KD-OH-LW-007
Lone Working Risk Assessment
The lone-working assessment: the tasks that may be done alone and the ones that never are, the person's suitability, the check-in method and interval, what happens when a check is missed, and the emergency plan — the assessment behind the out-of-hours and lone working permit.
2 pages · 99 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
- HSWA 1974 s.2
- Health and Safety (First-Aid) Regulations 1981 reg 3
- CDM 2015 reg 13
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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