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Laser Risk Assessment Form Template

Laser Risk Assessment Form Template

Use this laser risk assessment form template to establish a laser safety program for Class 3B and Class 4 lasers in accordance with applicable regulations and procedures.

Use this template
or download pdf
Laser Risk Assessment Form Template

Use this laser risk assessment form template to establish a laser safety program for Class 3B and Class 4 lasers in accordance with applicable regulations and procedures.

Use this template
or download pdf

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Preview of the template
Laser Risk Assessment
Laser Inventory
Is the Inventory for all 3B & 4 lasers correct?
Signs & Labels
Room postings correct?
Equipment properly labeled and registered?
Laser-controlled areas posted?
Users and Procedures
Are authorized users adequately trained?
Are written SOPs, maintenance procedures, and alignment procedures kept with or near laser equipment?
Are Class 3b and 4 lasers posted to indicate that eye protection is required to operate the device?
Are all commercially produced Class 3b and 4 lasers and all lasers made or modified been registered with LSO?
Are pre-operational safety checks conducted prior to each operation?
Controls
Protective housing and Interlocks in use?
Access restriction / area controls?
Adequate room illumination?
Beam stops present?
Reflective surfaces controlled?
Elements in beam path secured?
Proper eyewear available?
Skin protection for UV lasers?
No exposed wiring or circuits?
Barriers / screens (if present) non- combustible & no burn holes?
Are windows / ports which could allow a laser beam to stray into uncontrolled areas covered or protected during laser operation?
General
All other compliance items met?
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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.