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COSHH risk assessment form

Use this Control of Substances Hazardous to Health (COSHH) form, to control the exposure to dangerous substances and to prevent hazardous diseases and health problems. Identify the risks associated with the activity or work process obeyed and record all improving and examine measures as well as personal protection gear and tools that you and your team are using when dealing with these substances. 

Log all first aid steps in case of emergencies. Next record averages of disposing of dangerous wastes and contaminated containers. Finally, summarise the report by giving a risk rating after following the control measures. Use Lumiform to conduct better risk evaluations to decrease or eliminate health risks.

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COSHH risk assessment form


General Information

Participants in COSHH assessment
People who are at risk

Hazard Identification

Add activity or work process:

Control Measures

Name control measures e.g. extraction, ventilation, observation, include further controls for vulnerable persons where necessary
Is health surveillance or monitoring needed? (remember health surveillance may be needed for vulnerable persons, e.g. pregnant/young employees, those with asthma, dermatitis etc.)

Personal Protective Equipment

Identify type and specification of PPE
Provide standard measures for each PPE needed

First Aid Measures

Explain first measures when in contact with these substances

Storage and Disposal of Substances and Contaminated Containers

How do you deposit these substances?
Means of disposing dangerous waste


Is the exposure sufficiently controlled?
Rate the risk after following control measures:


Name and signature of the inspector:
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