Title Page

  • Job Location
  • Prepared on

  • Prepared by

  • Who will be involved in this workplace risk assessment and what is their role?

  • Where will this workplace risk assessment be performed? (for example - on-site)

Workplace Risk Assessment

  • To begin the workplace risk assessment, select the "+" icon next to Hazard:

  • Hazard
  • Description of hazard

  • Photo of the hazard (required)

  • Risk related to hazard

  • Who might be harmed?

  • Risk likelihood

  • Risk consequences

  • Use this risk matrix to identify the risk level:

    Risk Matrix SafetyCulture.png
  • Risk level

  • What Control Measures have you put in place?

  • What is the controlled Risk Likelihood?

  • What are the controlled Risk Consequences?

  • What is the risk level with controls implemented?

  • Do not perform high risk work and notify Manager immediately (risk assessment is a fail)

  • Do not perform high risk work and notify Manager immediately (risk assessment is a fail)

  • What are your controls to control this risk (existing risk control measure)?

  • What is the controlled Risk Likelihood?

  • What are the controlled Risk Consequences?

  • What is the risk level with controls implemented?

  • Do not perform high risk work - Notify Manager

  • Do not perform high risk work - Notify Manager

  • To ADD another hazard to the workplace risk assessment, select the "+" icon next to Hazard.
    To END the workplace risk assessment, select the "Next Page >" button at the bottom right.

Completion/Review

  • What risk control measures have you developed?

  • Name and Signature of Site Supervisor

  • Name and Signature of additional installers on-site

  • Name and Signature of additional installers on-site

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.