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Risk Assessment
To be completed by the Crew Leader / Safety Champion as the site risk assessment
Step
1
of
3
33%
Today's date
DD slash MM slash YYYY
Please select your Country
(Required)
Australia
New Zealand
Your State
(Required)
ACT
NSW
NT
QLD
SA
TAS
VIC
WA
Name of Crew Member submitting
(Required)
First
Last
Time of assessment
(Required)
Hours
:
Minutes
AM
PM
AM/PM
Date
(Required)
DD slash MM slash YYYY
Customer Name
(Required)
For Example, Woolworths, Jaycar, Bunnings
Customer Location
(Required)
For Example: Toorak VIC
Hazard/ Risk Identified
(Required)
Description of the Hazard
(Required)
Action taken to resolve
(Required)
Name of onsite contact reported to
(Required)
Hazard/ Risk Photos
(Required)
Accepted file types: jpg, jpeg, png, gif.
Any further feedback or further action needed
(Required)
Δ
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