Food Handler Safety Acknowledgment Form
Employee Name
Position/Title
Department
Safety Instructions Received
Personal hygiene requirements and proper hand washing
Proper use of gloves and utensils
Prevention of cross-contamination
Proper temperature control for food storage and service
Cleaning and sanitizing procedures
Reporting symptoms of illness or injuries
Acknowledgment
I acknowledge that I have received training and understand the food safety procedures mentioned above.
Employee Signature
Date
Supervisor Name
Supervisor Signature