Risk Assessment Template

Name Role Date

(Competent person carrying out the risk assessment) (Job Title / Department) (DD/MM/YYYY)

Department
(Enter details of the department that the risk
assessment is being carried out on, including site
information if multiple sites)

Additional control
Control measures
measures required Name Date controls
Hazards identified Person(s) at risk currently in place Completed
(Consider the hazards (Enter details of anyone
(Enter details of any new (Person must be
(Enter details of all responsible for
actions that need to be actioned by (DD/MM/YYYY,
specific to the type of who might be at risk of control measures that implementing
taken to reduce, control Signature)
activities being assessed) harm and how) are currently in place controls) (DD/MM/YYYY)
or eliminate the risks of
on site)
each hazard)

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 Additional control
Control measures
Hazards identified Person(s) at risk measures required Name Date controls
currently in place Completed
(Consider the hazards (Enter details of anyone
(Enter details of any new (Person must be
(Enter details of all
specific to the type of who might be at risk of control measures that
actions that need to be responsible for actioned by (DD/MM/YYYY,
taken to reduce, control implementing Signature)
activities being assessed) harm and how) are currently in place (DD/MM/YYYY)
or eliminate the risks of controls)
on site)
each hazard)

Page 2
 Additional control
Control measures
Hazards identified Person(s) at risk measures required Name Date controls
currently in place Completed
(Consider the hazards (Enter details of anyone
(Enter details of any new (Person must be
(Enter details of all
specific to the type of who might be at risk of control measures that
actions that need to be responsible for actioned by (DD/MM/YYYY,
taken to reduce, control implementing Signature)
activities being assessed) harm and how) are currently in place (DD/MM/YYYY)
or eliminate the risks of controls)
on site)
each hazard)

Page 3
 Additional control
Control measures
Hazards identified Person(s) at risk measures required Name Date controls
currently in place Completed
(Consider the hazards (Enter details of anyone
(Enter details of any new (Person must be
(Enter details of all
specific to the type of who might be at risk of control measures that
actions that need to be responsible for actioned by (DD/MM/YYYY,
taken to reduce, control implementing Signature)
activities being assessed) harm and how) are currently in place (DD/MM/YYYY)
or eliminate the risks of controls)
on site)
each hazard)

Page 4
 Additional control
Control measures
measures required Name Date controls
Hazards identified Person(s) at risk currently in place
(Enter details of any new (Person must be Completed
(Consider the hazards (Enter details of anyone (Enter details of all responsible for
specific to the type of who might be at risk of control measures that
actions that need to be actioned by (DD/MM/YYYY,
taken to reduce, control implementing Signature)
activities being assessed) harm and how) are currently in place controls) (DD/MM/YYYY)
or eliminate the risks of
on site)
each hazard)

Don’t forget to sign and date this Risk Assessment document once complete

Risk Assessment shared with

(Enter details of which departments
and roles the risk assessment must be
shared with)

Name Signed Current Date Latest Date for Review

(Competent person carrying out assessment) (Signature) (DD/MM/YYYY) (DD/MM/YYYY)

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