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Risk assessment form

Name of assessor Date

Time Work area

Task being assessed

New risk
How might Existing Risk rating rating Action/ Action/
What is the Who might be Additional
people be risk control (Residual) monitored by monitored by
hazard? harmed? controls
harmed? measures whom? when?
L C R L C R
Risk assessment form

New risk
How might Existing Risk rating rating Action/ Action/
What is the Who might be Additional
people be risk control (Residual) monitored by monitored by
hazard? harmed? controls
harmed? measures whom? when?
L C R L C R

Review date Signature

Training Provider name

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