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JSA risk assessment template

JSA risk assessment template

Use this JSA risk assessment template to analyze potential dangers and develop preventive actions so your team stays safe throughout each task.

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The Lumiform application helps frontline teams uphold internal standards effortlessly.
  • Customize this template or build your own
  • Fill out templates via mobile app
  • Assign and track corrective actions
  • Get reports and analyse your data
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or Download template as PDF
JSA risk assessment template

Use this JSA risk assessment template to analyze potential dangers and develop preventive actions so your team stays safe throughout each task.

Use this template with Lumiform

The Lumiform application helps frontline teams uphold internal standards effortlessly.
  • Customize this template or build your own
  • Fill out templates via mobile app
  • Assign and track corrective actions
  • Get reports and analyse your data
Prices start from ░░░ per month
Book a demo
Learn more
or Download template as PDF

Our JSA risk assessment template guides you through documenting workplace hazards and creating a manageable action plan for them. You can analyze job tasks, calculate risk probabilities, and document protective strategies using one form. When tackling high-stakes operations like confined space entry or elevated work, this template provides the framework to protect team members while satisfying regulatory requirements.

The National Safety Council found that over 60% of CFOs reported that each $1 invested in injury prevention returned $2 or more. By applying this template, you’ll strengthen workplace protections and potentially boost your organization’s financial performance through enhanced productivity.

Related categories

  • Health and safety management templates
  • Risk management and compliance templates
  • Construction templates
  • General templates
  • Manufacturing templates
  • Risk assessment templates
  • Workplace safety templates
Preview of the template
Page 1
Task Information
Task Name
Task Description
Department/Area
Planned Start Date
Planned Completion Date
Hazard Identification
What are the potential hazards associated with this task?
What are the potential consequences of these hazards?
Risk Assessment
Likelihood of Incident Occurring
Severity of Incident
Risk Level
Controls and Mitigation
What controls/measures are in place to mitigate the risks?
Are the controls/measures adequate?
If no, what additional controls/measures are required?
Responsibilities and Review
Name of Assessor
Assessor Signature
Date of Assessment
Name of Approver
Approver Signature
Date of Approval
Date of Next Review

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Related resources

Access a complete set of resources aimed at maximizing safety, quality, and operational excellence, including detailed guides, related templates, and real-world use cases.

Topic guides

Read in-depth guides covering key topics related to this article.

Job safety analysis (JSA): A comprehensive guideConstruction site safety: Essential guidelines and best practicesEffective risk assessment: Key steps and best practices
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Template collections

See comprehensive collections of best practice templates related to this topic.

3 free OSHA 300 form templates for informed workplace safety6 free health and safety risk assessment templates45 free risk assessment templates for every industry 
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Safety Incident Reporting SoftwareRisk management software for anticipating and adressing safety risksRisk assessment softwareWorkplace safety software
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Other resources

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4 ways that workplace safety increases worker productivity10 reasons why workplace safety is important4 benefits of safety management and how to communicate themThe importance of personal protective equipment (PPE) in workplace safety

Frequently asked questions

What are the most common mistakes when filling out a JSA risk assessment template?

The most common mistakes include being too vague in describing hazards, underestimating risks, overlooking less obvious hazards, and proposing inadequate control measures. Also, failing to involve workers who actually perform the task can lead to missing practical insights about real-world risks.

What types of control measures should I include in my JSA template?

Follow the hierarchy of controls: first try elimination or substitution of hazards, then engineering controls, administrative controls, and finally personal protective equipment. Aim to include controls from multiple levels for higher-risk tasks to create redundancy in your safety system.

How can I ensure my team actually uses our completed JSA risk assessments?

Make JSAs easily accessible, review them during pre-job briefings, and use them in training sessions. Encourage worker participation in creating and updating assessments. Regularly reference JSAs during safety meetings and demonstrate that management values and uses these tools.


This template, developed by Lumiform employees, serves as a starting point for businesses using the Lumiform platform and is intended as a hypothetical example only. It does not replace professional advice. Companies should consult qualified professionals to assess the suitability and legality of using this template in their specific workplace or jurisdiction. Lumiform is not liable for any errors or omissions in this template or for any actions taken based on its content.
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