Incident Report Form

Part A - Employee to Complete

Please complete the form below if you are the employee who was involved in the incident/accident.

  • Person(s) involved

  • DD slash MM slash YYYY
  • Incident Details

  • Injury details (if applicable)

  • Supporting documentation

  • Max. file size: 50 MB.

 

 

Part B - Line Manager to Complete

Please complete the form below if you are the Line Manager of the employee or subcontractor involved in the incident/accident.

  • Investigation of Incident

  • Insurance

    The following information is required for Insurance Claims and is to be completed for all Reports.
  • Third Party Details (if applicable)

    The following information is required where Non-Company Vehicles, Equipment or Personnel are involved causing injury or damage.
  • Your details