- Treating surveillance as a substitute for controlling exposure.
- Missing the dates when checks are due.
- Not acting on advice or restrictions that come back.
Document workflow
A health surveillance record usually follows the exposure record — for noise, vibration or skin contact — that identifies where surveillance is needed, and it is arranged through an occupational health referral. It is used with the relevant exposure records and may trigger a review of controls if a problem is found.
See the related documents below for what is commonly completed before, alongside and after a health surveillance record.
Retention (high level)
Health surveillance records are generally kept for a period that can be long for certain exposures, in line with the employer’s obligations and data-protection duties, with clinical detail held confidentially. Specific retention periods vary by jurisdiction.
This page does not state a required period — confirm retention with the applicable law and the official authority.
Completing and sharing as a PDF
High-level surveillance records are commonly stored as PDFs, kept securely and separately from confidential clinical data. Exporting to PDF supports documentation; it does not make the record official or guarantee compliance.
Employer checklist
- Take competent advice on where surveillance is needed.
- Keep only the high-level record you are entitled to hold.
- Act on advice, restrictions and review triggers.
- Protect confidential health data and control access.
Worker notes
- Attend surveillance appointments when asked.
- Raise symptoms you think may be linked to your work.
- Understand what is recorded and how your data is protected.
Country considerations
Where surveillance is required, by whom and for how long records are kept varies by country, and the official authority differs. This page is general and high-level — it is not a statement of any country’s law and not legal advice.
Always confirm the current requirements with the official authority for your country and a qualified professional.
Who is responsible
The employer is responsible for arranging health surveillance where it is required, acting on the outcome and protecting health data — and for compliance. This page is an educational overview with a template example; it does not determine where surveillance is needed, does not make a workplace compliant and does not transfer responsibility.
Export, edit and share documents
The documents, policies and templates this involves can be exported, edited, signed, stored and shared as PDFs with the HELPERG PDF Editor.
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