This Alcohol Consumption Assessment Form is a critical tool designed to evaluate an individual's alcohol consumption patterns and their potential impact on workplace safety and job performance. It is structured into five key sections, guiding both the individual and a trained assessor through a comprehensive review. Section 1 gathers essential personal information, while Section 2 focuses on self-reported alcohol consumption, including frequency, quantity, and awareness of company policies. Section 3 details observed behavioral and physical indicators of potential impairment, to be completed by a trained assessor based on factual evidence. Section 4 outlines the assessor's evaluation, risk assessment, and recommendations for further action, such as employee assistance program referrals or disciplinary measures. Finally, Section 5 requires signatures and declarations from both the individual and the assessor, confirming the accuracy of the information and the assessment process. This form emphasizes confidentiality and adherence to company policies, referencing the 'Alcohol and Substance Abuse Policy' and relevant health and safety regulations. It is an indispensable resource for maintaining a safe and productive work environment by proactively addressing alcohol-related risks. Ideal for Safety Officers, HSE Managers, HR Professionals, Supervisors, and Compliance Officers.
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