Pest treatment visit record: free blank PDF
Download a printable pest treatment visit record for England, Wales, Scotland. The PDF contains the record sections shown below and writing space for the actual findings.
Download the blank printable PDF for free.
Free blank Pest treatment visit record form
Print the blank record and keep the completed copy with the job. The preview shows the actual blank download.
Blank Pest Control Treatment Report / Visit Record form
Record scope and contents
England, Wales, Scotland. The competent technician carrying out and recording the authorised treatment.
- Record Details: Visit record number, Date, Reason for treatment
- Work location: Work jurisdiction
- Pest control business: Company name, Company address, Company postcode, Phone
- Customer: Customer name, Customer address, Customer postcode, Phone
- Site: Site address, Site postcode
- Type, level and extent of the infestation: Pest species, Species, Level and extent, Areas inspected
- Treatment applied: Trade name, Active ingredient, MAPP or HSE number, Quantity, Formulation, Location, Area or structure treated
- Bait points and monitors
- COSHH assessment: Risk assessment findings, Health risks, Exposure controls
- Environmental risk assessment: Wildlife and environment risks, Wildlife precautions
- Recommendations and follow-up: Hygiene, proofing and housekeeping, Warnings, Post-treatment requirements, Follow-up visit date, Follow-up information
- End of treatment: Uneaten bait recovered, Dead rodents removed
- Technician: Chemicals recorded, Technician name, Technician qualification, Technician signature, Date
- Customer acknowledgement: Received and understood, Customer name, Customer signature, Date
Primary source for this record · checked 2 October 2026
What the Pest treatment visit record covers
Record the survey, pest activity, product and application, precautions, actions and customer handover for a treatment visit. Keep the product authorisation, label and risk assessment with the job. A visit record is separate from a pesticide qualification or product-use permission.
Who needs one
- The competent technician carrying out and recording the authorised treatment.
- Record scope: England, Wales, Scotland.
- Keep the completed record with the source documents, findings and job reference.
Related templates
Questions sole traders ask
More free certificates
Electrical Installation Condition Report
Full BS 7671 condition report: circuits, test results, C1–C3 & FI codes, Satisfactory/Unsatisfactory outcome.
Electrical Installation Certificate
Certify new circuits, installations and consumer unit changes: BS 7671 design, construction and test declarations.
Minor Electrical Installation Works Certificate
Certify additions and alterations to existing circuits: the lightweight BS 7671 counterpart to an EIC.
EV Charge-Point Installation Certificate
Certify EV charger installs: charger detail, open-PEN and RCD protection, commissioning tests, BS 7671.
Earthing & Bonding Certificate
Confirm main protective bonding to water, gas and services is present and adequate: BS 7671.
Domestic fire alarm commissioning record
Certify domestic fire detection: grade, category, device and audibility tests to BS 5839-6.
Free certificates. Admin that does itself.
Keep the job, quotes and customer records together in Tradehand.