Lumiform
Features Solutions Resources Templates Enterprise Pricing
Select a language
Englishen
Deutschde
Françaisfr
Españoles
Português (BR)pt-BR
en
Contact salesLog in
Sign up
Back
Englishen
Deutschde
Françaisfr
Españoles
Português (BR)pt-BR
Features Solutions Resources Templates Enterprise Pricing
Free demo
Log in
en
Book a personal demoView video demoContact sales
Explore
Resource hubCentral repository for all Lumiform resourcesCustomer storiesReal-world successes and experiences with Lumiform.
Learn
Template collectionsComprehensive collections of best practice templates.Topic guidesComprehensive safety, quality, and excellence insights.LexiconDefinitions key to quality, safety, and compliance.
Support
Developer's guideTechnical documentation for developers.Help centerAssistance with onboarding and platform mastery.
Featured reads
Explore our collection of 38 free preventive maintenance checklists

Template collection

Explore our collection of 38 free preventive maintenance checklists

Start reading
Your guide to performing and documenting efficient child care observation

Topic guide

Your guide to performing and documenting efficient child care observation

Start reading
Lumiform as customer journey mapping tool in gastronomy

Success story

Lumiform as customer journey mapping tool in gastronomy

Start reading
Book a personal demoView video demoContact sales
By industry
Food and hospitalityManufacturingConstructionRetailTransport and logisticsFacility managementView all industries
By business needs
Health and safety managementQuality managementOperational excellenceRisk management and complianceView all business needs
By use case
Safety management softwareEnergy audit appForklift inspection appBuilding management softwareVehicle inspection appQMS appKaizen method appProperty inspection appRestaurant inspection appElevator management appProject management softwareFire inspection app
View all app uses
Book a personal demoView video demoContact sales
Overview
Template libraryDiscover over 12,000 free, ready-made and expert proofed templates.
Use cases
CleaningMaintenanceRisk assessmentSupply chainIncident management
Business needs
Health and safety managementQuality managementOperational excellenceRisk management and compliance
Industries
Food and hospitalityManufacturingRetailTransport and logisticsConstructionFacility management
Book a personal demoView video demoContact sales
Overview
Product overviewAll features
Capabilities
Digitize
Form builderMobile AppActions
Automate
Workflow automationApprovalsIntegrations
Transparency and accountability
ReportsAnalytics
Orchestrate
Administration
Book a personal demoView video demoContact sales
Templates
Fall risk assessment form

Fall risk assessment form

Evaluate and mitigate fall risks with this comprehensive assessment form. It helps identify individuals at risk and implement preventive measures. Use this form to enhance safety and reduce the likelihood of falls.

Use this template
or download pdf
Fall risk assessment form

Evaluate and mitigate fall risks with this comprehensive assessment form. It helps identify individuals at risk and implement preventive measures. Use this form to enhance safety and reduce the likelihood of falls.

Use this template
or download pdf

About the Fall risk assessment form

Using a fall risk assessment form template streamlines the process of identifying and mitigating potential hazards in your environment. By employing a structured template, you ensure consistency and thoroughness in evaluating risk factors, which is crucial for maintaining safety standards. This approach helps you systematically document each aspect of the assessment, reducing the likelihood of oversight.

A template tailored for fall risk assessments serves you by providing predefined fields that guide you through the evaluation process, making it easier to focus on critical areas. You can optimize your workflow by quickly adapting the template to suit specific needs, whether in healthcare, construction, or elder care settings. 

This ensures that you address all relevant factors, enhancing the effectiveness of your safety protocols. By using a template, you not only save time but also improve the accuracy and reliability of your assessments.

Key elements of a fall risk assessment form template

A fall risk assessment form template is structured to ensure comprehensive evaluation and mitigation of potential fall hazards. Here are the key elements that make it effective:

  • Risk factor identification: Start by documenting specific conditions or behaviors that increase the likelihood of falls. This section helps you focus on areas that require immediate attention. Identifying these factors allows you to prioritize your preventive measures effectively.
  • Environmental assessment: Evaluate the physical surroundings, such as flooring, lighting, and obstacles. This section ensures you address both obvious and subtle risks effectively. By thoroughly assessing the environment, you can implement targeted interventions to enhance safety.
  • Preventive measures and action plan: Outline strategies to reduce identified risks. This might include recommendations for equipment modifications or staff training. By detailing these actions, you ensure that all team members are aligned in their preventive efforts.
  • Follow-up and review: Track the implementation of your action plan and reassess risks over time. This continuous evaluation helps you maintain a high standard of safety. Regular reviews allow you to adapt to any changes in the environment or population, keeping your assessments relevant.

When to use a fall risk assessment form template

A fall risk assessment form template is most beneficial in environments where safety is a top priority, such as healthcare facilities, construction sites, and elder care settings. You can use this template when conducting routine safety audits to ensure that all potential fall hazards are identified and addressed. It is particularly useful when you need to evaluate new environments or changes in existing ones, as it helps you systematically assess risks.

If your team is implementing new safety protocols or equipment, a template like this serves you by providing a consistent framework for evaluation. This ensures that all team members are aligned in their approach.

