Home Working Risk Assessment – A M Water Services Forms

Comments

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To be completed by the prospective home worker and forwarded to the HSQE Consultant. Covers DSE, seating, environment, and health.

Document Reference	HS_FM_15 — Home Working Risk Assessment
Issue Number	2
Issue Date	12 May 2026
Next Review	12 May 2027
Controlled By	Sean Ashton (HSQE Consultant, Onyx Operations)
Approved By	Aaron Mason, Managing Director
Status	Paper version (HS_FM_15, Issue 1) retired on digital go-live.

Name of home worker(Required)

Job title(Required)

Department

Home address(Required)

Email address(Required)

Phone number(Required)

What do you mainly use your DSE for?

If yes — month and year of last eye test

Any other concerns or comments?

Photos / plan of the room showing the workstation, windows, doors and sockets

Drop files here or

Accepted file types: jpg, jpeg, png, heic, pdf, Max. file size: 5 MB, Max. files: 5.

JPG / PNG / PDF up to 5MB each, max 5 files.

Comments / anything else to flag

Employee signature(Required)

Date(Required)