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Risk Assessment Form –
Part A
Production Name: Ultra Media Guy Organisation
Production Address: Ne38 7qh Producer / Editor
Tel:
Mobile:
Henry Briggs
7377 876435
Start date 10/1/24 End date 30/01/24
Distribution
Who gets a copy of the assessment
Alex Campion
Outline of risk assessment
Summary of what is proposed in
terms of sequences and set ups.
Potential running and/or walking around the household.
Team members / experts /
contractors / contributors etc.
List those involved
Alex Campion, Henry Briggs
Locations
Outline locations involved – indicate
any which are hostile environments
54 Byland court and Barnes Park
Assessor Name
Signature
Henry Briggs Date completed 30/11/2023
Authoriser Name
(if not Assessor) Signature
Henry Briggs Date authorised 30/11/2023
Hazard list – select your hazards from the list below and use these to complete Part B
Situational hazards Tick Physical / chemical hazards Tick Health hazards Tick
Assault by person * Contact with cold liquid / vapour Disease causative agent
Attack by animal * Contact with cold surface Infection
Breathing compressed gas Contact with hot liquid / vapour Allergic reaction
Cold environment * Contact with hot surface Lack of food / water
Crush by load * Electric shock Lack of oxygen
Drowning Explosive blast Physical fatigue *
Entanglement in moving machinery Explosive release of stored pressure Repetitive action
High atmospheric pressure Fire Static body posture
Hot environment Hazardous substance Stress / anxiety
Manual handling * Ionizing radiation Venom poisoning
Object falling, moving or flying * Laser light
Obstruction / exposed feature Lightning strike * Environmental hazards
Sharp object / material * Noise * Litter
Shot by firearm Non-ionizing radiation Nuisance noise / vibration
Slippery surface Stroboscopic light Physical damage *
Trap in moving machinery Vibration Waste substance released into air
Trip hazard * Waste substance released into soil / water
Vehicle impact / collision Managerial / organisational hazards
Falls from height Management factors (lack of communication,
co-operation, co-ordination and competence)
Risk matrix – use this to determine risk for
each hazard i.e. ‘how bad and how likely’ Likelihood of Harm
Severity of Harm
Remote
e.g. <1 in 1000 chance
Very unlikely
e.g. 1 in 200 chance
Unlikely
e.g. 1 in 50 chance
Possible
e.g. 1 in 10 chance
Likely
e.g. >1 in 3 chance
Negligible e.g. small bruise Trivial Trivial Trivial Low Low
Slight e.g. small cut, deep bruise Trivial Trivial Low Low Medium
Moderate e.g. deep cut, torn muscle Trivial Low Medium Medium High
Severe e.g. fracture, loss of consciousness Low Medium High High Extremely high
Very Severe e.g. death, permanent disability Low Medium High Extremely high Extremely high
Risk Assessment Form – Part B
Activity1
– Each individual activity you are proposing: Location – where this activity will take place: Dates / times:
Hazards2
List what could cause harm from this activity
e.g. falls from height, trip hazard, fire, etc.
Who exposed
List who might be harmed
from this activity
e.g. staff, contractors,
contributors, public, etc.
Risk3
For each hazard, decide
level of risk as if you were to
do the activity without your
controls
Control measures
For each hazard, list the measures you will be taking to minimise the risk identified
e.g. appointing competent persons, training received, planning and rehearsals, use of personal protective
equipment, provision of first aid, etc.
Risk3
For each hazard,
decide level of risk
once all your controls
are in place
Hyperthermia Alex Campion, Henry
Briggs
Slight Making sure that everyone wraps up warm and has things to help the combat the cold. Slight
Slips trips and falls.
Alex Campion, Henry
Briggs
Slight Make sure to remove anything from the area that may cause a fall, ensure the area is clean
and tidy to prevent this.
Negligible
Broken equipment
Alex Campion, Henry
Briggs
Negligible Remove broken or damaged equipment out of the way to be repaired, make sure to check
the equipment before usage.
Negligible
Fire
Alex Campion, Henry
Briggs
Very Severe Ensure all crew members understand the fire procedures and know the escape routes. Negligible
Here, this is the risk assessment I had to do so then I knew the risks of shooting in the locations that I will use for the short horror
film. Using this, I can confidentially say I am more organised, and I can be expected to complete the short film for the deadline
date. In addition, I did this to make sure I can be well-equipped for anything that could go wrong. If I did not do this, I would be
endangering my crew as there could be a serious health hazard unchecked if I did not check for hazards and in the industry, you would
be held legally accountable if there was an injury in the workplace.

