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Manual Handling Risk Assessment Form

Department / Service: Location: Date :


Assessed by: Signature: Review Date :

NUMBER OF PERSONS

TOTAL RISK VALUE


WHO MAY CARRY OUT THE RISK OF INJURY TASK FREQUENCY
TASK
COMMENTS
Ref ACTIVITY / TASK
Proposed Controls

Probable
Unlikely

Possible

Regular
Certain

Infreqt

Freqt
Occ
1-2 3-7 8-15 >15

RISK VALUE (RV) 1 2 3 4 0 4 6 8 1 2 3 4


TOTAL RISK VALUE = No of person (RV) + Risk of Injury (RV) + Task Frequency (RV)
'Infreqt' = Infrequent (Several times a year) 'Occ' = Occasionally (Several times a month
'Regular' = Regularly (Several times a week) 'Freqt' = Frequent (Several times a day)
Note: If the total risk value is equal or greater than 9, detailed control measures should be carried out as per this assessment
This form is used by the Manual Handling and Moving & Handling Assessors to ascertain whether a full manual handling / Moving & Handling risk assessment is required

All dates to be entered in format: dd/mm/yyyy 1 of 1


702639079.xlsx

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