DATE of Assessment: xx / xx / 201x ASSESSMENT No [Enter your departmental reference number] [Enter name of author] [name of Department/School] Assessed by (Name): DEPARTMENT name or code: [Enter a description of the activity/equipment/workplace covered by this NATURE OF ACTIVITY: DATE OF ACTIVITY: [add if relevant for activity being risk assessment]. assessed] LOCATION: [location of the NEXT REVIEW DATE: [maximum 3years after date of activity/equipment/workplace] assessment] [Head of Department/School, print name [Date HoD approves risk Approved by APPROVAL DATE: & signature] assessment] Persons Risk Additional Control Measures Revised Date at Risk & Rating Action Hazard Current Control Measures Required Risk Action by who action Nature of Severity x by when Rating complete (Further action required) Likelihood harm
DATE of Assessment: xx / xx / 201x ASSESSMENT No [Enter your departmental reference number] Assessed by (Name): [Enter name of author] DEPARTMENT name or code: [name of Department/School] NATURE OF ACTIVITY: [Enter a description of the activity/equipment/workplace covered by this risk assessment]. DATE OF ACTIVITY: [add if relevant for activity being assessed] LOCATION: [location of the activity/equipment/workplace] NEXT REVIEW DATE: [maximum 3years after date of assessment] Approved by [Head of Department/School, print name & signature] APPROVAL DATE: [Date HoD approves risk assessment] Hazard Persons at Risk & Nature of harm Current Control Measures Risk Rating Severity x Likelihood Additional Control Measures Required (Further action required) Revised Risk Rating Action by who Action by when Date action complete
General%20Risk%20Assessment%20Form.docx