RISK ASSESSMENT FORM 1 2 3 4 5 6 7 8 Hazard Potential Risk Severity of Likelihood Risk Level Existing Control Additional Controls Monitor Controls Harm Measures Measures to of Rating Implement Occurrence Area, Harm (injury, Assign Value Assign Value Multiply What control What do you need to Create and Equipment, illness, or 1 to 4 1 to 4 Severity and measures you implement implement a Job, Task, or damage) the Likelihood already have in (Look at Hazard procedure (such as a Process that hazard could Control Methods to check list or testing) (See Risk presents a cause determine course of that defines how you Matrix. potential action.) will ensure measures Appendix ?) danger. eliminate or control the hazard.
RISK ASSESSMENT FORM 1 2 3 4 5 6 7 8 Hazard Potential Risk Severity of Harm Likelihood of Occurrence Risk Level Rating Existing Control Measures Additional Controls Measures to Implement Monitor Controls Area, Equipment, Job, Task, or Process that presents a potential danger. Harm (injury, illness, or damage) the hazard could cause Assign Value 1 to 4 Assign Value 1 to 4 Multiply Severity and Likelihood (See Risk Matrix. Appendix ?) What control measures you already have in What do you need to implement (Look at Hazard Control Methods to determine course of action.) Create and implement a procedure (such as a check list or testing) that defines how you will ensure measures eliminate or control the hazard.