Workplace Risk Assessment Form Template
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Workplace Risk Assessment Form

Please fill out the form with your information below.

Personal Information

Name

    Assessment Date

      Assessor Name

        Position

          Workplace Information

          Department/Area Assessed

            Hazard Description

              Risk Assessment

              Likelihood of Harm

                Severity of Harm

                  Proposed Measures

                    Acknowledgment and Approval

                    I confirm that the above information is accurate to the best of my knowledge and that all necessary actions will be taken to minimize risk.

                    Date:

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