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1. Assessment Information: Details of the assessment including date, assessor name, and review schedule
2. Employee Details: Information about the employee including name, department, role, and stage of pregnancy/maternity
3. Workplace Information: Details of the workplace, department, and general working conditions
4. Risk Categories Assessment: Systematic evaluation of different risk categories including physical, chemical, biological, and ergonomic risks
5. Current Control Measures: Existing measures in place to protect new and expectant mothers
6. Additional Control Measures Required: New or enhanced measures needed to ensure adequate protection
7. Working Hours and Patterns: Assessment of working time arrangements including night work and shift patterns
8. Action Plan: Detailed plan of required actions, responsibilities, and timeframes
9. Emergency Procedures: Specific emergency arrangements for new and expectant mothers
10. Sign-off and Declarations: Signatures from assessor, employee, and relevant managers confirming agreement with assessment
1. Display Screen Equipment Assessment: Specific assessment for office-based workers using computers regularly
2. Manual Handling Assessment: Detailed assessment for roles involving lifting or moving objects
3. Chemical Exposure Assessment: In-depth evaluation for workplaces with potential chemical hazards
4. Radiation Exposure Assessment: For workplaces where ionizing or non-ionizing radiation may be present
5. Temperature Extremes Assessment: For workplaces with very hot or cold working conditions
6. Lone Working Assessment: For employees who work alone or in isolated conditions
7. Travel Requirements Assessment: For roles involving business travel or commuting between sites
1. Schedule 1: Risk Assessment Matrix: Standard risk assessment scoring matrix and guidance
2. Schedule 2: Workplace Hazard Checklist: Comprehensive checklist of potential workplace hazards
3. Schedule 3: Control Measures Reference: Detailed list of possible control measures for different risks
4. Appendix A: Relevant Legislation: Summary of applicable Belgian and EU legislation
5. Appendix B: Emergency Contact Information: List of relevant emergency contacts and procedures
6. Appendix C: Health and Safety Guidelines: Specific guidelines for new and expectant mothers
7. Appendix D: Review Log: Record of assessment reviews and updates
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