Blank Return to Work Risk Assessment

Carrying out a COVID-19 Risk Assessment is one of the 5 steps the Government has stipulated as necessary in order to manage the risk of the spread of Coronavirus and ensure the safety of staff returning to work.

This Blank Risk Assessment Form template can be used to identify the general factors that cause the spread of the virus (the hazards) such as contaminated surfaces and proximity to other people and covers for staff/contractors/visitors who might enter the workplace premises or site locations. It provides for controls and measures taken to manage, mitigate or eliminate the hazards, further action to be taken and who has responsibility for such further action with target and completion dates.

If any of your staff/contractors/visitors are vulnerable persons your risk assessment must identify that within the 'Persons at Risk' section, and the controls and measures required to provide additional protection must be included within the risk assessment.

It is recommended that a separate form should be applied to each separate department within each premises/location. The department/staff section provides details covering those people at risk.

The risk assessment element of the template is divided into 3 sections, each formatted as a Word table:

1. Factors causing of the spread of the virus

2. Workplace Premises – identifying specific controls for different parts of a location

3. Workplace Tasks – identifying specific controls for certain jobs within a business/location/department.

This document is in open format which enables tables to be added or deleted, and rows/columns to be added or deleted within these tables. Please also adjust the wording to suit your purposes.

Worked example templates for different business types are also downloadable which may assist by prompting the identification of hazards, those at risk, controls undertaken, further action and the results of further action. The Pub/Restaurant Example, for instance, has 4 rather than 3 sections, the additional section headed as Customer Service Areas. It is imperative that the risk assessment is specific to each business, location and department and that all measures and controls are carried out and not just recorded on the form.

The government has advised that all business with 50 employees or more must share the completed COVID-19 risk assessment form with their workforce, but it is recommended that all employers should do so, even if they have less than 50 employees.

Once you have subscribed to the appropriate document folder click on the “Download Document” button below. You will be asked what you want to do with the file. It is recommended that you save the document to a location of your choice prior to viewing.