KAPPA PSI PHARMACEUTICAL FRATERNITY, INC. ACTIVITY RISK ASSESSMENT WORKSHEET 1. ACTIVITY/EVENT DESCRIPTION 2. DATE OF ACTIVITY 3. PREPARED BY a. NAME b. CHAPTER/PROVINCE c. POSITION d. e. TELEPHONE f. DATE PREPARED Five steps of Risk Management: (1) Identify the hazards (2) Assess the hazards (3) Develop controls (4) Implement controls (5) Supervise and evaluate 6. INITIAL 8. HOW/WHO TO 9. FINAL 4. ACTIVITY 5. HAZARD 7. CONTROL IMPLEMENT RISK RISK (H/M/L) (H/M/L) □ □ □ HIGH MEDIUM LOW 10. OVERALL RISK LEVEL (ONCE CONTROLS IMPLEMENT): □ □ YES NO 11. WILL ANY CITY, COUNTY, OR STATE LAWS BE VIOLATED? CHAPTER POLICIES, UNIVERSITY/COLLEGE RULES? IF YES, EXPLAIN: □ □ YES NO 12. IS THE STATED LIABILITIES WORTH THE BENEFITS OF THIS EVENT? □ □ APPROVE DISAPPROVE 13. APPROVAL OR DISAPPROVAL OF a. NAME b. POSITION c. CONTACT INFORMATION d. ADDITIONAL GUIDANCE
KAPPA PSI PHARMACEUTICAL FRATERNITY, INC. ACTIVITY RISK ASSESSMENT WORKSHEET 1. ACTIVITY/EVENT DESCRIPTION 2. DATE OF ACTIVITY 3. PREPARED BY a. NAME b. CHAPTER/PROVINCE c. POSITION d. e. TELEPHONE f. DATE PREPARED Five steps of Risk Management: (1) Identify the hazards (2) Assess the hazards (3) Develop controls (4) Implement controls (5) Supervise and evaluate 4. ACTIVITY 5. HAZARD 6. INITIAL RISK (H/M/L) 7. CONTROL 8. HOW/WHO TO IMPLEMENT 9. FINAL RISK (H/M/L) 10. OVERALL RISK LEVEL (ONCE CONTROLS IMPLEMENT): □ HIGH □ MEDIUM □ LOW 11. WILL ANY CITY, COUNTY, OR STATE LAWS BE VIOLATED? CHAPTER POLICIES, UNIVERSITY/COLLEGE RULES? □ YES □ NO IF YES, EXPLAIN: 12. IS THE STATED LIABILITIES WORTH THE BENEFITS OF THIS EVENT? □ YES □ NO 13. APPROVAL OR DISAPPROVAL OF □ APPROVE □ DISAPPROVE a. NAME b. POSITION c. CONTACT INFORMATION d. ADDITIONAL GUIDANCE
Risk%20Assessment%20Form-2.docx