Hi
Incident/Hazard/Pre-check successfully submitted
6:44PM, Fri 15th Jan 2021
REPORT INCIDENT
Upload photos
- - Must be in .jpg, .jpeg, or .png format
- - Maximum file size allowed not more than 6 MB
REPORT INCIDENT
Incident description
REPORT INCIDENT
Incident summary
Date of incident
Time of incident
Venue
Report Completed by
Specific Location
Activity
Incident Type
Participant/Casualty Details
Participant/Casualty Name
Participant/Casualty Age, DOB
Area of injuries
Injury Description
Photos
Incident Description
Cause of incident
Type of hazard
What happened
First aid given
First aid completed by
Witnesses
Additional Medical Assistance called for
Actions taken to prevent further incidents or risk
Any additional notes
Parent/Guardian informed
REPORT INCIDENT
Incident completion
I have checked the information I have entered is accurate and understand that once submitted it can not be edited.
Are follow up actions required?
REPORT HAZARD
Hazard Action
with controls in place?
REPORT HAZARD
Upload photos
- - Must be in .jpg, .jpeg, or .png format
- - Maximum file size allowed not more than 6 MB
REPORT HAZARD
Hazard Action
REPORT HAZARD
Hazard summary
Date of assessment 15/01/2021
Time of assessment
Venue
Report Completed by
Hazard Location
Activity taking place
Hazard Details
Description
Category of Hazard
Risk Rating
Who is at risk
Photos
Safe to continue with controls in place?
Other affected members of staff informed
Responsible manager/leader informed?
Venue Management informed?
Changes made to allow activities to continue
Long term action/future controls required
Date to be checked again
REPORT HAZARD
Hazard completion
I have checked the information I have entered is accurate and understand that once submitted it can not be edited.
Are follow up actions required?