Equality Risk Assessment Report Form (Form A)
Name of policy
Brief summary of the aims of the policy
Policy owner Date
What evidence was used to assist your decision-making?
Does, or could, the policy have a differential impact on members of the following
equality target groups?
Group Yes No Unclear Comments
What is the nature of this impact?
Group Positive Negative Unclear Comments
Findings Further action required
No risks identified No further action required. Return a copy of this form once
completed to email@example.com Append this
form to your policy as it proceeds through committee
Minor risks identified State how your policy was amended. Please note that this
requiring policy might include introducing monitoring/feedback systems
amendments where more data are required to indicate the impact of your
policy. Return a copy of this form once completed to
firstname.lastname@example.org Append this form to your
policy as it proceeds through the committee consultation
Major risks identified Please complete the template for Assessment of Impact of
requiring full Identified Risks (Form B) and append to your policy as it
assessment of impact proceeds through the committee consultation process.
For additional advice or support, please email the Equality and Diversity Team at equality-
email@example.com or call us on 0117 33 18087.
‘Policy’ is used as shorthand to cover written policies, strategies, activities, practices, provisions, criteria or key decision-making.