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PSE HR to complete Massey work accident illness or incident Report Form Please return to Regional Health and Safety Advisor within 24 hours of Accident / Incident Serious Harm injuries must be reported to Manager Health and Safety Advisor and Department of Labour immediately SECTION A PARTICULARS INJURED PERSON OR FIRST ON SCENE TO COMPLETE Date of Accident /Incident/onset of symptoms Time Circle one Accident / Illness / Incident Date Reported Hours worked since arrival at work Shift Day...

How to fill out massey work accident illness

How to fill out Massey Work Accident, Illness or Incident Report Form

1. Obtain the Massey Work Accident, Illness or Incident Report Form from HR or the company intranet.
2. Enter the date and time of the incident at the top of the form.
3. Fill in the names and job titles of the affected employee(s) and any witnesses.
4. Describe the incident in detail, including what happened, how it happened, and any immediate actions taken.
5. Note the location of the incident, including specific details like the building and room number.
6. Indicate if the employee sought medical treatment and provide details of the treatment obtained.
7. Sign and date the report at the bottom to confirm that the information provided is accurate.

Who needs Massey Work Accident, Illness or Incident Report Form?

1. All employees who experience a work-related accident, illness, or incident.
2. Supervisors or managers overseeing the affected employee.
3. Human Resources personnel for record-keeping and compliance purposes.

People Also Ask about

What are the 8 types of reportable incidents?

The 8 types of reportable incidents are: unreasonable use of force. unlawful sexual contact or inappropriate sexual conduct. psychological or emotional abuse. unexpected death. stealing or financial coercion by a staff member. neglect. inappropriate use of restrictive practices. unexplained absence.

How do I write a work accident report?

What to include in a work incident report The date and time of the incident. The name of the witness or author of the report. A detailed description of the events. The names of the affected parties. Other witness statements or important information. The result of the incident.

What type of incident must be reported?

Various incidents are reported, including workplace injuries, accidents and near-misses, data breaches and security threats, medical emergencies, and customer complaints. Each one needs to be properly documented so incidents can be tracked over time and patterns can be identified.

What are the 4 major stages to the incident investigation?

“Incident (Accident) Investigations: A Guide for Employers” simplifies how to approach incident or accident investigations — providing helpful information on how to: Preserve and document the scene. Collect Data. Determine root causes. Implement corrective actions.

What are the 4 types of incident reports?

Incident reports can be categorized into four main types: injury, illness, near miss, and property damage. Each type serves a specific purpose and provides valuable insights into different aspects of workplace safety.

How do I create an accident report form?

Accident report forms should include fields for names and contact information of the individuals and witnesses involved, the type of accident, the date and time the accident occurred, the location of the accident, a detailed description of the accident, and room for any additional comments.

How do you write an incident and accident report?

What to Include in an Incident Report General information. Setting or environment. Affected people. Injuries and the severity. Witnesses. Administered treatment. Property and equipment damages. Events.

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What is Massey Work Accident, Illness or Incident Report Form?

The Massey Work Accident, Illness or Incident Report Form is a document used to formally record any accidents, illnesses, or incidents that occur in the workplace. It ensures that all relevant details are captured for review and potential follow-up.

Who is required to file Massey Work Accident, Illness or Incident Report Form?

Typically, all employees who experience or witness a workplace accident, illness, or incident are required to file the Massey Work Accident, Illness or Incident Report Form. Additionally, supervisors may also need to complete the form for incidents they manage.

How to fill out Massey Work Accident, Illness or Incident Report Form?

To fill out the report form, start by providing the date, time, and location of the incident. Then, include details about the individuals involved, nature of the incident, a description of what happened, and any witnesses. Finally, sign and date the form before submitting it to the appropriate supervisor or HR department.

What is the purpose of Massey Work Accident, Illness or Incident Report Form?

The purpose of the form is to document workplace incidents comprehensively. This allows for proper investigation, adherence to legal requirements, implementation of safety measures, and understanding of the incident's impact on workplace safety and health.

What information must be reported on Massey Work Accident, Illness or Incident Report Form?

The report form must include the date, time, and location of the incident, details of the injured or affected individuals, a summary of the incident, contributing factors, witness statements if available, and any immediate actions taken in response to the incident.