This document is a risk assessment form for a film shoot taking place at a public location. It identifies three main risks: animals/insects interrupting filming, extreme weather preventing or endangering filming, and the public entering the shot or being put in danger. For each risk, it lists the exposed parties, the action plan to mitigate the risk, and the person responsible. The actions include checking for animals before filming, canceling if weather is too dangerous, and having staff clear the public path and prevent harm. The director and producer sign off on the completed form.

1. PRODUCTION TITLE: SHOOT DATE/S:
PRODUCTION OFFICE PHONE/MOBILE:
LOCATION THIS FORM RELATES TO: (A separate form should be completed for each location)
Complete the following table rating
• each risks severity on scale from Negligible (N), Low risk (L), Moderate risk (M), Severe (S), Very severe (V)
• each risks likelihood on scale from Very unlikely (VU), Unlikely (U), Possible (P), Likely (L), Very likely (VL)
• Determine the risk factor from the table overleaf.
Hazard Present? Severity Likelihood Risk Factor
1 Alcohol/drugs
2 Animals/insects / M p 3
3 Audiences
4 Camera cable/grip equipment
5 Confined spaces
6 Derelict buildings/dangerous structures
7 Electricity/gas (other than normal supplies)
8 Fatigue/long hours
9 Fire/flammable materials
10 Hazardous substances
11 Heat/Cold/extreme weather / M P 3
12 Laser/strobe effects
13 Machinery/industrial/ crane/hoist
14 Materials - glass, non-fire retardant set materials
15 Night operation
16 Noise – high sound levels
17 Non standard manual handling
18 Public/crowds / M L 3
19 Radiation
20 Scaffold/Rostra
21 Smoking on set
22 Special effects/explosives
23 Special needs (elderly, disabled, inexperienced)
24 Specialised rescue/first aid
25 Stunts, dangerous activities
26 Tall scenery/suspended ceilings
27 Vehicles/speed
28 Water/proximity to water
29 Weapons
30 Working at heights
31 Working overseas
32 Other risks
Calculate the Risk Factor:
Very Unlikely Unlikely Possible Likely Very Likely
Very severe 3 4 4 5 5
Severe 2 3 3 3 5
Moderate 2 2 3 3 3
Slight 1 2 2 3 3
Negligible 1 1 2 2 3
Decide the action to take:
5 Very severe Take immediate action
4 Severe High priority
3 Moderate Risk Programme for action
2 Low Risk Action may be required
1 Negligible Probably acceptable
Then list each risk identified
LOCATIONRISKASSESSMENTFORM

2. Hazard no:2 Risk Factor (1-5) 3
Description As we will be filming outside there will be risk of nearby animals and insects
interrupting the filming
Person(s) exposed (detail if
cast/crew (C), outside
company (O) or public (P) )
C
Action to take I will have my assistant director check that the shot is free from animals and try to
shut down the situation
Person/company responsible
for action
Assistant director
To be completed at agreed later date -
Exposed person(s)
informed? (y/n)
y Agreed action taken? (y/n) y Risk removed? (y/n) y
Hazard no:11 Risk Factor (1-5) 3
Description The weather could be extreme and prevent filming and cause injury
Person(s) exposed (detail if
cast/crew (C), outside
company (O) or public (P) )
C
Action to take I will check the forecast before and on the morning of filming if it is raining or too
windy I will cancel filming and reschedule
Person/company responsible
for action
Director (aka me)
To be completed at agreed later date -
Exposed person(s)
informed? (y/n)
y Agreed action taken? (y/n) y Risk removed? (y/n) y
Hazard no18 Risk Factor (1-5) 3
Description The public has access to where we will be filming so there might be problem with
people entering the shot or putting the public into danger.
Person(s) exposed (detail if
cast/crew (C), outside
company (O) or public (P) )
P/C
Action to take My Assistant director will make sure that the path way is clear and that nobody is
harmed.
Person/company responsible
for action
Assistant Director
To be completed at agreed later date -
Exposed person(s)
informed? (y/n)
y Agreed action taken? (y/n) y Risk removed? (y/n) y
Copy and paste this table for each of the hazards, then get the form signed. If the producer has not completed
the risk assessment, then they should countersign this form.
Completed by: Amelia Hart Position: Director
Signature Amelia Hart Date: 07/10/2014
Countersigned by: Gillian Edwards PRODUCER
Signature Gillian Edwards Date:07/10/2014