University of Surrey
Faculty of Engineering and Physical Sciences
MEng and BEng Programmes in Mechanical, Aerospace & Medical
Engineering
Professional Training Placement Risk Profiling – Student Form
This form is provided for you to complete as part of the health and safety risk assessment for
your Professional Training Placement. Please complete the form, giving as much information
as possible relating to risks you perceive may be associated with your placement, and return
to Kathy Lilley at the final Level 2 PTY Briefing.
If you have any questions, please contact Mark Baker or Kathy Lilley.
1. Your details
First name
Family name
Placement Provider/Company
Location of placement (if known)
2. Identification of risks
Please select one or more of the risk factors list in each of the six categories if you consider
that this may apply to your placement.
2.1. Work and/or study factors
High risk: Work with hazards that have potential to cause permanent injury or
fatalities e.g. Construction site with work at height, dusts, moving machinery, electrical
systems / process plant operating at high temperatures and pressures with hazardous
substances / operation of machinery with mechanical hazards such as high speed
rotating parts, crushing or entanglement risks / laboratory work with toxic/hazardous
materials.
High risk: Activities requiring specific licences or qualifications (e.g. diving, flying
aircraft, crewing an aerial device, operation of plant).
High risk: Work involving significant hazards in small companies that do not have
professional health and safety advice.
Medium risk: Working in proximity to high risk factors (but not directly with them).
Low risk: Office work or other low hazard environments and activities.
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2.2. Travel and transportation factors
High risk: Significant travel to reach placement, prolonged or on local transport
facilities known to be high risk (poor driving or vehicle safety standards).
High risk: Demanding travel during placement.
High risk: You are required to drive others in unfamiliar vehicles.
Medium risk: Night travel.
Medium risk: Long daily commuting requirement.
Medium risk: You are required to drive familiar vehicle in reasonable conditions.
Low risk: No significant travel, comfortable daily commute.
Low risk: No driving associated with placement.
2.3. Location and/or regional factors
Very high risk: Significant risk of civil disorder, crime or similar danger, e.g.
placement in areas of political instability or civil unrest (placements in war zones,
countries where the Foreign and Commonwealth Office (FCO) advises against travel
are not permitted).
High risk: Unavoidable lone or remote working in proximity to significant risk (e.g.
medical student elective in a refugee camp).
High risk: Medical and rescue services not available quickly or locally.
High risk: Means of communication likely to be difficult or compromised.
Medium risk: Higher than normal risk of civil disorder, crime or comparable danger.
Medium risk: Delays likely in communicating with tutors and others.
Medium risk: Placements abroad in areas identified as low risk by the FCO.
Low risk: Placements in the UK with no significant local risks.
Medium risk: History of natural disasters or severe weather conditions.
2.4. General/environmental health factors
High risk: Regional/local health risks requiring mandatory and specific health
protection measures e.g. inoculations.
High risk: Very hot or strenuous working conditions (e.g. manual working outdoors in
the sun).
High risk: Very cold working conditions (e.g. catering placement in a food cold
storage/cook chill or freeze facility).
Medium risk: Regional/local conditions require some precautionary measures, e.g.
optional inoculations against diseases, medical travel kit is a sensible precaution.
Low risk: No significant environmental health risks.
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2.5. Individual / Personal Factors
High risk: Personal factors (e.g. health, disability, linguistic or cultural) may increase
the risk of illness or accident during work-related activity even following adjustments.
High risk: Personal factors may require specific adjustments or support if living away
from home, or make you susceptible to episodes of illness.
High risk: Your knowledge, understanding, and skills are low for the type of work,
local culture and language.
Medium risk: Personal factors may require specific adjustments or support during
work, or in social interactions at work.
Low risk: You have no personal factors likely to cause episodes of illness or require
specific support whilst on placement.
Low risk: You have relevant knowledge, understanding and skills for the type of
work.
2.6. Insurance Limitations
Very high risk: Locations, activities and/or circumstances that are excluded from
University of Surrey’s travel and personal accident insurance cover (e.g extreme
sports)
Very high risk: Countries where the Placement Provider's insurance does not cover
you for personal or third party liability associated with your work (placements not
recommended).
Medium risk: Locations, activities and/or circumstances that require prior acceptance
from Surrey University's insurers before being covered.
Low risk: Locations, activities and/or circumstances that are automatically included in
Surrey University's insurance cover.
Low risk: UK location and the Placement Provider has Employers' and Public Liability
Insurance cover.
This information, together with that known about your placement, will be used by the Division
and potentially the Placement Provider to complete a risk assessment for your placement.
Any High and/or Moderate risks identified will need to be mitigated by specific actions to
reduce the level and potential likelihood of the risk. This process needs to be completed
before you commence your placement.
Please sign below to confirm that you have attended the final Level 2 Placement Health and
Safety Briefing.
Signature: _____________________________________________
Date: __________
Subject to the information provided by the student and to the best of my knowledge I approve
the placement
Signature ………………………….
Dr Mark Baker
Senior Tutor for Professional Placements
Date………………….
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