Pest Control Risk Assessment Form
Complete this form to assess pest-related risks and site conditions for effective pest management.
Type of pest issue observed
*
Please Select
Rodents
Insects
Birds
Other wildlife
Other (please specify)
Area(s) affected by pest activity
*
Kitchen
Storage areas
Exterior perimeter
Bathrooms
Offices
Other (please specify)
Severity of infestation
*
Low
1
2
3
4
Severe
5
1 is Low, 5 is Severe
Evidence of pest activity (select all that apply)
*
Droppings
Damaged goods/materials
Odor
Live sightings
Nesting materials
Other (please specify)
Environmental or contributing conditions present
Food debris
Water leaks
Clutter/storage issues
Entry points/gaps
Vegetation close to building
Other (please specify)
Previous pest control treatments at this site?
*
Yes
No
Unknown
If previous treatment, describe method and date (if known)
Rate the level of safety or health concern
*
None
1
2
3
4
Very High
5
1 is None, 5 is Very High
Follow-up actions recommended
*
Immediate intervention required
Monitor and reassess
Routine maintenance
No action needed
Additional comments or observations
Submit Assessment
Should be Empty: