Author: Mads Frimann Madsen

Follow-up form for fieldwork / To be filled in by responsible DTU employer/leader/supervisor as well as the station employee/student
Name of responsible leader - as well as university unit:	Name of stationed employee/student:
Name of responsible external supervisor/field leader*:	Name of representative in local working environment organisation:
Place for field work (country):	Period for field work:
Working environment and risks
Where does the work take place (laboratory, forest, inland ice, ...):
Are there any changes in the type of work? / Briefly describe the altered job functions
Are there any new known risks associated with the work?
How are these new risks prevented? / Describe what safety equipment, technical and personal protective equipment to use
Are emergency procedure changed - for example as a result of the new risks? Describe which changes
Has the stationed employee/student received a local safety instruction? (This is the responsibility of the DTU leader)	[Yes] □ : / [No] □ :
Where is this declaration maintained?
Brief evaluation of the stay and any suggestions for improvement
This declaration is signed by	Date and signature
DTU leader (under responsibility)
Stationed employee/student
Local working environment representative
The statement is regularly reviewed and updated as needed