Risk Assessment Template 0.1

• Audit Title

• Document No.

• Client / Site

• Conducted on

  Date

• Prepared by

• Location
  Address

• Personnel

Note

• Risk assessments should be reviewed annually or if there has been a change to the working process or work activity.

Dates

• Date and time of the risk assessment?

  Date

• Reassessment date

  Date

Task Element.

• Element description?

Hazards

• Hazard and harmful effect.

Who is at risk

• People at risk are?

  Select Employees Contractors Visitors Employees and contractors Employees contractors and visitors

  • Employees
  • Contractors
  • Visitors
  • Employees and contractors
  • Employees contractors and visitors

Initial Risk Level

• Severity

  1

  2

  3

  4

• Likelihood

  1

  2

  3

  4

• Risk level

  Select 2 3 4 5 6 7 8

  • 2
  • 3
  • 4
  • 5
  • 6
  • 7
  • 8

• Risk evaluation

  Trivial

  Low

  Medium

  High

Measures and countermeasures

• Control measures to reduce likelihood

Controlled risk level

• Severity

  1

  2

  3

  4

• Likelihood

  1

  2

  3

  4

• Risk level

  Select 2 3 4 5 6 7 8

  • 2
  • 3
  • 4
  • 5
  • 6
  • 7
  • 8

• Risk evaluation

  Trivial

  Low

  Medium

  High

Task Element.

• Element description?

Hazards

• Hazard and harmful effect.

Who is at risk

• People at risk are?

  Select Employees Contractors Visitors Employees and contractors Employees contractors and visitors

  • Employees
  • Contractors
  • Visitors
  • Employees and contractors
  • Employees contractors and visitors

Initial Risk Level

• Severity

  1

  2

  3

  4

• Likelihood

  1

  2

  3

  4

• Risk level

  Select 2 3 4 5 6 7 8

  • 2
  • 3
  • 4
  • 5
  • 6
  • 7
  • 8

• Risk evaluation

  Trivial

  Low

  Medium

  High

Measures and countermeasures

• Control measures to reduce likelihood

Controlled risk level

• Severity

  1

  2

  3

  4

• Likelihood

  1

  2

  3

  4

• Risk level

  Select 2 3 4 5 6 7 8

  • 2
  • 3
  • 4
  • 5
  • 6
  • 7
  • 8

• Risk evaluation

  Trivial

  Low

  Medium

  High

Task Element.

• Element description?

Hazards

• Hazard and harmful effect.

Who is at risk

• People at risk are?

  Select Employees Contractors Visitors Employees and contractors Employees contractors and visitors

  • Employees
  • Contractors
  • Visitors
  • Employees and contractors
  • Employees contractors and visitors

Initial Risk Level

• Severity

  1

  2

  3

  4

• Likelihood

  1

  2

  3

  4

• Risk level

  Select 2 3 4 5 6 7 8

  • 2
  • 3
  • 4
  • 5
  • 6
  • 7
  • 8

• Risk evaluation

  Trivial

  Low

  Medium

  High

Measures and countermeasures

• Control measures to reduce likelihood

Controlled risk level

• Severity

  1

  2

  3

  4

• Likelihood

  1

  2

  3

  4

• Risk level

  Select 2 3 4 5 6 7 8

  • 2
  • 3
  • 4
  • 5
  • 6
  • 7
  • 8

• Risk evaluation

  Trivial

  Low

  Medium

  High

Signature of competent person

• Risk assessor signature

  Sign