Student Risk Assessment

• Student name

• Student ID

• Conducted on

  Date

• What course are you taking

• Requesting member of staff

Overview

• Reason for risk assessment

• When did the issue start / diagnosed

• How does this effect you in college

• What risk does your condition pose in college

• Current medication

• Anything else you would like to add

Reccomendations

• Adjustments needed

• aspects that cannot change

• Can the Student carry on their tasks in college

  Yes

  No

  N/A

• Student agree to the adjustments suggested

  Yes

  No

  N/A

Signatures

• Student

  Sign

• Health and Safety Officer

  Sign

• Witness 1

  Yes

  No

  N/A

• Job role

• Signature

  Sign

• Witness 2

  Yes

  No

  N/A

• Job role

• Signature

  Sign

• Witness 3

  Yes

  No

  N/A

• Job role

• Signature

  Sign

• Parent / Guardian

  Yes

  No

  N/A

• Name

• Signature

  Sign