Risk Assessment Department: Risk Assessment Completed by: Date: Description Who might be Existing Control Measures A. B. Risk Rating Comments/Actions Likely Likely (A) x (B) and location of harmed severity of Occurrence Hazard injury (1 to 3) (1 to 3) Score 3 2 1 Column A: Severity of Injury: Major Injury or death Injury requiring medical treatment Minor or no injury Column B: Likely Occurrence: Regular exposure of several Occasional exposure of few Exposure to hazard very rare. employees to hazard. employees.
Risk Assessment Department: Risk Assessment Completed by: Date: Description and location of Hazard Who might be harmed Existing Control Measures A. Likely severity of injury (1 to 3) B. Likely Occurrence (1 to 3) Risk Rating (A) x (B) Comments/Actions Score 3 2 1 Column A: Severity of Injury: Major Injury or death Injury requiring medical treatment Minor or no injury Column B: Likely Occurrence: Regular exposure of several employees to hazard. Occasional exposure of few employees. Exposure to hazard very rare.
example-risk-assessment-form.docx