KD-BL-MX-005
5×5 Risk Matrix and Scoring Guide
The one-page scoring guide behind the blank forms: likelihood and severity from 1 to 5 defined for construction work, the 5×5 matrix with its four bands and the action each requires, and seven rules for scoring residual risk honestly.
2 pages · 4 fillable fields · works in Adobe Reader, Preview, Chrome, or on a phone — or complete it online in your browser and download the finished document.
Page 1 of 2 — click to enlarge
Read all 2 pages first — watermarked sample, no email Before you submit: the checklist
Statutory basis, cited on the form
- MHSWR 1999 reg 3
What it is not
It is not a completed document and it is not health and safety advice. You must adapt it to your site and have a competent person complete and sign it off. See why we don't say "compliant".
Format
AcroForm fillable PDF. Every field has a tooltip. Tab order follows the reading order. Works on desktop and mobile, in Adobe and non-Adobe readers.
This revision was prepared against legislation current at 10 August 2026. Revision A0. Check kubitdocs.com/revisions for the current revision before use.
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