GENERAL RISK ASSESSMENT & HAZARD IDENTIFICATION
Job title
Task being assessed
Location
Risk assessment reference:
Assessors Name
Assessors signature
Date of assessment
Proposed Review Date
List
the key elements of the task;(Consider Who, What, Where, When and How in relation to the work being
carried out):
Authorised by (Manager)
Print Name
Date
Risk Level
Severity?
See risk assessment guidance notes
Likelihood?
No of
Persons
affected
Frequency
of task
Hazards Identified
(What has the potential
to cause harm?)
Existing control
measures
verified in place
Is the risk
adequately
controlled?
Additional control measures / monitoring
required?
How will this hazard be
monitored to ensure control is
maintained?
Conclusions
Risk Assessmernt
reference
Risks requiring action
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
Recommendations
Priority
RISK ASSESSMENT IMPLEMENTATION TRACKER
Assessment Reference No:
Recom
. No.
1.
2.
3.
4.
5.
6.
7.
8.
9.
10.
11.
12.
13.
14.
15.
16.
17.
18.
19.
20.
Manager:
Agreed action
Target Date
Action By
Completion
Date
Signed
RISK ASSESSMENT GUIDANCE NOTES
The level of risk depends on a combination of the probability of harm and the severity of harm. The table below demonstrates the assessment of risk:
Likelihood of harm x Severity of harm = Level of risk (Risk levels: 1-2 = Low (L) / 3-6 = Medium (M) / 8-9 = High / 12-16 = Intolerable)
Likelihood of harm
The severity of harm
Very unlikely 1
Slight 1
e.g. Nuisance, irritation,
temporary ill health
Moderate 2
e.g. Medical Attention with
several days off work
Major 3
e.g. Long term Injury or Illness
Extreme 4
e.g. Kill or Permanently Maim
Unlikely 2
Likely 3
Very likely 4
LOW
=1
LOW
=2
MEDIUM
=3
MEDIUM
=4
LOW
=2
MEDIUM
=4
MEDIUM
=6
HIGH
=8
MEDIUM
=3
MEDIUM
=6
HIGH
=9
INTOLERABLE
=12
MEDIUM
=4
HIGH
=8
INTOLERABLE
=12
INTOLERABLE
=16
To use the Risk Assessment Form:
1 Identify the Task/Activity
2 Identify those likely to be at risk (tick as appropriate)
3 Identify the hazard and the risks that might result from the hazard (there may be more than one risk resulting from a hazard).
4 Assess the initial risk (before any safety control measures are applied): Likelihood x Severity=Risk Level (R).
5 List the safety control measures in place or that need to be applied to reduce the identified risks. Is the ris adequately controlled?
6 Assess the remaining risk level once additional control measures are applied.
7 The task activity must not proceed if the remaining risk level is High or Intolerable.
RISK LEVEL
TRIVIAL

The risk is so small that no control measures or records are needed
LOW (1-2)



Control measures are not necessarily needed
Consider better solutions that don’t cause extra costs
The situation should be monitored to keep the risk under control



Control measures should be taken to reduce the risk. A suitable timescale can be planned for implementing the controls
The cost-effectiveness of the control measures should be carefully considered
If very harmful consequences are foreseeable (such as serious injury or fire in a production facility) the probability of the event should be
re-examined more thoroughly.



Work should not be started until the risk has been reduced.
Considerable resources may be needed to reduce the risk.
Where work is in progress, urgent action should be taken to reduce the risk.
MEDIUM (3-6)
HIGH (8-9)
INTOLERABLE (12-16) 
Work should not be started or continued until the risk has been reduced – regardless of the cost of the control measures.