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Incident/Accident Reporting Form Victims Company/Group Name: 1. Incident/Injury Details (Tick one) Illness Injury Property damage EnvironmentalMinor (First Aid) Moderate (Doctor) Serious (Hospitalized)
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How to fill out injury or near miss
How to fill out injury or near miss
01
Gather all relevant information such as date, time, location, and nature of the incident.
02
Fill out an incident report form with detailed descriptions of the injury or near miss.
03
Provide information on any witnesses or individuals involved in the incident.
04
Include any relevant photos or supporting documentation.
05
Submit the completed form to the appropriate supervisor or safety officer.
Who needs injury or near miss?
01
Anyone who has been involved in or witnessed an injury or near miss incident.
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What is injury or near miss?
An injury or near miss is an incident that results in harm to an individual or has the potential to cause harm.
Who is required to file injury or near miss?
Any individual who witnesses or is involved in an injury or near miss incident is required to file a report.
How to fill out injury or near miss?
To fill out an injury or near miss report, provide details such as location, date, time, individuals involved, and a description of the incident.
What is the purpose of injury or near miss?
The purpose of reporting an injury or near miss is to identify potential safety hazards, prevent future incidents, and improve safety measures.
What information must be reported on injury or near miss?
Information such as the date, time, location, individuals involved, description of the incident, and any contributing factors must be reported.
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