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Hazard Assessment Form Template

Ensure Workplace Safety with Our Comprehensive Assessment Tool

Identifying hazards in your workplace can be challenging, but you don't have to do it alone. This hazard assessment form template is designed to help you systematically evaluate potential risks, ensuring a safer environment for your employees. With clear sections for documenting hazards, prioritizing risks, and implementing safety measures, you'll enhance compliance with safety regulations, empower your team with knowledge, and streamline your reporting process. Take proactive steps towards a safer workplace by utilizing this ready-to-use template.

Assessment title or reference
Assessment date
Assessor full name
Assessor email
Site or facility
Specific area or asset
Task or activity being assessed
Brief description of the work
People potentially affected
Employees
Contractors
Visitors
Public
Temporary workers
Lone workers
Not applicable
Hazard categories observed
Describe the specific hazard(s)
Existing controls in place
Likelihood before controls
Very unlikely
Unlikely
Possible
Likely
Very likely
Severity before controls
Insignificant
Minor
Moderate
Major
Severe
Residual likelihood after controls
Not applicable
Very unlikely
Unlikely
Possible
Likely
Very likely
Residual severity after controls
Not applicable
Insignificant
Minor
Moderate
Major
Severe
Recommended control measures
Action description
Responsible person
Target completion date
Does this work require a permit?
Yes
No
Permit types
Assessor printed name
Date signed
I confirm the information in this assessment is accurate to the best of my knowledge
Strongly disagree
Disagree
Neither
Agree
Strongly agree
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Paper art illustration depicting a hazard assessment form template for FormCreatorAI article

When to use this form

Use this form before new work begins, after equipment or process changes, or when a near miss occurs. Safety officers, supervisors, and crew leads benefit most, along with contractors and visitors. For task-specific reviews, pair it with the Job hazard analysis form. If your review flags combustibles or ignition sources, follow up with a Fire risk assessment form. During drills or after incident trends, route findings into your Emergency evacuation checklist form to tighten procedures. Security teams can also scan for people-related risks and coordinate with the Threat assessment form. The result is a clear risk rating, control actions, owners, and due dates that keep work moving safely.

Must Ask Hazard Assessment Questions

  1. What task, location, and timeframe are you assessing?

    It sets clear scope so responders focus on the right work area and period. Precise context reduces vague answers and speeds approvals.

  2. What hazards are present (physical, chemical, biological, ergonomic, psychosocial)?

    Listing categories prompts a full sweep, not just obvious risks. It improves completeness and helps you match controls to each type.

  3. Who could be harmed and how (employees, contractors, visitors, public)?

    This ties risks to real people and exposure paths. It helps you prioritize high-consequence groups and plan briefings.

  4. What controls exist now, and what additional controls will you implement (elimination, substitution, engineering, admin, PPE) with owners and due dates?

    Writing both current and planned measures reveals gaps. Assigning owners and deadlines drives action and accountability.

  5. Have there been recent incidents, near misses, or violations related to this task or area?

    Past issues signal patterns you must fix. If behavior or policy breaches are involved, route follow-up through the Employee safety violation form.

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