Incidents

Coming soon

Asterisk (*) indicates a required field.

Name*

Incident Type?*

Manager Name*

Manager Department*

Manager Email*

Manager Extension No.

Date/Time Accident Occurred*

Location*

Describe what happened*

Who was injured or suffered ill-health?*

What injuries or ill-health effects were caused?*

Were there any witnesses?*

How did the accident happen?*

What activities/tasks were being carried out at the time of the accident?*

Was there a risk assessment covering the activities/tasks being undertaken?*

Were the people involved trained and competent to carry out activities?*

In relation to the working environment and/or equipment involved, was maintenance and cleaning up to date?*

Were witnesses interviewed?*