Lock Out Tag Out Form

The lock out tag out process is critical for working with hazardous energy sources. This checklist provides the basic steps of the LOTO process for your employees to follow.

Like all the templates in our library, this Word document is fully customizable so you can create a site-specific checklist that aligns with your lockout tagout training program.

Employees should use this checklist before they perform the process to ensure that:

• The area is clear of additional hazards.
• Nearby workers step away from the equipment being locked out.
• All energy sources are shut off properly before maintenance begins.
• Equipment is correctly reconfigured and activated after completion.