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New and Expectant Mother Risk Assessment

Purpose of this assessment

Under Regulation 16 of the Management of Health and Safety at Work Regulations 1999, once an employee has notified Granite Leisure in writing that she is pregnant, has given birth within the last six months, or is breastfeeding, we must assess the specific risks her role poses to her and her baby, and put in place any necessary adjustments, alternative duties, or (where no alternative exists) paid suspension on maternity grounds under section 67 of the Employment Rights Act 1996.
This form must be completed jointly by the employee and a competent manager/assessor — it must not be completed by the employee alone. It should be reviewed again at least once each trimester, and immediately if duties, working conditions, or medical advice change.

Section 1: Assessment details

Manager / Assessor full name

Manager / Assessor job title

Manager / Assessor email address

Employee full name

Employee job title / role

Site / location

Date this assessment is being completed