Incident Reporting

This is a reporting form for client’s work-related incidents.

If it is relevant and appropriate you can send us an image of the incident if it helps to show what happened before you complete the form, here:

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The person who is completing the form (in confidence).
Your email address if we need to follow up on any information we can contact you.
A telephone number to reach you on if we need to clarify details.
Click the button above, what kind of 'incident' has happened?
Describe in plain english, what happened
Please describe: The name of the site/space or event or an address or a reference point.
When did the incident happen?
Tick all of the boxes above for the things that were involved in, or applied to the incident.
Fill this in if people were injured. Include the age and sex of the injured person(s) here. If more than one person, please describe them all. This will be treated in confidence. No one injured? Then leave this box empty.
The injured person(s). Click the button to say what type of people were injured?
Click above the kind of help, if given to the injured person(s)