Template risk assessment for a new or expectant mother
Name of employee:
Name of person undertaking risk assessment:
Date for review:
Has the midwife or doctor provided any advice which should be taken into account in this risk assessment? Yes/No
|Action to be taken to remove or reduce hazard
|Be specific about the hazard you have identified.
|Be specific about the action to be taken.
For pregnant employees:
Where can the employee rest?
For employees who are breastfeeding:
Where can the employee breastfeed or express milk?
Where can the employee store expressed breastmilk?
Where can the employee wash, sterilise and store receptacles for breastmilk?
Signed by person undertaking the risk assessment:
Signed by employee:
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