Fillable Printable Composite Risk Management Worksheet
Fillable Printable Composite Risk Management Worksheet
Composite Risk Management Worksheet
Risk Acceptance Authority Levels
Extremely High--Commanding General, USAFACFS
High--General Officers, Colonels
Moderate--LTCs, NCOA Commandant
Low--Btry Cdrs
COMPOSITE RISK MANAGEMENT WORKSHEET
For use of this form, see FM 5-19; the proponent agency is TRADOC.
1. MSN/TASK:
2a. DTG BEGIN
2b. DTG END
3. DATE PREPARED (YYYYMMDD)
4. PREPARED BY
a. LAST NAME
b. RANK
c. POSITION
5. SUBTASK
6. HAZARDS
7. INITIAL
RISK
LEVEL
8. CONTROLS
9.
RESIDUAL
RISK
LEVEL
10. HOW TO IMPLEMENT
11. HOW TO SUPERVISE (WHO)
12.
WAS
CONTR
OL
EFFEC-
TIVE?
Additional space for entries in Items 5 through 11 is provided on Page 2.
13. OVERALL RISK LEVEL AFTER CONTROLS ARE IMPLEMENTED (Check one)
LOW MODERATE HIGH EXTREMELY HIGH
14. RISK DECISION AUTHORITY
a. LAST NAME
b. RANK
c. DUTY POSITION
d. SIGNATURE
DA FORM 7566, APR 2005
Page 1 of 2
APD V 2.00
Risk Acceptance Authority Levels
Extremely High--Commanding General, USAFACFS
High--General Officers, Colonels
Moderate--LTCs, NCOA Commandant
Low--Btry Cdrs
ITEMS 5 THROUGH 12 CONTINUED
5. SUBTASK
6. HAZARDS
7. INITIAL
RISK
LEVEL
8. CONTROLS
9.
RESIDUAL
RISK
LEVEL
10. HOW TO IMPLEMENT
11. HOW TO SUPERVISE (WHO)
12.
WAS
CONTR
OL
EFFEC-
TIVE?
DA FORM 7566, APR 2005
Page 2 of 2
APD V 2.00
Risk Acceptance Authority Levels
Extremely High--Commanding General, USAFACFS
High--General Officers, Colonels
Moderate--LTCs, NCOA Commandant
Low--Btry Cdrs
Risk Assessment Matrix
HAZARD PROBABILITY
FREQUENT
LIKELY
OCCASIONAL
SELDOM
UNLIKELY
A
B
C
D
E
CATASTROPHIC
I
II
III
IV
CRITICAL
MODERATE
NEGLIGIBLE
EH EH H H M
EH H H M L
H M M L L
M L L L
L
EFFECT
1. CATASTROPHIC - Death or permanent total disability, system loss, major property damage.
2. CRITICAL - Permanent partial disability, temporary total disability, major system damage, major property damage.
3. MODERATE - Minor injury, lost workdays, compensable injury/illness, minor system damage, minor property damage.
4. NEGLIGIBLE - First aid or minor supportive medical treatment, minor system impairment.
PROBABILITY
A. FREQUENT - Occurs often - resources are continuously exposed.
B. LIKELY - Occurs frequently - resources are exposed frequently and/or several times.
C. OCCASIONAL - Occurs sometimes - resources are exposed sporadically.
D. SELDOM - Remote occurrence - resources are possibly exposed.
E. UNLIKELY - Rare occurrence of exposure
S
E
V
E
R
I
T
Y
