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Workplace Hazard Assessment Form (Canada) Mobile App

The Workplace Hazard Assessment Form (Canada) is a template to assess a variety of workplace hazards. An unlimited number of hazards can be entered into the form, and for each, a variety of categories can be reported on. Hazard categories include physical, chemical, biological, ergonomically, environmental, safety, as well as a space to add another category (these categories are fully customizable). The work flow or work area where the hazard exists is recorded, as well as the hazards being identified. The assessment of the hazard is based on 4 criteria - Severity (on a scale of 0-6), Frequency (included as a diagram to assess, using a 1-3 score based on a grid), Probability (-1, 0, or 1 based on less than average, average, or above average chance of loss), and Significance (0-10, based on low to high). Within the form, it can be commented whether training is required, and whether controls are in place and if they are adequate.

The form can then be signed and dated, and as with all other GoCanvas forms, is fully customizable.

  • Lendlease
  • The Cooperative
  • PG&E
  • Red Bull
  • Mirvac

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Take a peek inside the Workplace Hazard Assessment Form (Canada) Mobile App

Included Features

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Included Fields

Customize to add, remove, or edit any of the fields below.

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    Guidance for Hazard Assessment

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    A.

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    Note: Make dollar figures relative to your own company.

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    B.

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    See Table In Drawing

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  • Ico statictext

    C.

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    - 1: Less than average chance of loss 0: Average chance of loss +1: Greater than average chance o...

  • Ico statictext

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    D.

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    0-2: Low 3-5: Medium 6-10: High

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    Work Area / Work Flow

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    Hazard Category

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    Other

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    Identified Hazards

  • Ico dropdown

    Assessment: A - Severity

  • Ico dropdown

    Assessment: B - Frequency

  • Ico dropdown

    Assessment: C - Probability

  • Ico dropdown

    Assessment: D - Significance

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    Training Required

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    Controls In Place

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    Adequate?

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    Location

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    Completed By:

  • Ico signature

    Signature

  • Ico date

    Date

  • ...and More!

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