Free Work from Home Risk Assessment Sheet Template

Work from Home Risk Assessment Sheet

Company: [YOUR COMPANY NAME]
Date: 12/06/2062

Employee Details

  • Name: [YOUR NAME]

  • Position: Marketing Specialist

  • Department: Digital Marketing

Work Environment Checklist

Risk Factor

Yes/No

Actions Required

Adequate lighting?

  • Yes

  • No

None

Ergonomic desk setup?

  • Yes

  • No

Upgrade chair and desk setup

Secure internet access?

  • Yes

  • No

None

Safe electrical setup?

  • Yes

  • No

Inspect wiring and install surge protector

Employee Well-being

  • Can you manage your workload effectively? Yes

  • Are regular breaks being taken? No

  • Do you feel supported by your manager? Yes

Sign-Off

  • Employee Signature: ____________________

  • Manager’s Signature: ___________________

This assessment ensures a safe and productive work-from-home environment. Please submit the completed form to the HR Department.

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