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Hazard Register Template

Central register for tracking identified workplace hazards from open to closed with risk ratings and controls

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Details
# Register Item Detail Status Review Date Notes
Hazard Identification
1 Hazard reference number
2 Date identified
3 Reported by
4 Source (inspection / near miss / audit / observation)
5 Location and work area
6 Hazard description
7 Who could be harmed
Risk Assessment
8 Likelihood (rare / unlikely / possible / likely / almost certain)
9 Consequence (insignificant / minor / moderate / major / catastrophic)
10 Initial risk rating (likelihood x consequence)
11 Risk level (low / medium / high / extreme)
Controls
12 Control type (elimination / substitution / engineering / administrative / PPE)
13 Control description
14 Date controls implemented
15 Residual likelihood after controls
16 Residual consequence after controls
17 Residual risk rating
Responsibility and Status
18 Responsible person
19 Due date for control implementation
20 Current status (open / in progress / closed)
21 Date closed (if applicable)
22 Verified effective (yes / no)
23 Next review date
Declaration & Sign-Off

I confirm that all items have been inspected/completed as indicated above. Any defects or concerns have been noted and reported.

Completed By
Reviewed / Approved By