Hazard Identification and Risk Assessment (HIRA) Form
Hazard Identification and Risk Assessment (HIRA)
Please use this template to identify hazards and assess risks in your workplace, ensuring a safe environment for all.
Project/Activity Name
Date of Assessment
Assessor Name
Job Title
Hazard Identification
Hazard Description
Location
Potential Consequences
Risk Assessment
Likelihood
Rate the probability of the hazard occurring, with 1 being rare and 5 being highly likely.
Severity
Assess the potential impact of the hazard if it occurs, ranging from 1 (insignificant) to 5 (catastrophic).
Risk Level (Likelihood x Severity)
Calculate the risk level by multiplying the likelihood and severity scores. This will help prioritize risks for mitigation.
Control Measures
Current Controls
Additional Controls Needed
Responsible Person
Review Date
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