Gas Safe - Risk Assessments - Training and Consultancy for Gas Users

Fire Risk Assessment Request Form

To assist in providing you with a quotation to carry out your fire risk assessment please complete and submit the following information to us:

Company name
Contact name
Telephone number:
Address
Nature of Business
Use of building or premises	Office Shop Factory Residential
Other use (brief description)
Size of building (Length x Width x Height) Approx
Approximate date of construction
Number of floors
Number of rooms on the ground floor excluding toilets/bathrooms
Number of rooms above the ground floor excluding toilets/bathrooms
Number of staff
Number of residents/ customers (if known)
Any hazardous substances or processes carried out on the premises?	Yes No
(If yes, please specify) Brief details
Are scale drawings available for each floor?	Yes No
Was the building previously issued with a fire certificate?	Yes No
Are there any letters or notices recevied from the Fire Service? (e.g. Prohibition notices)	Yes No
Date of previous fire risk assessment?

Risk Assessments

If you prefer to download this form click here and faxback on 01270 758891.

Thank you for completing this enquiry form. Our prompt attention is assured.