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Sample Risk Assessment Form

How can risks be assessed?

Risks should be systematically identified and reviewed to ensure those things, activities, situations, processes, etc. that cause harm to people or property are controlled. One way to ensure that all risks are evaluated in the same way is to use a risk assessment form. This procedure should be carried out by someone who is experienced and fully familiar with the activity (e.g., a "competent person").

Please note: see the OSH Answers Risk Assessment for more information about risk assessments in general, and how to rank hazards.

Is there a procedure for identifying risks?

The risk assessment form should be completed for any activity, task, etc. before the activity begins.

Step Action Deliverable
1 Identify hazards and their potential for causing harm. An inventory of hazards.
2 Rank hazards by priority A ranked list of hazards. This list will be useful in planning further action.
3 Determine hazard control measures. A record of hazard control measures at various locations.
Adequacy of hazard control measures.
4 Implement controls. Controls are in place and functioning appropriately.
5 Measure the effectiveness of controls. Monitor periodically to confirm controls continue to function.
6 Make changes to improve continuously. Monitor for improvements.

What is a sample risk assessment form?

The following is a sample. Be sure to customize it for your needs at your workplace.


Sample Risk Assessment Form
Name of person doing assessment:

Activity / Procedure being assessed:

Known or expected hazards associated with the activity:

The risk of injury and its severity likely to arise from these hazards:

Who is at risk?

Measure to be taken to reduce the level of risk:

Training prerequisites:

Level of risk remaining:

Action to be taken in an emergency:

References, if any:

Signature of Assessor:


Document last updated on February 2, 2009


Although every effort is made to ensure the accuracy, currency and completeness of the information, CCOHS does not guarantee, warrant, represent or undertake that the information provided is correct, accurate or current. CCOHS is not liable for any loss, claim, or demand arising directly or indirectly from any use or reliance upon the information.