Participant Individual Risk Assessment

Participant name:

First NameLast Name

Which COVEY Services apply to the participant (tick all that apply)

Please detail one risk at a time. There will be the opportunity to detail additional risks later.

Please give details of the risk:

Who is at risk?

If you are unsure of how to determine and calculate the risk rating below, please find a guidance document here:

Likelihood	Severity
1 = Rare	1 = Unlikely
2 = Unlikely	2 = Minor
3 = Probable	3 = Moderate
4 = Likely	4 = Major
5 = Highly Likely	5 = Fatal

What is the risk level? (likelihood rating x severity rating)

**If this risk rating is over 16. Please make sure you inform your line manager.** (2)

Control measures in place:

Additional controls required:

Name of person responsible for actioning the above:

First NameLast Name

Would you like to add a 2nd risk?

YesNo

Please give details of the risk (2):

Who is at risk? (2)

Likelihood	Severity
1 = Rare	1 = Unlikely
2 = Unlikely	2 = Minor
3 = Probable	3 = Moderate
4 = Likely	4 = Major
5 = Highly Likely	5 = Fatal

What is the risk level? (likelihood rating x severity rating) (2)

**If this risk rating is over 16. Please make sure you inform your line manager.** (2)

Control measures in place (2):

Additional controls required (2):

Name of person responsible for actioning the above (2):

First NameLast Name

Would you like to add a 3rd risk?

YesNo

Please give details of the risk (3):

Who is at risk? (3)

Likelihood	Severity
1 = Rare	1 = Unlikely
2 = Unlikely	2 = Minor
3 = Probable	3 = Moderate
4 = Likely	4 = Major
5 = Highly Likely	5 = Fatal

What is the risk level? (likelihood rating x severity rating) (3)

**If this risk rating is over 16. Please make sure you inform your line manager.** (3)

Control measures in place (3):

Additional controls required (3):

Name of person responsible for actioning the above (3):

First NameLast Name

Would you like to add a 4th risk?

YesNo

Please give details of the risk (4):

Who is at risk? (4)

Likelihood	Severity
1 = Rare	1 = Unlikely
2 = Unlikely	2 = Minor
3 = Probable	3 = Moderate
4 = Likely	4 = Major
5 = Highly Likely	5 = Fatal

What is the risk level? (likelihood rating x severity rating) (4)

**If this risk rating is over 16. Please make sure you inform your line manager.** (4)

Control measures in place (4):

Additional controls required (4):

Name of person responsible for actioning the above (4):

First NameLast Name

Would you like to add a 5th risk?

YesNo

Please give details of the risk (5):

Who is at risk? (5)

Likelihood	Severity
1 = Rare	1 = Unlikely
2 = Unlikely	2 = Minor
3 = Probable	3 = Moderate
4 = Likely	4 = Major
5 = Highly Likely	5 = Fatal

What is the risk level? (likelihood rating x severity rating) (5)

**If this risk rating is over 16. Please make sure you inform your line manager.** (5)

Control measures in place (5):

Additional controls required (5):

Would you like to add a 6th risk?

YesNo

Please give details of the risk (6):

Who is at risk? (6)

Likelihood	Severity
1 = Rare	1 = Unlikely
2 = Unlikely	2 = Minor
3 = Probable	3 = Moderate
4 = Likely	4 = Major
5 = Highly Likely	5 = Fatal

What is the risk level? (likelihood rating x severity rating) (6)

**If this risk rating is over 16. Please make sure you inform your line manager.** (6)

Control measures in place (6):

Additional controls required (6):

Name of person responsible for actioning the above (6):

First NameLast Name

Would you like to add a 7th risk?

YesNo

Please give details of the risk (7):

Who is at risk? (7)

Likelihood	Severity
1 = Rare	1 = Unlikely
2 = Unlikely	2 = Minor
3 = Probable	3 = Moderate
4 = Likely	4 = Major
5 = Highly Likely	5 = Fatal

What is the risk level? (likelihood rating x severity rating) (7)

**If this risk rating is over 16. Please make sure you inform your line manager.** (7)

Control measures in place (7):

Additional controls required (7):

Name of person responsible for actioning the above (7):

First NameLast Name

Would you like to add an 8th risk?

YesNo

Please give details of the risk (8):

Who is at risk? (8)

Likelihood	Severity
1 = Rare	1 = Unlikely
2 = Unlikely	2 = Minor
3 = Probable	3 = Moderate
4 = Likely	4 = Major
5 = Highly Likely	5 = Fatal

What is the risk level? (likelihood rating x severity rating) (8)

**If this risk rating is over 16. Please make sure you inform your line manager.** (8)

Control measures in place (8):

Additional controls required (8):

Name of person responsible for actioning the above (8):

First NameLast Name

Name of staff member completing this risk assessment:

First NameLast Name

Date of Completion:

Date

Review Date:

Date

Participant Individual Risk Assessment

Details of the Risk

Details of Risk (2)

Details of Risk (3)

Details of Risk (4)

Details of Risk (5)

Details of Risk (6)

Details of Risk (7)

Details of Risk (8)