Title Page

  • Conducted on

  • Prepared by

  • Location


  • Enter description of procedure, task or worksite being assessed

Hazards, Risks and Controls

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

  • Hazard
  • Identify the task

  • What are the risks associated with each activity?

  • Photo of hazard (optional)

  • Risk rating

  • Select control measures (include notes)

  • Enter other control measures


  • Recommendations

  • Signature

The templates available in our Public Library have been created by our customers and employees to help get you started using SafetyCulture's solutions. The templates are intended to be used as hypothetical examples only and should not be used as a substitute for professional advice. You should seek your own professional advice to determine if the use of a template is permissible in your workplace or jurisdiction. You should independently determine whether the template is suitable for your circumstances.