KD-HR-NM-004
New or Expectant Mother Risk Assessment
The individual assessment for an employee who has told the employer in writing that she is pregnant, has given birth in the last six months or is breastfeeding: fifteen construction risks with the controls for her, then the order reg 16 and employment rights legislation set — alter conditions or hours, offer suitable alternative work, suspend on pay — with the agency and night-work routes, rest facilities, and review at each stage and on return.
3 pages · 131 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 3 — click to enlarge
Read all 3 pages first — watermarked sample, no email Before you submit: the checklist
Statutory basis, cited on the form
- MHSWR 1999 regs 1, 3, 16, 16A, 17, 18 and 18A
- CDM 2015 Schedule 2 para 5(2)(b)
- Workplace (Health, Safety and Welfare) Regulations 1992 reg 25(4)
- Data Protection Act 2018 and UK GDPR
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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