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Basic Risk Assessment Template

March 2008 (Creativebias)

Basic Risk Assessment Template



This form must be completed for all areas and specific projects and activities.

Area, Project or Activity: _________________________________________________

Who is undertaking the risk assessment?: ____________________________________



Basic Assessment:

1. Are there any electrical hazards? Yes/No
2. Are there any hazards due to extremes of temperature
(e.g. welding or freezing) or any special fire risks?
Yes/No
3. Are there any mechanical hazards involving nipping, impact,
entrapment, heavy weights or moving parts?
Yes/No
4. Are there any chemical hazards or COSHH related substances? Yes/No
5. Are there any hazards that may cause medical alarm*?
(* Medical factors can be treated confidentially.)
Yes/No
6. Is part of the work out of doors? Yes/No
7. Are there any special risks or hazards? Yes/No


If the answer to any of the above is Yes, a full Risk Assessment must be carried out.



The following participated in this assessment:

Name: _________________________________________________
Position: _________________________________________________
Signature: _________________________________________________
Date: _________________________________________________




The original of this form must be deposited with the Safety Secretary. A copy must be posted near the activity to which it refers

Date of Assessment: _________________________________________________

 


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