COVID-19 Risk Assessment Template Checklist for Healthcare
Healthcare
Safety
Inspired by the CDC’s guidance for the identification and management of potentially exposed contacts of a confirmed case of COVID-19, use this risk assessment template to help determine steps to contain the spread of COVID-19.
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Audit

General

Enter the worksite where the risk assessment is conducted
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Risks and Recommendations

Identify the type of exposure
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Risk rating
High
Medium
Low
No Identifiable Risk
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Enter control measures
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References

Risk Categories derived from https://www.cdc.gov/coronavirus/2019-ncov/php/risk-assessment.html

CDC Recommendations derived from https://www.cdc.gov/coronavirus/2019-ncov/php/risk-assessment.htmlHigh Risk Management

Medium Risk Management

Low Risk and No Identifiable Risk Management

Completion

Comments
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Signature

Signature
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