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New/Expectant Mother Risk Assessment form template

New or Expectant Mother Workplace Risk Assessment


This New/Expectant Mother Workplace Risk Assessment form should be used after the Expectant Mother Letter has been sent. This risk assessment form covers issues that would affect all staff but is specifically aimed at the expectant or new mother - manual handling, workplace temperatures, workload and posture, shift work, smells, rest facilities and access. Additional fields can be used for other identifiable hazards appropriate to the job and employee.


We suggest that you print off a copy of the form and manually write in your findings; the identified hazards and the controls you have and will need. To help with this process you may wish to refer to: Guidance Notes - How to do a Risk Assessment and the New/Expectant Mother Risk Assessment (Worked Example).

Once you have hand-written your expectant mother risk assessment form you may wish to revisit the electronic version and input your data to create a neater more professional looking document. We have set the template fields so as to be sufficient for most levels of information at a limit of 200 characters.

Once you have completed your risk assessment form whether hand-written or electronic, you should transfer the information in the ‘further controls/action’ column into your Action Plan so that you can monitor who has carried out the works and when.

This template is in fixed field format and contains macros. All macros are virus free. Always click "enable" if an automatic pop-up appears.

Simply press TAB to jump from one field to the next and SHIFT + TAB to go back. Alternatively, use the mouse to click from one field to the next.

The template can be unlocked by clicking on the "Padlock" icon on the tool bar.

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