Individual journey management plan checklist

Template Information

This journey management plan enables the traveller to document their commute plans in accordance with the fitness for work: fatigue management plan.

Category: mining

Template Questions

  • Surname
  • Given Name
  • Personnel Number
  • Company
  • Department
  • Position
  • Crew
  • Roster Pattern
  • Personnel Details
  • Name
  • Contact Number
  • Relationship
  • Daily Commute Plan
  • From Address
  • Start time Date
  • To Address
  • Finish time Date
  • Activity - All
  • Route distance (km)
  • Dayshift
  • Nightshift
  • Do you have any pre-existing medical conditions that may affect your journey management plan?
  • What are your additional controls measures to manage fatigue?
  • List other controls
  • Signature - Traveller
  • Traveller
  • Signature - Direct Supervisor
  • 1-up Line Manager
  • Approved
  • Not Approved
  • Comments
  • Overall Risk Ranking
  • Date Approved Date
  • This Individual Journey Management Plan Form shall be reviewed bi-annually or if there is a change in