Fire Risk Assessment Form

Floor/Area/Room No Reference No
Use
Assessor Name: Supervisor Name:
Signed: Signed:
Sheet Number Date of
Assessment
Persons at risk
Identify The Fire
Hazards
Sources of ignition Sources of Fuel Sources of Oxygen

Evaluate the Risk of the Evaluate the Risk Remove or Reduce the Remove or Reduce the
Fire Starting to people Hazards that might start a risks to people from fire
Fire

Further Action Required By When? Responsibility

Risk Assessment Comments