Title Page

  • Employee name

  • Department

  • Title

  • Conducted on (Date and Time)

The Incident

Risk Identifications

Incident Details

  • Incident Risk

  • Current/Active Risk

  • Potential Risk

  • Risk Title

  • Description of risk

  • Impact on Project (Identification of consequences):

  • Work Breakdown time

  • Comments

  • Employee Signature

For Risk Management unit purpose

  • Individual/Group responsible for mitigation action (Risk owner)

  • Assessment of Likelihood

  • Assessment of Seriousness (Impact)

  • Score

  • Grade

  • Change in Grade since last review

  • Date of last review

  • Mitigation Strategy (Actions)

  • Cost (if any)

  • Timeline for mitigation action(s)

  • Risk Management unit Opinion

  • Name

  • Signature

  • Internal Audit unit opinion

  • Name

  • Signature

  • Compliance Group opinion

  • 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.