
The Regulatory Reform (Fire Safety) Order 2005 
FIRE RISK ASSESSMENT 
Employer or other 
responsible person 
Name of Premises 
Address    
Post Code  Telephone N
o 
Name of Assessor(s) 
Date of Assessment  Date of Review 
Building               GENERAL INFORMATION 
Property Use 
N
o 
of floors 
N
o
 of floors below 
ground 
Approx area in m
2
 of footprint 
of building 
Age of building 
Brief details of construction 
GENERAL INFORMATION 
Building Occupants 
Enter range A= <20, B= 20 – 49, C=50-99, D=100-1000, E= >1000 
Occupancy Profile: 
Maximum Number of persons, in the 
most highly occupied compartment 
to be effected by an uncontrolled fire 
within 30 minutes, assuming no 
evacuation. 
WEEKDAYS  WEEKENDS 
0000 to 0400  0000 to 0400 
0400 to 0800  0400 to 0800 
0800 to 1200  0800 to 1200 
1200 to 1600  1200 to 1600 
1600 to 2000  1600 to 2000 
2000 to 2400  2000 to 2400 
Description of Occupants: 
Predominant Type 
Atypically mobile for this type of occupancy 
Average mobility for this type of occupancy 
Untypically vulnerable for this type of occupancy 
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