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Incident Report
Incident Report
Client Name
*
Incident Location
*
Site Telephone No
*
Site/Contract Manager's Name
*
Site Name
*
Name of Injured Person
*
Trade/Occupation
*
Nature of incident - How did it happen?
*
Nature and extent of injury sustained/part affected or... the dangerous occurence/industrial disease...:
*
Severity of Incident Severity of Incident
Loss Time
Riddor
Fatality
Support Material Attained?
Accident Book Copy
Daily / Morning Briefing
Induction Records
Method Statements
Risk Assessments
Training Records
Email
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