Workplace Biological Risk Assessment Form
Use this form to assess biological hazards in a workplace area, review exposure conditions and controls, and document risk ratings and corrective actions.
Workplace Details
Workplace Location or Department
*
Area or Task Being Assessed
*
Assessor Job Title or Role
*
Biological Hazard Assessment
Biological hazard type(s) present
*
Mold
Bacteria
Viruses
Bloodborne exposure
Animal exposure
Insect exposure
Wastewater or sewage
Laboratory specimens
Contaminated surfaces
Other workplace biological agents
Brief description of hazard source or scenario
*
Exposure and Control Review
Exposure Frequency
*
Rare
Occasional
Frequent
Continuous
Existing Control Measures
*
Rows
In Place
Adequate
Ventilation
1
2
PPE
3
4
Cleaning/Disinfection
5
6
Isolation/Containment
7
8
Training
9
10
Waste Handling
11
12
Exposure Reporting Procedures
13
14
Risk Rating and Actions
Likelihood Rating
*
Rare
1
2
3
4
5
6
7
8
9
Almost Certain
10
1 is Rare, 10 is Almost Certain
Severity Rating
*
Minor
1
2
3
4
5
6
7
8
9
Severe
10
1 is Minor, 10 is Severe
Overall Risk Level / Priority
*
Low
Moderate
High
Critical
Corrective Actions / Recommendations (include responsible person and target completion date if needed)
Submit
Should be Empty: