Job Safety Analysis sample. Edit it or build your own.

Job Safety Analysis Form

A job safety analysis (JSA) report form to be completed prior to the start of any job, task, etc. A job step process to determine hazards and hazard management strategies. Checkout the Forms Library »

Job Safety Analysis - Printable PDF
Download a printable Job Safety Analysis (PDF).

What is a JSA?

A Job Safety Analysis (JSA) is where a team meets before a job to identify potential hazards and discuss the safest way to do the job. A JSA is also known as a JHS (Job Hazard Analysis) or possibly a Job Hazard Breakdown.

Potential hazards are not limited to the job and tools you will be directly working with, but any other potential hazard such as environmental risks (e.g the weather) or dangerous tasks, equipment, chemicals, etc used by other persons in the same work area.

JSA's typically include the following 6 steps:

  1. Identify the Procedure - figure out which specific procedures are high risk
  2. Identify the Steps - figure out each step that needs to be done to complete the job
  3. Identify Hazards - for each step identify what could go wrong
  4. Implement Solutions - take action to reduce, contain, revise, or eliminate the hazards
  5. Communicate - share your findings with your team & make it easily accessible to everyone
  6. Review / Update - review and update your procedures, steps, hazards, and solutions as needed

This form is a sample report which can be imported into your KPA EHS account. All forms including this one can be easily modified to fit your organization's policies and procedures.

Don't have a KPA EHS account? Download the printable Job Safety Analysis PDF form so your team can fill out a paper copy.

Check out the forms library.
Check out the forms library.

Top Features of KPA EHS Reporting

Check out the Forms Overview or learn about specific features:


Form Builder »

Start from a pre-built template or design your own form from scratch.


Offline / Mobile Reporting »

Once team members have downloaded the app, they can fill out reports offline - including attachments! The report will automatically upload once connectivity resumes.


Follow-Up Tracking »

Assign follow-ups within a report and track incomplete items.


Permissions »

You decide who can submit reports, view responses, and more.


Alerts & Notifications »

Setup individual or group notifications for certain reports. For example, you may want notifications for critical issues but not minor ones.


Analysis Tools »

KPA EHS automatically generates rich analytic tools so you can filter, visualize, and export all the data you're collecting.


Participation Reports »

Run participation reports to see who is submitting reports and when they're being submitted.


Electronic Signatures »

Collect electronic signatures when your team fill out reports.


Multilingual »

Forms filled out through the web browser can be automatically translated into 100+ languages.


Revision History

As your team edits a report, the system will automatically track what was changed, the author, and the date.


Data Lists

As projects, locations, etc change, the form will automatically update to include the latest options.


Auto-Hiding Fields

Clicking "Does Not Apply" dozens of times is counter-productive. Instead, hide questions that don't apply.



Some forms can be extremely complex, but that's no problem in KPA EHS. Setup sub-reports to make it easier to fill out in sections.