Pregnancy risk assessment form template
A structured template to assess and manage workplace risks for pregnant employees, ensuring safety and legal compliance.
- 2 pages / 357 words.
- Last updated 18/09/2025.
- Designed for United Kingdom use.
- Suitable for use in other territories; check local laws first.
- Instantly download as Word / PDF / plain text, or send by email.
- Includes 12 months’ access, with all updates to this page provided free of charge and notified to you.
Pregnancy risk assessment form
Under the Management of Health and Safety at Work Regulations, we have a responsibility to ensure that new and expectant mothers are not exposed to risks that could affect their health, safety, or wellbeing, or that of their child.
When an employee notifies us that they are pregnant, have given birth within the last six months, or are breastfeeding, we must carry out a specific risk assessment and take appropriate measures to remove, reduce or control any identified risks.
| Department | |
| Date of risk assessment | |
| Name of person carrying out risk assessment |
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This Pregnancy Risk Assessment Form template helps employers identify, evaluate, and manage potential hazards for employees who are pregnant, have recently given birth, or are breastfeeding.
It guides managers through a consistent assessment process, ensuring suitable controls are in place to protect health and wellbeing.
Using this template demonstrates commitment to employee safety, compliance with health and safety law, and supports a positive and inclusive workplace culture.
Flowchart
Flowchart
Check which resources should be implemeted before and/or after the Pregnancy risk assessment form template, to understand the workflow.
Pregnancy notification checklist form
Our pregnancy notification checklist is designed to guide managers through key steps when an employee notifies them verbally of their pregnancy.
Timings
Timings
Follow these best practice actions to get the most from the Pregnancy risk assessment form template, guiding you before, during, and after implementation:
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| Step | Description | Responsibility | Timing |
| 1 | Employee notifies employer of pregnancy, including expected due date, so appropriate risk assessments can be initiated. | Employee | As soon as pregnancy is known |
| 2 | Line Manager or HR schedules a pregnancy risk assessment meeting, reviewing workplace duties, environment, and potential hazards. | HR / Line Manager | Within 1 week of notification |
| 3 | Complete the Pregnancy Risk Assessment Form with input from the employee, assessing risks related to physical demands, chemicals, biological hazards, and work patterns. | Line Manager / Employee | During the assessment meeting |
| 4 | Agree on control measures or adjustments required to mitigate risks, document them on the form, and provide a copy to the employee and HR. | HR / Line Manager | Immediately after assessment meeting |
| 5 | Review and update the risk assessment regularly throughout pregnancy or if work circumstances change, ensuring continued safety and wellbeing. | HR / Line Manager | Every 4–6 weeks or as required |
Frequently Asked Questions
Frequently Asked Questions
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Can I use this template in my small business?
Yes. The Pregnancy risk assessment form template is designed to be flexible and suitable for organisations of all sizes, including small businesses and charities. It follows UK employment law best practice, so even if you don't have an in-house HR team, you can confidently apply it.
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Is this template compliant with 2025 UK employment law?
Absolutely. All of our templates are drafted with the latest ACAS guidance and UK employment legislation in mind. We review and update them regularly, so you can be confident they remain compliant.
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Can I customise it for my organisation?
Yes, we highlight the areas that you need to update with your own details, and where you need to make decisions to suit your situation. This saves you time and ensures that you meet best practice.
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Do I get instant access?
Yes. Once purchased, you'll be able to download it instantly. Templates are provided in editable Word or Excel format so you can customise them easily, and in PDF format for easy sharing.
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What if I need more help, not just this template?
If you're looking for broader support, we also offer toolkits and library bundles that include this template, along with other HR templates and policies for fully managing your situation. These may be more cost-effective if you need deeper advice.
