FinchDeal

COSHH assessment template

A blank COSHH assessment to print and fill in by hand, one sheet per substance. The sections follow the points HSE lists for an assessment: who could be harmed and how, how often and for how long, the controls in place, and what else needs doing, by whom and by when.

Use your browser's print dialog to save it as a PDF.

Using a common product? Start from a sheet that already has the hazards, PPE and first aid filled in from the supplier's safety data sheet: COSHH sheets by product.

1. Assessment details

Business name
Workplace and location
Assessment reference
Assessed by
Date of assessment
Date for review

2. The substance

Product name
Supplier
Safety data sheet revision date
Signal word and hazard statements (section 2 of the data sheet)
Workplace exposure limit (EH40/2005 or section 8)

3. How it is used

Task or process
Quantity used
How often and for how long
Who is exposed (employees, contractors, visitors, anyone more at risk)

How people could be exposed:

4. Controls

Controls already in place (e.g. substitution, ventilation, enclosure)
PPE required (eyes, hands with glove type, breathing, skin)
Further action needed
Action by whom
Action by when

5. Emergencies

First aid (section 4 of the data sheet)
Spills (section 6)
Storage and materials to keep away from (sections 7 and 10)

6. Sign-off

Assessor signature and date
Manager signature and date
Shared with staff on (date)

Notes on using this template

HSE says that with 5 or more employees you must record your COSHH assessment, and that it makes sense to write it down even with fewer. Review it when staff, processes, substances or equipment change, and after an accident, near miss or other problem. HSE guidance on COSHH assessments.

The template is a form, not advice. You, as the employer, are responsible for deciding whether the controls are adequate.

Opening soon at £19 a month

Unlimited assessments, cancel any time. The tool isn't open yet, so there is nothing to pay today.