Free Hazard Assessment Form Template

Hazard Assessment Form

Please fill out this form to help us identify and address potential hazards.

Date

    Assessor

      Email

        Phone Number

          Location/Area Assessed

            Type of Hazard(s) Identified

            Select all that apply:

              • Slip/Trip/Fall

              • Electrical Hazard

              • Chemical Exposure

              • Equipment Malfunction

              • Fire Hazard

              • None

              Hazard Description

                Immediate Actions Taken (if any)

                  Recommendations for Mitigation

                    Supporting Documents

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