Work Activity

Advise the work activity that appears to be a risk

Enter details of activity

Hazards Identified

List all the hazards identified in relation to the particular activity

Take picture of hazard if possible
Who might be harmed?

Who can be harmed or affected by these risks?


Advise description of risks

Risk rating


Probability of occurance

Risk rating

Reference: Risk Matrix

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Existing Measures

Were there any existing measures in place to control this risk?

Please detail existing measures


Indicate if this risk can be controlled immediately or not

Implementation Plan

Enter description of implementation plan

List who will be responsible for actioning the implementation plan

When will this be actioned and completed by?

Risk assessment has been completed

Risks reported have been resolved and completed