Title Page

  • Site

  • Conducted on

  • Prepared by

  • Location

General Details

  • Description of task or worksite being assessed

Hazards and Risks

  • Are there risks? Click "Add"

  • Details on Risks
  • Description of observed risk

  • Attach photos of hazard (optional)

  • Identify type of hazard

  • Identify risk level

  • Risk severity

  • Likelihood of risk

  • Persons at risk

Safety Systems

  • Department(s) involved in implementing safety

  • What needs to be done?

  • Is there a need for extra safety measures?

  • Identify needed measure

  • Specify

  • Estimated date of implementation

Completion

  • Additional comments and recommendations

  • Audited by (Full Name & 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.