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Risk Assessment.docx

  • 1. Risk Assessment Form – Part A Production Name: Ultra Media Guy Organisation Production Address: Ne38 7qh Producer / Editor Tel: Mobile: Henry Briggs 7377 876435 Start date 10/1/24 End date 30/01/24 Distribution Who gets a copy of the assessment Alex Campion Outline of risk assessment Summary of what is proposed in terms of sequences and set ups. Potential running and/or walking around the household. Team members / experts / contractors / contributors etc. List those involved Alex Campion, Henry Briggs Locations Outline locations involved – indicate any which are hostile environments 54 Byland court and Barnes Park Assessor Name Signature Henry Briggs Date completed 30/11/2023 Authoriser Name (if not Assessor) Signature Henry Briggs Date authorised 30/11/2023 Hazard list – select your hazards from the list below and use these to complete Part B Situational hazards Tick Physical / chemical hazards Tick Health hazards Tick Assault by person * Contact with cold liquid / vapour Disease causative agent Attack by animal * Contact with cold surface Infection Breathing compressed gas Contact with hot liquid / vapour Allergic reaction Cold environment * Contact with hot surface Lack of food / water Crush by load * Electric shock Lack of oxygen Drowning Explosive blast Physical fatigue * Entanglement in moving machinery Explosive release of stored pressure Repetitive action High atmospheric pressure Fire Static body posture Hot environment Hazardous substance Stress / anxiety Manual handling * Ionizing radiation Venom poisoning Object falling, moving or flying * Laser light Obstruction / exposed feature Lightning strike * Environmental hazards Sharp object / material * Noise * Litter Shot by firearm Non-ionizing radiation Nuisance noise / vibration Slippery surface Stroboscopic light Physical damage * Trap in moving machinery Vibration Waste substance released into air Trip hazard * Waste substance released into soil / water Vehicle impact / collision Managerial / organisational hazards Falls from height Management factors (lack of communication, co-operation, co-ordination and competence) Risk matrix – use this to determine risk for each hazard i.e. ‘how bad and how likely’ Likelihood of Harm Severity of Harm Remote e.g. <1 in 1000 chance Very unlikely e.g. 1 in 200 chance Unlikely e.g. 1 in 50 chance Possible e.g. 1 in 10 chance Likely e.g. >1 in 3 chance Negligible e.g. small bruise Trivial Trivial Trivial Low Low Slight e.g. small cut, deep bruise Trivial Trivial Low Low Medium Moderate e.g. deep cut, torn muscle Trivial Low Medium Medium High Severe e.g. fracture, loss of consciousness Low Medium High High Extremely high Very Severe e.g. death, permanent disability Low Medium High Extremely high Extremely high
  • 2. Risk Assessment Form – Part B Activity1 – Each individual activity you are proposing: Location – where this activity will take place: Dates / times: Hazards2 List what could cause harm from this activity e.g. falls from height, trip hazard, fire, etc. Who exposed List who might be harmed from this activity e.g. staff, contractors, contributors, public, etc. Risk3 For each hazard, decide level of risk as if you were to do the activity without your controls Control measures For each hazard, list the measures you will be taking to minimise the risk identified e.g. appointing competent persons, training received, planning and rehearsals, use of personal protective equipment, provision of first aid, etc. Risk3 For each hazard, decide level of risk once all your controls are in place Hyperthermia Alex Campion, Henry Briggs Slight Making sure that everyone wraps up warm and has things to help the combat the cold. Slight Slips trips and falls. Alex Campion, Henry Briggs Slight Make sure to remove anything from the area that may cause a fall, ensure the area is clean and tidy to prevent this. Negligible Broken equipment Alex Campion, Henry Briggs Negligible Remove broken or damaged equipment out of the way to be repaired, make sure to check the equipment before usage. Negligible Fire Alex Campion, Henry Briggs Very Severe Ensure all crew members understand the fire procedures and know the escape routes. Negligible Here, this is the risk assessment I had to do so then I knew the risks of shooting in the locations that I will use for the short horror film. Using this, I can confidentially say I am more organised, and I can be expected to complete the short film for the deadline date. In addition, I did this to make sure I can be well-equipped for anything that could go wrong. If I did not do this, I would be endangering my crew as there could be a serious health hazard unchecked if I did not check for hazards and in the industry, you would be held legally accountable if there was an injury in the workplace.