Accident and Incident

Accident and Incident Reporting form

If your event is on Kinetic, complete the reporting form in your event record.
Use this form to report all work-related injuries, illnesses, incidents, or near misses.
If in doubt about the severity of an incident, err on the side of caution and submit a form.
Complete the form as soon as possible after the occurrence. If you cannot do this promptly, ask someone to complete it on your behalf.
A separate form must be completed for each injured person in the event of an accident.

About the event

What are you reporting? *

Accident

Incident (including near misses)

When did the event occur? *

On what site did the event occur? *

Where on site did the event occur? *

What happened? (Please describe the occurrence, including events that led up to it, and details about any equipment, substances, or materials involved) *

Was any First Aid treatment provided and, if so, can you describe how this was performed? *

Were the Emergency Services required and, if so, can you describe the circumstances? *

Who witnessed the event? (Provide 2 persons, if possible) *

Witness contact details *

Follow up work

Had staff on site both read and followed the event risk assessment? *

Yes

What can TAWS do to provide capacity and scope for staff to do this prep next time?

Do you have any additional thoughts or suggestions on preventing this happening again?

Submit

Your name *

Your role *

Your email *

Are you happy for his information to be shared internally, and externally with HSE? *

I agree to this information being shared

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