Health and Safety Form Template

The "stand-alone" health and safety template is a suite of three forms combined into one.

  • The overall Process Risk Assessment
  • A Method Statement
  • A hazardous chemical risk assessment. This is often referred to as a COSHH (Control Of Substances Hazardous to Health) risk assessment.


The form allows for the review and approval of the assessment, after which it becomes "locked" from alteration to keep the integrity of the form.



The "Opening Page" 


At the top, the user can choose which of the three assessments will be completed. One, two or all may be selected. If not selected, the section will remain hidden from view. If a section is "deselected" at any point, any information entered  in those sections will be hidden, not deleted.


This allows for the input of 

  • where the task is being done
  • the originator's details
  • a descripion of the task being assessed
  • who is supervising and doing the first review

The "Risk Assessment Page" 


If selected, the risk assessment for the overall task is displayed.


The top part (Sections 1 - 4) allow for the entry of risks that apply across the activity and are broken down into four categories -

  • The workplace
  • Hazardous Substances
  • The activities that will take place during the task
  • The organisation of work to be completed

There is the ability to add more than one line to each of the categories ( The + button ) 


The images below show examples of the drop-down options for some of the fields. Click on these to zoom in.


For every hazrd identified in the Categories above, the risks for each need to be evaluated . This is done by estimating :

  • Who is most at risk (and by extension, how many peple may be affected)
  • The actual risk posed
  • The estimated impact should the risk be realised (from "Slightly Harmful", "Harmful", "Very Harmful")
  • The likelihood of the risk occurring (from "Highly Unlikely", "Likely", "Very Likely")
  • This will give a 

The "Method Statement Page" 


This page allows users to describe, in detail, what equipment, user training, chemicals should be considered before work begins.


There is a section to document any accident and/or spillage procedures in the event of an incident.


The last section allows the user to document  -  
step by step, what actions need to be done to complete the task, and for each step, identify the precautions required to keep the process safe. This should include safety precautions for people, plant and machinery, infrastructure and third-parties.


Although presented as "one line", the + button allows for many steps to be added. It is advised that each "line" should detail one operation, so the precautionary procedures can be linked to them.

The "Sign-off Page" 


This is the final page of the template.

Here, the supervisor can digitally "sign" the document once approved. 

At this point, once signed, all the details above the signature line become locked and cannot be changed.


The document is then sent to the final approval from the Safety Officer to review, assign the approprite reference numbers and the date for the next review.


At that point the Safety Officer digitally signs the document and it it becomes completely un-editable.


Should the assessment require changing, or when a review is required, the Safety officer must "unsign" the document, pass it on to the supervisor who must also "unsign" it. Once that has been done, the entire document becomes un-locked and able to be changed.


Once the changes have been made, the supervisor  must review and re-sign, then the Safety Officer must set a new review date and sign again, locking the document again.

The "COSHH Page" 


Every hazardous substance being used during the task should have an individual COSHH risk assessment. This should be based on the substances' Safety Data Sheet (SDS or MSDS) which will detail the information needed to complete most of the form.


This image shows an example of  a harmful flammable chemical.


The substance should be named,  its Chemical Abstract Service (CAS) number and any Workplace Exposure Limits entered.


The exposure to the substance is then assessed by way of the volume being used, the length of time it is in use, what process controls are in place and the physical state the substance is expected to be in.


The hazard phrases (or "H" Numbers), from the SDS are added. These are selectd from a drp down list already in the template.   From these statements, the template will display the hazard pictograms appropriate to the hazard and the routes of exposure. These are set in the "tick boxes" in the exposure section. Once all the H statements have been added, an overall Hazard rating will be calculated.


The precaution phrases should be added (again from the SDS). As these are entered, the Overall (or Residual) Risk is calculated. Ideally the overall risk should be low.


More H and P phrases can be added by using the + button at the side of the Hazards and Precaution boxes.


Finally,  any special considerations for storage, disposal and spillage procedures can be added.

Again, there are drop-down suggestions, but these can be over-typed.


Further substances an be added by using the "+ Add another chemical" buttom at the bottom.


At the bottom of the page (not shown here) the highest hazard is shown to give an indication of the hazard overall.
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