Accident/Incident Report Form

Use this form for reporting accidents, incidents or hazards which have occurred either on Company premises or whilst engaged on Company business. 

If the accident/incident has resulted in someone suffering serious injury (e.g. broken bones) please report it immediately to a Senior Manager

Details of person filling in this form

Details of person filling in this form (copy)

Description of the accident or incident (e.g. a near-miss)

First aid treatment

Reportable accidents and incidents

Accident or incident investigation and prevention

The information given may be passed onto the Health & Safety (‘H&S’) Enforcing Authority (where this is required by law); our Insurers (to advise on risk/claims matters); our H&S/HR professionals (to provide information about accidents or incidents, injuries and illness), and Company Managers (to discuss general accident and adverse incident prevention strategies).