Understanding potential risks can be daunting, especially in healthcare settings where patient safety is paramount. This Preliminary Risk Assessment Form template is tailored for hospitals, clinics, and healthcare facilities, helping you identify and evaluate risks associated with patient safety, infection control, medical equipment, and emergency procedures. By using this template, you'll gain clarity on risks, ensure compliance with safety regulations, enhance your decision-making process, and ultimately safeguard your patients. Try the live template and streamline your risk assessments today.
Responsible person or role for implementing controls
This is a test
Additional controls recommended
Enhanced training or competency
Are specific legal or permit requirements triggered?
Not sure
Permits likely required
None or not applicable
Are external notifications required (e.g., regulator, client, landlord)?
Not sure
Are there specific emergency risks for this activity?
No
Emergency contact details or notes
This is a test
Emergency arrangements in place
Alarm or communication tested
Estimated residual likelihood after recommended controls
Not applicable
Estimated residual severity after recommended controls
Catastrophic
Residual risk level after recommended controls
Medium
Approval decision
Approved with conditions
Conditions or approval notes
This is a test
Reviewer or approver full name
John Smith
Date of review
2025-10-15T00:00:00.000Z
I confirm the information provided is accurate to the best of my knowledge
Yes
When to use this form
When you kick off a project, open a new site, bring on a vendor, or change a process, use this form to spot hazards early and set controls. It helps project leads, safety officers, HR, and IT capture location, activity, assets, and people at risk, then rate likelihood and impact. The outcome is a clear priority list and owners for mitigation before work begins. To gather wider input from staff, pair this with the Risk assessment survey form. If your risks involve worker health, PPE, or job tasks, add the Occupational health and safety questionnaire form, and for continuity steps after an incident, use the Contingency plan checklist form.
Must Ask Preliminary Risk Assessment Questions
What task, asset, or area are you assessing, and where will it take place?
This defines the scope so responses stay focused and comparable. Clear context reduces duplicate entries and helps you match risks to the correct site, team, or system.
Which hazards or threats could cause harm, and who or what is exposed?
Listing credible sources of harm surfaces real exposure and affected people, equipment, or data. If systems or data are in scope, consult the Cyber security risk assessment checklist form to cover common threat vectors.
Without current controls, what is the likelihood and impact of each risk?
Estimating inherent risk reveals worst-case priorities and prevents false confidence. It also sets a baseline you can compare to residual risk after controls are applied.
What controls or procedures exist today, and how well are they followed?
Documenting safeguards and their effectiveness shows where training or discipline is needed. For workforce behaviors, recent results in the Employee safety performance review form can validate how consistently practices are applied.
What new controls, owner, and deadline will reduce each risk to an acceptable level?
Assigning actions, accountable owners, and due dates turns findings into a plan. This drives follow-through and makes it easy to audit progress later.
