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Risk Assessment Rating Template

Use this template to distinguish workplace risks, evaluate initial risk ratings, control means and residual risk ratings. Use the Risk Matrix chart to identify the severity, likelihood and risk rating before and after implementing control measures.

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Instructions: 1. Inspect and identify workplace risks on site which could generate harm to workers. Follow and repeat the steps underneath for all hazards classified 2. Add a hazard to document risk evaluation 3. Describe the hazard, attach a photo and include annotations where needed 4. Evaluate the risk rating based on the risk matrix reference at the bottom of the template 5. Select the proper controls with reference to the hierarchy of controls at the bottom of the template 6. Complete the risk evaluation by giving general recommendations and a digital signature 7. Generate and export your report in PDF, Word or Web Links
Describe the procedure, task or worksite being evaluated:
Hazards, Risks and Controls
Add the hazard you have observed and identified:
Describe the hazard:
Photo of hazard (optional):
What can you do to get rid of that hazard or to limit the risk?
Possible control measures:
Initial risk rating
Initial consequence:
Initial probability:
Rate the risk initial:
Residual risk rating
Residual consequence:
Residual probability:
Rate the risk:
Risk Matrix Reference:
Hierarchy of Controls Reference:
Further recommendations:
Full name and signature of the inspector:
Share this template:

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Please note that this checklist template is a hypothetical appuses-hero example and provides only standard information. The template does not aim to replace, among other things, workplace, health and safety advice, medical advice, diagnosis or treatment, or any other applicable law. You should seek your professional advice to determine whether the use of such a checklist is appropriate in your workplace or jurisdiction.