Occupational Health Risk Assessment Review

• Name of Staff member

• Client / Site

• Conducted on

  Date

• Prepared by

• Location
  Address

Information

• Staff Members Name

• Date of Birth

• Review Date

  Date

• Site Location

  Select Moorfield Ayre Greenford London Head Office

  • Moorfield
  • Ayre
  • Greenford
  • London Head Office

• Department

• Last Review Date

  Date

Review

• Discuss details of previous Risk Assessment with Staff member

• Since the last Assessment / Review, have there been any significant changes in your medical condition. (eg: improvement or deterioration)

  NO

  YES

• Since the last Assessment / Review, have there been any significant changes in your job role, that affects your health or welfare

  NO

  YES

• Since the last Assessment / Review, have there been any significant changes in your working environment, that affects your health or welfare

  NO

  YES

Significant Risks Identified

• Since the last risk assessment / review, are there any additional significant risk that effect or impact on your Safety, Health or Welfare<br>

  NO

  YES

• Risk 1

• Suitable control measure

• Risk 2

• Suitable control measure

• Risk 3

• Suitable control measure

• Risk 4

• Suitable control measure

Sign Off

• Conducted by

  Sign

• Date Completed

  Date

• Review period

  Select Monthly Quarterly Bi-Annually Annually No more Reviews Required

  • Monthly
  • Quarterly
  • Bi-Annually
  • Annually
  • No more Reviews Required

• I confirm, that I have been actively involved in this risk assessment review and have provided information to the assessor to assist. I also agree that the the recommended control measures have been discussed with me and I am satisfied that they are suitable and sufficient and that should there be any changes in circumstances, I will bring this to the attention of management immediately.

• I can confirm that I have read and had the opportunity to read this completed document.

• Staff Member

  Sign