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Sample Policies and Forms

The forms and policies collected below are intended as samples. Review them with your employment law counsel to confirm that they are appropriate for your specific needs and situation. Used as a starting point, these can greatly reduce the cost of having an attorney draft documents from scratch for use in your organization.


Online Exclusive: Sample policy for seasonal and communicable diseases
COCA Online Exclusive January 2012
Each year in the United States, as many as one in five people fall victim to seasonal influenza. Twenty million will suffer some form of gastroenteritis (stomach illness).And more than a billion cases of "the common cold" strike each year--that's more than two colds apiece. Peak season for all of these illnesses typically hits in January and February. . . . more »
Online Exclusive: Sample Policy for Employee Participation in Incident Investigations
COCA Online Exclusive June 2012
The U.S. Chemical Safety Board (CSB)--which investigates the root causes of catastrophic chemical incidents--recently released a new policy on employee participation in those investigations. Like many employers, the CSB already included employees in its incident investigations; the new policy is intended to assure uniformity and increase employee participation. . . . more »
Online Exclusive: Sample Voluntary Respirator Use Policy
COCA Online Exclusive May 2012
In many workplaces, hazards from air contaminants are not generally present at levels that require respiratory protection, so respirators are not part of the personal protective equipment regularly used. . . . more »
Online Exclusive: Sample Healthcare Worker Injury Prevention Policy
COCA Online Exclusive February 2012
California has adopted the Hospital Patient and Health Care Worker Injury Protection Act in Section 6403.5 of the Labor Code. The act covers the lifting, repositioning, and transfer of patients by healthcare workers in acute care hospitals. . . . more »
Online Exclusive: Sample Slip, Trip, and Fall Prevention Policy
COCA Online Exclusive February 2012
Slips, trips, and falls are the leading cause of lost-worktime injuries in California, so it makes sense for employers to have a policy in place to prevent these accidents. A formal policy that involves everyone in the organization in identifying and controlling slip, trip, and fall hazards can help you prevent these accidents. . . . more »
Featured Resource: Portable Fire Extinguisher Use Policy
August 2011
Many workplaces are equipped with portable fire extinguishers that can control small fires, preventing property damage and loss of life. However, General Industry Safety Orders Section 6151(g) prohibits workers from using fire extinguishers unless they have received training in their proper use. . . . more »
Sample Return-to-Work Policy
COCA Online Exclusive May 2011
When an employee has been away from work because of an injury or illness or is returning to work with new medical issues (for example, a veteran who has been injured on duty), you may need to provide accommodations to help the worker smoothly re-enter the workplace. The sample return-to-work policy below will help you provide the necessary assistance while complying with workers' compensation and disability rights laws. . . . more »
Online Exclusive: Sample Policy for Preventing Lead Exposures During Pregnancy and Breastfeeding
COCA Online Exclusive April 2011
Workers in more than 100 industries may be exposed to lead on the job. These exposures can be dangerous to adults—but they can be especially dangerous to pregnant or breastfeeding women an . . . more »
Sample Forklift Attachment and Modification Policy
COCA Online Exclusive July 2010
Adding attachments to or modifying the lifting apparatus on a forklift can create hazards if not done with care. Under this company's policy, the following must be done if any attachment is added to a forklift or modification made to the lifting apparatus: . . . more »
Cell Phone Policy
Updated May 2010
Cell Phone Policy This sample policy has been newly updated to reflect the latest technology changes, including texting


. . .
more »
Sample Incident and Near Miss Reporting Policy
Updated May 2010
Sample Incident and Near Miss Reporting Policy In order to ensure a safe, healthful, and efficient work environment for our employees, the Company has established the following incident and near miss reporting policy as a condition of employment and continued employment

. . .
more »
Online Exclusive: Sample Policy Prohibiting Workplace Bullying
Updated May 2010
Workplace bullies are off the hook when their behavior violates no law or company policy. Make bullying behavior a violation of company policy, either on its on or through an expanded definition within . . . more »
Drug- and Alcohol-Free Workplace Policy
Updated May 2010
Drug- and Alcohol-Free Workplace Policy In order to ensure a safe, healthful and efficient work environment you can use the following alcohol- and drug-free workplace policy to establish a safer workplace. . . . more »
Substance Abuse by Employees: Sample Last-Chance Agreement
Updated May 2010
Substance Abuse by Employees: Sample Last-Chance Agreement The following agreement gives an employee with a substance abuse problem one more chance, spelling out that he or she will be fired for not complying with its terms. However, if someone who signed . . . more »
Sample Telecommuting Agreement
Updated May 2010
Here's a sample agreement in the form of a letter signed by you and your employee. The letter can be easily modified to fit your needs. . . . more »
Sample Telecommute Policy
Updated May 2010
Sample Telecommute Policy If telecommuting is right for your company, it's important to have a written policy so employees who wish to telecommute understand their rights and your expectations. Here's a sample policy that you can use . . . more »
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