Risk Assessment Template
for Clinicians
Last updated: March 2026
Reviewed by the WellNotes Clinical Team
Type or dictate your safety evaluation findings. Get a thorough risk assessment — risk factors, protective factors, safety plan, and recommendations — in minutes.
What is a Risk Assessment?
A risk assessment is a critical clinical document used to evaluate a client's risk for self-harm, suicidal behavior, or violence toward others. Thorough risk documentation protects both clients and clinicians — it demonstrates clinical due diligence and guides safety planning decisions.
The risk assessment format examines the full clinical picture: identifying risk factors that elevate concern, protective factors that mitigate risk, the client's current status and level of intent, a concrete safety plan, and clinical recommendations for ongoing management. This comprehensive structure ensures no critical element is overlooked during high-stakes clinical moments.
Risk assessments are required whenever a client presents with suicidal ideation, self-harm behaviors, homicidal ideation, or other safety concerns. All licensed mental health professionals — therapists, psychologists, counselors, social workers, and psychiatrists — must be proficient in risk documentation. Proper risk assessment documentation is one of the most legally scrutinized areas of clinical practice.
How It Works
Three steps to a finished risk assessment
Describe the Assessment
Type or dictate your clinical findings — risk factors, protective factors, current status, and safety plan details. No special formatting needed.
WellNotes Structures Your Assessment
Your findings are organized into a proper risk assessment with risk factors, protective factors, current status, safety plan, and clinical recommendations.
Review, Edit, and Sign
Read through the assessment carefully, verify every detail, then export as PDF or copy to your EHR. Done.
Risk Assessment Sections Explained
Risk Factors
Identified factors that elevate the client's risk level — current ideation, prior attempts, access to means, substance use, recent losses, demographic risk factors, and psychiatric history.
Protective Factors
Factors that reduce the client's risk level — reasons for living, social support, treatment engagement, coping skills, religious beliefs, and responsibility to others.
Current Status
The client's present level of risk — current ideation (frequency, intensity, duration), presence or absence of plan, access to means, intent, and overall risk classification (low, moderate, high, imminent).
Safety Plan
A collaborative safety plan developed with the client — warning signs, internal coping strategies, people to contact for distraction, professionals to contact in crisis, and means restriction steps.
Recommendations
Clinical recommendations based on the risk assessment — level of care needed, treatment modifications, consultation plans, follow-up frequency, and documentation of clinical reasoning.
Documentation Before & After WellNotes
A client just disclosed suicidal ideation. You spend the session assessing risk and building a safety plan. Now you need to document every detail — risk factors, protective factors, your clinical reasoning — under time pressure.
Assessment complete. You dictate your findings. A structured risk assessment appears — risk factors, protective factors, safety plan, and recommendations — ready for careful review and sign-off.
Risk Assessment Example
A realistic sample generated by WellNotes
Risk Factors
Static risk factors: Prior suicide attempt (overdose, age 19, hospitalized). Family history of completed suicide (uncle). Male gender. Chronic pain condition. Dynamic risk factors: Current passive suicidal ideation ("sometimes I think everyone would be better off without me"). Recent divorce finalized 6 weeks ago. Increased alcohol use (from 2-3 drinks/week to daily drinking, 4-5 drinks). Social isolation — reports losing mutual friends in divorce. Insomnia (sleeping 3-4 hours/night). Recently prescribed sleep medication with access to 30-day supply. Job performance declining — received formal warning at work.
Protective Factors
Two children ages 8 and 11 — client states "I could never do that to my kids." Active engagement in therapy (has not missed a session in 4 months). Willingness to discuss suicidal thoughts openly. No current plan or intent. Religious faith — describes suicide as "against my beliefs." One close friend who checks in regularly. Employed with health insurance. Future-oriented statements present ("when things get better"). Historically responsive to treatment — previous depressive episode resolved with therapy and medication.
Current Status
Risk classification: MODERATE. Client reports passive suicidal ideation occurring 2-3 times per week, typically in the evening when alone. Ideation is described as fleeting thoughts ("what's the point") lasting seconds to minutes. Denies active plan or intent. Denies rehearsal behaviors. Denies homicidal ideation. Reports ideation has increased over past 3 weeks coinciding with divorce finalization and increased alcohol use. Acknowledges access to means (sleep medication, 30-day supply). Affect is congruent — tearful when discussing children, flat when discussing future. Judgment is fair — agreed to safety planning and means restriction.
Safety Plan
1. Warning signs: Feeling of "emptiness," increased urge to drink, cancelling plans with friends, not returning children's calls. 2. Internal coping: Go for a walk, call friend Mark, play guitar, watch comedy, review photos of children. 3. Social contacts for distraction: Friend Mark (555-0123), sister Karen (555-0456). 4. Professional contacts: Therapist office (555-0789), 988 Suicide & Crisis Lifeline, local crisis center (555-0321). 5. Means restriction: Client agreed to give 30-day supply of sleep medication to friend Mark, keeping only 3-day supply at home. Will remove alcohol from apartment. 6. Emergency: 911 or go to nearest emergency department. Client signed safety plan and received copy.
Recommendations
1. Increase session frequency from biweekly to weekly. 2. Refer for psychiatric evaluation — medication management for depression and insomnia (non-lethal alternatives to current sleep medication). 3. Recommend substance abuse assessment given escalating alcohol use. 4. Verify means restriction completed by next session. 5. Consult with colleague Dr. Williams regarding level of care appropriateness. 6. Reassess risk at each session until stabilized. 7. If ideation becomes active (plan, intent, or timeline), coordinate immediate psychiatric evaluation for possible hospitalization. 8. Document: Clinical judgment supports outpatient treatment at this time given strong protective factors, absence of plan/intent, and client's active engagement in safety planning.
Who Uses Risk Assessment?
Frequently Asked Questions
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Learn moreStart Writing Risk Assessment in Minutes
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