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APPENDIX I INCIDENT REPORT FORM Incident details Date of incident Time Event Venue Club/team Incident Athlete details Surname Address Given name(s) Street Address Tel (H): Mobile: Suburb/Town/City

How to fill out incident report form

How to fill out an incident report form:

1. Start by gathering all the necessary information related to the incident. This includes the date, time, and location of the incident, as well as any witnesses or individuals involved.
2. Begin filling out the incident report form with the basic details. Provide your name, job title, and contact information. If applicable, also include the name and contact information of the person submitting the report on behalf of someone else.
3. Clearly describe the incident in a concise and objective manner. Include specific details such as what happened, who was involved, and any injuries or damages that occurred. Use clear language and avoid making assumptions or speculations.
4. Outline any actions taken immediately following the incident. This can include providing medical assistance, contacting the appropriate authorities, or implementing initial safety measures. Be sure to include the names and roles of those involved in these actions.
5. If there were any witnesses to the incident, their statements should be recorded. Include their names, contact information, and a detailed account of what they observed. Encourage witnesses to be as specific as possible.
6. Document any photographic evidence or video recordings that were captured at the scene. Include a brief description of each piece of evidence and ensure it is properly attached or filed alongside the incident report form.
7. At the end of the form, provide a section for the person completing the report to sign and date. This signature serves as confirmation that the information provided is accurate and truthful to the best of their knowledge.

Who needs an incident report form:

1. Employers: Incident report forms are crucial for employers as they help keep a record of workplace incidents. These reports are vital for understanding trends, identifying potential hazards, and implementing preventive measures to improve employee safety.
2. Employees: Individuals directly involved in an incident should report it using an incident report form. This allows them to provide a detailed account of the event, ensuring that all relevant information is documented and considered.
3. Insurance Companies: Incident report forms are often required by insurance companies to process claims related to accidents, injuries, or damages. These forms provide comprehensive information that helps in assessing the legitimacy and severity of the incident.
4. Regulatory Agencies: In certain industries, regulatory agencies may require incident report forms to be submitted for compliance purposes. These agencies use the information provided to monitor safety standards and enforce regulations.

In summary, filling out an incident report form requires gathering all necessary details, describing the incident objectively, documenting actions taken, including witness statements and evidence, and signing the form. Incident report forms are needed by employers, employees, insurance companies, and regulatory agencies.

For pdfFiller’s FAQs

What is incident report form?

An incident report form is a document used to record information about an unexpected event or situation in the workplace.

Who is required to file incident report form?

Employees who witness or are involved in an incident are typically required to file an incident report form.

How to fill out incident report form?

To fill out an incident report form, provide detailed information about the incident, including date, time, location, witnesses, and a description of what happened.

What is the purpose of incident report form?

The purpose of an incident report form is to document and investigate workplace incidents to prevent future occurrences.

What information must be reported on incident report form?

Information such as date, time, location, description of incident, names of individuals involved, and any injuries sustained must be reported on an incident report form.

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