Related categories

  • Risk management and compliance templates
  • Construction templates
  • Risk assessment templates
Preview of the template
Page 1
General Information
Name
Date
Department
Job Title
Fall Risk Assessment
Have you experienced a fall in the past year?
Do you use any assistive devices (cane, walker, etc.)?
Do you have any conditions that may increase your fall risk (e.g., vision, hearing, or balance issues)?
Are there any environmental hazards in your work area (e.g., slippery floors, clutter, poor lighting)?
Have you received any fall prevention training?
What is your current fall risk level?
Action Plan
Describe any steps you will take to reduce your fall risk:
Who will you notify about your fall risk?

More templates like this

Medicare Fall Risk Assessment Form
Medicare Fall Risk Assessment Form
A form designed to meet the specific requirements of Medicare compliance, featuring sections for patient history, medication review, and environmental assessments.
Risk assessment templates
Morse fall risk assessment form
Morse fall risk assessment form
Use this morse fall risk assessment form to help evaluate a patient's probability of falling.
Risk assessment templates
Nursing Fall Risk Assessment Form
Nursing Fall Risk Assessment Form
A comprehensive form for assessing fall risk in healthcare settings, with detailed patient information, risk factor identification, and automated action triggers for high-risk findings.
Risk assessment templates
Obstetric Fall Risk Assessment
Obstetric Fall Risk Assessment
Designed for obstetric care settings, this form focuses on assessing fall risks specific to pregnant patients.
Risk assessment templates
Patient Fall Risk Assessment Template
Patient Fall Risk Assessment Template
This fall risk assessment template is used to assess a patient’s likelihood of falling.
Risk assessment templates
STEADI fall risk assessment
STEADI fall risk assessment
Comprehensive assessment for fall risk in older adults
Risk assessment templates

Related resources

Access a complete set of resources aimed at maximizing safety, quality, and operational excellence, including detailed guides, related templates, and real-world use cases.

Topic guides

Read in-depth guides covering key topics related to this article.

Fall protection: A guide to staying safe at heightsDynamic risk assessment: Your guide to proactive management (with real world case studies)Effective risk assessment: Key steps and best practicesEnvironmental risk assessment: A step-by-step guide
See all topic guides

Template collections

See comprehensive collections of best practice templates related to this topic.

9 free fall risk assessment form templates Top 6 free fall protection inspection forms3 free elderly home safety checklists to reduce risks4 best free office risk assessment checklists
See all template collections

Use cases

Check out how the Lumiform software can be utilized for related use cases.

Risk assessment softwareRisk management software for anticipating and adressing safety risksApply Lumiform's workflow automation platform to all use casesHealthcare risk management software
See all use cases

Other resources

Explore all the additional resources we offer to assist you in mastering this topic.

6 benefits of maintenanceBenefits of a forklift checklist appHow to evaluate compliance measuresDisaster risk management: the philosophy of disaster preparedness

Frequently asked questions

What is a fall risk assessment form template?

A fall risk assessment form template is a tool you can use to help you systematically evaluate potential fall hazards in various environments. It provides a structured approach to identifying risk factors, documenting preventive measures, and tracking follow-up actions, ensuring a comprehensive safety assessment.

Who should use a fall risk assessment template?

Professionals in healthcare, construction, and elder care settings should use a fall risk assessment form template. It is especially valuable for safety officers, facility managers, and healthcare providers who need to ensure high safety standards and prevent fall-related incidents effectively.

How does a fall risk assessment template improve safety?

By using a fall risk assessment template, you enhance safety through consistent documentation and evaluation of risk factors. This structured approach helps you identify hazards early, prioritize preventive measures, and ensure all team members follow a unified safety protocol, reducing the likelihood of accidents.

Why is it important to update a fall risk assessment template regularly?

Regular updates to a fall risk assessment template are crucial because they ensure that new hazards or changes in the environment are under supervision. This practice helps you maintain relevant safety protocols and adapt to evolving risks, keeping your assessments accurate and effective.


This template, developed by Lumiform employees, serves as a starting point for businesses using the Lumiform platform and is intended as a hypothetical example only. It does not replace professional advice. Companies should consult qualified professionals to assess the suitability and legality of using this template in their specific workplace or jurisdiction. Lumiform is not liable for any errors or omissions in this template or for any actions taken based on its content.
Lumiform logo
Platform
HomeSign upProductAll featuresPricingEnterpriseTrust and securityCustomer success offeringsDownload the app
Solutions
IndustriesFood and hospitalityManufacturingConstructionRetailTransport and logisticsFacility management
Business needsHealth and safety managementQuality managementOperational excellenceCompliance and risk management
Uses cases
Learn
Template collectionsTopic guidesLexiconHelp centerJournalInfographicsVideos
Resources
Lumiform templatesby industryby use caseby business needAll categories
Customer storiesDeveloper APIResource hubIntegrations
Company
AboutJobsLegalBook a demoContact sales
© 2025 LumiformTerms and conditionsPrivacyData processingSitemap
App StoreGoogle play