Free Hazard Identification and Risk Assessment (HIRA) Form Template

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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