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Organisation Name
Dept / Work Area
Task Being Assessed
Email Address
First Signature
Second Signature
Print Name
Print Name
Date
Date
Risk Assessment
Fill out the form below to complete your risk assessment. All fields are mandatory unless specified.
Hazards and Risks
What
Describe the danger/hazard
Who
Who could be harmed
How
How could they get harmed
Measures
What steps have already been taken
Risk – Likehood
How likely is it that the hazard will cause harm?
Risk – Consequence (or Severity)
How severe would the outcome be if the hazard caused harm?
Risk Rating
The overall risk level, usually calculate by multiplying Likelihood and Consequence
Actions and Reviews
Action
Action to reduce risk
Risk – Likehood
Risk – Consequence
Risk Rating
Who / When
Action reviewed
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