Incident and first aid records · IN-02

Risk Assessment Form

A free printable blank risk assessment form — hazards, existing controls, further action, owner and review date, with nothing pre-filled.

Download Free · no sign-up

2 pages. Choose your paper size — both versions are laid out identically, so neither one gets shrunk to fit.

Print it and write on it

A4 57 kB US Letter 57 kB

Fill it in type and save

A4 142 kB US Letter 142 kB

The fillable versions have real form fields — open them in any PDF reader, type into them and save. Printing help.

What this sheet is for

Record a risk assessment you have carried out yourself, in a layout that captures the part people forget: who is doing the further action, by when, and when it gets reviewed.

Who it is for

Anyone who has to write an assessment down — small employers, self-employed trades, clubs, village halls, event organisers and volunteer committees.

How to use it

Write down the rating scale you are using before you start, so the numbers in the table mean something to whoever reads it next.
Take one activity or area per sheet rather than trying to cover a whole site.
Fill in the controls that already exist before deciding what else is needed — most of the work is usually already done.
Give every further action an owner and a date, then date it again when it is done.
Set a review date and put it somewhere you will see it.

What is on the sheet

2 pages, in this order:

Page 1

Printed under the title: A blank pro-forma for recording a risk assessment you have carried out yourself — the activity, what could go wrong, what is already in place, and what still needs doing.

A blank form, not a standard. This sheet contains no hazards, no control measures and no scoring scale, and that is deliberate. What has to be assessed, who is competent to assess it, how risk is rated and what must be written down all differ by country and by the kind of work. Check what applies to you. Filling this in records your assessment; it does not demonstrate that you have complied with anything.

This assessment

Write-on lines: Reference · Date of assessment · Review date · Activity, task or area assessed · Site · Assessed by · Role · Signature · Who could be harmed · How many people

Your rating scale — write down the scale you are using, so the numbers below mean something

Write-on lines: Likelihood scale used · Severity scale used

Ruled lines: How you are combining them, and what counts as acceptable

Hazards and controls

Table, 4 rows: Hazard · What could go wrong · Controls already in place · Rating · Further action needed · Owner · By when · Done

Page 2

Review

Table, 15 rows: Review date · Reviewed by · Changed since last time · Next review

Questions

Why does the form not list any hazards?

Because the hazards depend entirely on what you are doing, and a printed list encourages people to tick the ones we happened to think of and stop. The value of an assessment is in looking at your own activity. What has to be assessed, and by whom, differs by country and by the kind of work — check what applies to you.

Does filling this in mean I have complied with something?

No. It is a blank pro-forma. It records your assessment and nothing more. Whether you are required to assess anything, what form it must take and how long it must be kept are questions for the rules where you are.