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1. Employee and Workplace Details: Information about the pregnant employee, their role, department, and general workplace location
2. Assessment Information: Details of when the assessment was conducted, by whom, and the stage of pregnancy
3. Current Role Analysis: Detailed description of the employee's current duties, responsibilities, and working conditions
4. Physical Workplace Hazards: Assessment of physical hazards including manual handling, posture requirements, radiation, vibration, and noise
5. Chemical and Biological Hazards: Evaluation of exposure to chemicals, substances, or biological agents that may affect pregnancy
6. Working Conditions Assessment: Analysis of working hours, breaks, workstation setup, and environmental conditions
7. Control Measures: Specific actions and adjustments to be implemented to minimize identified risks
8. Review and Monitoring Plan: Schedule and process for reviewing and updating the assessment throughout the pregnancy
1. Emergency Procedures: Special emergency protocols for the pregnant employee - include when workplace involves high-risk activities or remote locations
2. Travel Requirements: Assessment of business travel risks - include when role involves regular travel
3. Night Work Assessment: Specific assessment for night shift work - include when employee works evening or night shifts
4. Remote Work Considerations: Assessment of home office or remote working arrangements - include when hybrid or remote work is applicable
5. Special Equipment Needs: Assessment of specialized equipment requirements - include when role involves equipment operation or specific tools
1. Risk Matrix: Detailed matrix showing risk levels and their assessment criteria
2. Hazardous Substances List: Complete list of workplace chemicals and substances with their pregnancy-related risk levels
3. Action Plan Template: Template for documenting and tracking required control measures and their implementation
4. Review Schedule: Timeline for periodic reviews throughout the pregnancy
5. Emergency Contact Information: List of relevant emergency contacts and medical facilities
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