HTA blank risk assessment form [DOCX 70.35KB]

advertisement
This is a controlled document
Any printed versions of this document will be classed as uncontrolled
Human Tissue Act
SOP - Risk Assessment
Risk Assessment Reference Number:
Date of Assessment:
Responsible Person:
Project Title:
Review Date:
Activity Description and Process:
Relevant Internal SOPs:
Relevant Internal COSHH assessments:
Assessor:
(Print name/sign and date)
Procedure and
Potential
potential hazard
outcomes
DI Approval:
(Print name/sign and date)
Risk Rating
Existing control measures
Likelihood
Acquisition of
material
Transportation
Storage
1 of 4
Severity
Rating
Controls
Adequate?
Additional
control
measures
required?
Steps to be
taken; by
whom,
target date
This is a controlled document
Any printed versions of this document will be classed as uncontrolled
Human Tissue Act
SOP - Risk Assessment
Use
Disposal
Receipt of the Risk Assessment:
This assessment has been issued to and read by:
Name of Recipient:
Signature
Date of Receipt
2 of 4
This is a controlled document
Any printed versions of this document will be classed as uncontrolled
Human Tissue Act
SOP - Risk Assessment
Review of the Risk Assessment:
Have the control measures been effective in controlling the risk?
Yes
No
Have there been any changes in the procedure or in information available which affect the estimated level of risk?
Yes
Date of
No
Name of Reviewer
Review:
Date of Next
Review
Signature:
3 of 4
Download