James Hall Group of Companies H&S 15 (Issue 1)

DYNAMIC RISK ASSESSMENT FORM

Department: Site: Reference No:

Activity: People at Risk:

Assessor(s): J Date: Review Date:

Accidents / Incidents in Previous 12 months:

You should complete a Dynamic Risk Assessment if there is a change to an existing process or a new hazard to staff, that is temporary and ensure that
the risk assessment includes human capabilities, emergency situations and any changes in hazard knowledge. You must also communicate the findings to
all relevant Employees to make them aware of the control measures in place and review the Dynamic Risk Assessment until the hazards have gone.

Hazard, Hazardous Event and Assessment Control Measures Residual Risk Additional Measures Required Residual Risk Additional
Expected Consequence of Risk before After Control After Measures
Control Measures Additional Actioned
Measures Measures
L xX C R L xX C R L xX C R YES / NO
X = X = X =

Likelihood: 1 – Very Unlikely 2 – Unlikely 3 – Fairly Likely 4 – Likely 5 – Very Likely

Consequences: 1 – No Injury 2 – Minor Injury 3 – Moderate Injury 4 – Major Injury 5 - Death
Risk Ratings: 1 - 8 Low Risk 9 - 15 Medium Risk 16 - 25 High Risk

H&S15 – Dynamic Risk Assessment (Issue 1)

 James Hall Group of Companies H&S 15 (Issue 1)

Hazard, Hazardous Event and Assessment Control Measures Residual Risk Additional Measures Required Residual Risk Additional
Expected Consequence of Risk before After Control After Measures
Control Measures Additional Actioned
Measures Measures
L xX C R L xX C R L xX C R YES / NO
X = X = X =

Additional Measures Required Responsibility Completion Date Completed by Confirm Communicated

to all Relevant Staff

Likelihood: 1 – Very Unlikely 2 – Unlikely 3 – Fairly Likely 4 – Likely 5 – Very Likely

Consequences: 1 – No Injury 2 – Minor Injury 3 – Moderate Injury 4 – Major Injury 5 - Death
Risk Ratings: 1 - 8 Low Risk 9 - 15 Medium Risk 16 - 25 High Risk

H&S15 – Dynamic Risk Assessment (Issue 1)