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Basic Workplace Risk Assessment Template

The Basic Risk Assessment Template is designed to help identify, assess, and control workplace hazards before starting tasks. It includes sections for detailing the task, identifying hazards, assessing risks, and documenting control measures. The template also requires signatures from the assessor and reviewer to ensure accountability and approval.

Uploaded by

Liliana Paredes
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© All Rights Reserved
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6 views7 pages

Basic Workplace Risk Assessment Template

The Basic Risk Assessment Template is designed to help identify, assess, and control workplace hazards before starting tasks. It includes sections for detailing the task, identifying hazards, assessing risks, and documenting control measures. The template also requires signatures from the assessor and reviewer to ensure accountability and approval.

Uploaded by

Liliana Paredes
Copyright
© All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd

Basic Risk Assessment Template

Use this basic risk assessment form to identify, assess and control
hazards in the workplace. This template can be used at any time when
assessing risk and control measures but should be ideally conducted
before commencement of tasks.

1/7
Title Page

Task/Activity being assessed Text answer

Assessed by Text answer

Conducted on Date/time

Enter Date and Time:

/ /

: AM / PM

Location Text answer

2/7
Audit

General

Describe the job, process, or task being assessed Text answer

Hazards, Risks and Controls

Click Add Hazard (+) after you have observed and identified a hazard Instruction

Hazard Repeat section

Name the hazard Text answer

3/7
Describe the risk Text answer

Who is at risk? Text answer

Photo of hazard Media

Using this matrix as reference, please assign the corresponding risk rating Media
for the identified hazard

4/7
* Risk rating Select one

[ ] High
[ ] Medium
[ ] Low

What measures are currently in place to control the risk? Multiple choice

[ ] Elimination
[ ] Substitution
[ ] Engineering Controls
[ ] Administrative Controls
[ ] PPE
[ ] Other
[ ] No controls in place

If answer is Other Answer Question(s) 7.0

7.0 - Enter other control measures Text answer

5/7
If answer is No controls in place <trigger not defined>

Completion

Assessor's Signature Signature

Date: / /

6/7
Approval

* Approver: Select one

[ ] _________________

* Review Date Date/time

Enter Date and Time:

/ /

: AM / PM

* Signature of Reviewer Signature

Date: / /

7/7

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