Health promotion in workplace settings has been prioritised to reduce chronic disease risk factors, both in Australia and internationally. This paper describes the design of a health risk assessment tool, the Brief Health Check (BHC). The BHC is one of two components of Get Healthy at Work, a state government-funded health promotion program for New South Wales workplaces. Policy imperatives required scaled-up delivery in the absence of a full preimplementation summative evaluation. Translational formative evaluation was adapted to design an evidence based health risk assessment tool, a process for referring workers to healthy lifestyle programs, and a process for general practitioners to help workers mitigate their risk of chronic disease, independently of the workplace. The tool had good feasibility and acceptance, but barriers included business organisational issues (including the time taken to facilitate the health checks) and some scepticism among workers about the motivation of businesses and the absence of measurements other than waist circumference. A cluster nonrandomised trial showed no benefit of a modest incentive for participation. A significant proportion of workers were identified as being at risk of chronic disease, and many received an appropriate referral to an evidence based program. More work to improve uptake of referrals will increase the public health impact of the BHC.