Basic Risk Assessment Template
March 2008 (Creativebias)
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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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