Project/Activity Name

Department

Name

Email

Please enter your email address.

Are there any known risks associated with this project/activity?

If yes, please describe the risks:

How likely are these risks to occur?

Rate from 1 (very unlikely) to 10 (very likely)

What would be the impact if these risks occur?

• Major

• Moderate

• Minor

• Negligible

Are there existing measures in place to manage these risks?

If yes, please list the risk mitigation measures:

How effective do you think these measures are in reducing risk?

• Very Effective

• Somewhat Effective

• Neutral

• Not Effective

Is the team or staff aware of these risks?

Have there been any training or briefings to address risk management?

How would you rate the level of preparedness of the team to respond to these risks?

Rate from 1 (very poor) to 10 (very excellent)

How concerned are you about the potential risks associated with this project/activity?

• Very Concerned

• Somewhat Concerned

• Neutral

• Not Concerned

Are there additional risks not yet identified that should be considered?

If yes, please describe:

Additional Comments

Provide any additional feedback, suggested changes, improvements, notes, etc.