The Health and Safety Assessment Form is a critical document required under New Zealand's workplace safety regulatory framework. It serves as a primary tool for organizations to meet their obligations under the Health and Safety at Work Act 2015 and related regulations. This assessment form should be used whenever there are significant changes in workplace conditions, introduction of new equipment or processes, or as part of regular safety reviews (typically annually or bi-annually). The document captures essential information about workplace hazards, risk levels, control measures, and action plans, while ensuring worker consultation throughout the assessment process. It is designed to be adaptable across different industries while maintaining compliance with New Zealand's specific regulatory requirements for workplace safety assessments.
Thank you! Your submission has been received!
Oops! Something went wrong while submitting the form.
Your data doesn't train Genie's AI
You keep IP ownership of your docs
1. Assessment Details: Basic information including date, location, assessor name, and purpose of assessment
2. Workplace Information: Details about the workplace being assessed, including physical address, type of business, and number of workers
3. Hazard Identification: Systematic identification of all potential hazards in the workplace, categorized by type (physical, chemical, biological, psychological)
4. Risk Assessment Matrix: Evaluation of identified hazards using a risk matrix to determine likelihood and consequence ratings
5. Control Measures: Existing and proposed control measures following the hierarchy of controls
6. Action Plan: Specific actions required, including responsible persons and timeframes for implementation
7. Consultation: Record of worker consultation and involvement in the assessment process
8. Review and Sign-off: Assessment review details, authorization, and next review date
1. Emergency Response Procedures: To be included when assessing high-risk workplaces or where specific emergency protocols are required
2. Hazardous Substances Register: Required when the workplace handles or stores hazardous substances
3. Noise Assessment: For workplaces where noise exposure may be a significant hazard
4. Manual Handling Assessment: For workplaces with significant manual handling tasks
5. Personal Protective Equipment (PPE) Requirements: Detailed section when specific PPE is crucial for workplace safety
6. Contractor Management: When external contractors regularly work on site
7. Remote Work Considerations: For organizations with remote or hybrid working arrangements
1. Appendix A: Risk Matrix Guide: Detailed guide for using the risk assessment matrix, including definitions of likelihood and consequence levels
2. Appendix B: Hazard Checklist: Comprehensive checklist of common workplace hazards to assist in identification
3. Appendix C: Control Measures Reference: Reference guide for various types of control measures and their appropriate application
4. Appendix D: Relevant Legislation: Summary of applicable health and safety legislation and requirements
5. Appendix E: Incident Report Form: Template for recording any incidents or near-misses identified during the assessment
6. Appendix F: Review Schedule: Timeline and triggers for reviewing and updating the assessment
Find the exact document you need
Water Risk Assessment
A New Zealand-compliant assessment document that evaluates water-related risks and provides mitigation strategies in accordance with local regulations and standards.
Download
Tree Surgeon Risk Assessment
A New Zealand-compliant risk assessment template for tree surgery operations, ensuring safety and regulatory compliance under NZ health and safety legislation.
Download
Risk Assessment Health And Social Care
A New Zealand-compliant risk assessment framework for health and social care settings, addressing clinical and operational safety requirements.
Download
Risk Assessment Form Project Management
A New Zealand-compliant Risk Assessment Form for systematic identification and management of project-related risks, aligned with local health and safety regulations.
Download
Risk Assessment For Schools
A New Zealand-compliant risk assessment framework for schools, addressing safety and operational risks under local education and health & safety regulations.
Download
Risk Assessment Chemistry
A New Zealand-compliant chemical risk assessment document for evaluating and managing workplace chemical hazards under NZ health and safety regulations.
Download
Risk Analysis Form
A structured risk analysis document compliant with New Zealand health and safety legislation, designed for systematic workplace risk assessment and management.
Download
Oxygen Risk Assessment Form
A New Zealand-compliant risk assessment form for evaluating and managing safety risks associated with oxygen systems and handling procedures.
Download
Model Risk Assessment
A New Zealand-compliant document for assessing and documenting risks associated with business decision-making models, aligned with RBNZ and FMA requirements.
Download
Laboratory Risk Assessment
A structured risk assessment document for laboratory operations that ensures compliance with New Zealand health and safety regulations while establishing comprehensive safety protocols and control measures.
Download
Home Risk Assessment
A New Zealand-compliant assessment document for identifying and evaluating safety hazards and health risks in residential properties, including detailed recommendations for risk mitigation.
Download
Hazard Risk Assessment
A systematic evaluation of workplace hazards and risks, required under New Zealand health and safety legislation, including risk analysis and control measures.
Download
Health And Safety Assessment Form
A New Zealand-compliant Health and Safety Assessment Form for systematic workplace hazard identification and risk management under NZ Health and Safety at Work Act 2015.
