Laboratory Coat and Safety Gear Acknowledgement Form
Employee Information
Full Name
Department
Position/Title
Date
Acknowledgement
I confirm that I have received and been instructed on the appropriate use, care, and return of the following laboratory safety gear:
Laboratory Coat
Safety Goggles
Gloves
Face Mask
Other
If other, specify:
I acknowledge my responsibility to wear and maintain the issued safety gear as instructed and to report any loss or damage immediately.
Employee Signature
Supervisor Signature