Army Risk Assessment Form Sample
RISK MANAGEMENT WORKSHEET
(CDTCMD Reg 385-10; proponent agency is Cadet Command Safety)
1. Organization and Unit Location:
2. Page
1
of
2
3. Mission/Task:
4. Begin Date:
5. End Date:
6. Date Prepared:
7. Operational Phase in which the Mission/Task will be conducted:
8. Tasks
9. Identify Hazards
10. Initial
Risk Level
11. Develop Controls
12. Residual
Risk Level
13. Implement Controls (“How To”)
14. Who/How Supervised
15. Determine Overall Mission/Task Risk Level After Countermeasures Are Implemented:
(Circle Highest Remaining Risk Level)
LOW (L)
MODERATE (M)
HIGH (H)
EXTREMELY HIGH (E)
16. Medical Support: Advanced Trauma Life Support (ATLS) is required within 1 hour. On-site Medical Support provided (Circle one): Medic Combat Lifesaver ARC/NSC First-Aid Responder None
17. Prepared by: (Rank, Last Name, Duty Position)
18. Reviewed by Action Officer/Commander: (Rank, Last Name, Duty Position and Signature):
19. Risk Decision Authority (Signature Block and Signature):
Extremely High Risk: Not Applicable for Cadet Command
High Risk: CG or DCG
Moderate Risk: Brigade Cdr (0-6). At Advanced/Basic Camp – Region Cdr or CofS
Low Risk: Battalion Cdr. At Advanced/Basic Camp – Committee Chief or Regimental Cdr/TAC Officer
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