Download
Government Risk Assessment
A New Zealand public sector document for systematic assessment and management of government operational and strategic risks, aligned with local legislative requirements.
Download
Face Risk Assessment
A New Zealand-compliant assessment framework for evaluating risks and privacy implications of facial recognition technology implementation.
Download
Construction Risk Assessment Form
A New Zealand-compliant document for identifying and managing construction site risks under the Health and Safety at Work Act 2015.
Download
Building Risk Assessment
A New Zealand-compliant legal document for assessing and documenting building-related risks, safety measures, and compliance requirements under NZ building and safety regulations.
Download
Bribery And Corruption Risk Assessment
A structured assessment of organizational bribery and corruption risks under New Zealand's regulatory framework, with analysis and mitigation recommendations.
Download
Area Risk Assessment
A structured assessment document for identifying and managing workplace risks in compliance with New Zealand health and safety regulations.
Download
Site Visit Risk Assessment
A New Zealand-compliant risk assessment document for evaluating and managing safety hazards during site visits, aligned with local Health and Safety regulations.
Download
Risk Self Assessment
A structured risk self assessment template compliant with New Zealand's health and safety legislation, designed for systematic workplace risk identification and management.
Download
Pharmacy Risk Assessment
A New Zealand-compliant risk assessment framework for identifying and managing operational risks in pharmacy settings, aligned with local pharmaceutical and safety regulations.
Download
Makeup Artist Risk Assessment
A New Zealand-compliant risk assessment template for makeup artists, outlining safety protocols and hazard management procedures under NZ health and safety regulations.
Download
Forestry Risk Assessment
A New Zealand-compliant risk assessment document for forestry operations, evaluating operational, environmental, and safety risks with corresponding mitigation strategies.
Download
Smoking Risk Assessment
A structured assessment document for managing smoking-related risks in New Zealand workplaces, ensuring compliance with local health and safety regulations.
Download
Ppe Risk Assessment
A New Zealand-compliant workplace safety document that assesses risks and specifies requirements for personal protective equipment use and management.
Download
Participant Risk Assessment
A New Zealand-compliant legal document for assessing and documenting risks associated with participant involvement in activities, aligned with the Health and Safety at Work Act 2015.
Download
Machine Guarding Assessment
A technical safety assessment document for evaluating machine guarding systems and safety measures in New Zealand workplaces, ensuring compliance with local health and safety regulations.
Download
Bar Risk Assessment
A New Zealand-compliant risk assessment template for identifying and managing operational risks in bar establishments, aligned with local health, safety, and alcohol service regulations.
Download
Machine Guarding Risk Assessment
A technical safety assessment document for evaluating machine guarding risks and control measures under New Zealand workplace safety regulations.
Download
Home Visit Risk Assessment
A New Zealand-compliant risk assessment framework for managing safety during professional home visits, aligned with local health and safety regulations.
Download
Workstation Risk Assessment Form
A standardized form for assessing workstation-related health and safety risks in compliance with New Zealand workplace safety regulations.
Download
Formal Hazard Assessment
A systematic workplace hazard identification and risk management document compliant with New Zealand's Health and Safety at Work Act 2015.
Download
Risk Assessment And Management Plan
A New Zealand-compliant document that identifies, analyzes, and establishes management strategies for operational risks under the Health and Safety at Work Act 2015.
Download
High Level Risk Assessment
A comprehensive risk assessment document compliant with New Zealand regulations, providing systematic evaluation and treatment recommendations for organizational risks.
Download
Care Home Risk Assessment
A New Zealand-compliant risk assessment framework for care home facilities, addressing safety and operational risks in accordance with local healthcare regulations.
Download
Workplace Assessment
A legal framework for conducting workplace assessments in New Zealand, ensuring compliance with local health and safety legislation while providing structured evaluation guidelines.
Download
Employee Health Risk Assessment
A New Zealand-compliant framework for assessing and managing workplace health risks, aligned with the Health and Safety at Work Act 2015.
Download
Asset Management Risk Assessment
A New Zealand-compliant risk assessment framework for asset management, incorporating regulatory requirements and risk mitigation strategies.
Download
Display Screen Equipment Risk Assessment
A structured assessment tool for evaluating and managing display screen equipment risks in New Zealand workplaces, aligned with national health and safety regulations.
Download
ұԾ’s Security Promise
Genie is the safest place to draft. Here’s how we prioritise your privacy and security.
Your documents are private:
We do not train on your data; ұԾ’s AI improves independently
All data stored on Genie is private to your organisation
Your documents are protected:
Your documents are protected by ultra-secure 256-bit encryption
We are ISO27001 certified, so your data is secure
Organizational security:
You retain IP ownership of your documents and their information
You have full control over your data and who gets to see it
.png)