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CASES21 INCIDENT NOTIFICATION FORM School Name/Location: School Number: BRIEF ACCOUNT OF INJURY Details of Incident: Accident Date: Accident Time: ACTIVITY (GENERAL & DETAILED) 1. Chemical Use.

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How to fill out the Incident Notification Form online

This guide provides step-by-step instructions on completing the Incident Notification Form online. By following these clear directions, users can ensure accurate and effective reporting of incidents that occur within the school environment.

Follow the steps to successfully fill out the Incident Notification Form online.

  1. Click the ‘Get Form’ button to access the Incident Notification Form. This will allow you to open the form in an online editor for completion.
  2. Begin with the School Name/Location and School Number fields. Enter the relevant information accurately to ensure proper identification of the incident.
  3. In the 'Brief account of injury' section, provide a detailed description of the incident, including circumstances and any relevant details.
  4. Fill in the Accident Date and Accident Time to pinpoint when the incident occurred.
  5. Indicate the type of activity involved in the incident by selecting from the predefined options, such as Chemical Use, Sports, or Manual Handling.
  6. Describe the accident type from the provided list, such as Slip, Fall, or Collision, ensuring to specify any other type if necessary.
  7. In the Accident Site section, select the location where the incident took place, indicating which campus if applicable.
  8. Complete the Staff on Duty section by providing the names and the number of staff present during the incident.
  9. Provide details of the injured person, selecting their type (Student, Staff, Family) and filling in their personal information as required.
  10. If initial assistance was provided, include those details in the next section, filling out the type of assistance given.
  11. Assess and document the severity of the injury by selecting the appropriate option, such as First Aid or Hospital Treatment.
  12. If applicable, specify the treatment the doctor provided for the injury.
  13. Identify the nature of the injury from the available options, ensuring a comprehensive description.
  14. State the location of the injury on the body by selecting one or multiple relevant areas.
  15. If there were witnesses to the incident, include their details in the Witness Details section.
  16. In the Preventive Action section, describe any measures taken or proposed to prevent future incidents.
  17. Finally, review all the entries for accuracy, then save changes, download, print, or share the completed form as needed.

Complete your Incident Notification Form online to ensure accurate reporting and effective incident management.

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Tips for reporting incidents Date and time of the event. Location. Type of incident. Names of the employees involved in the event. Details about the incident. Medical attention any involved employees received. Available photographs or recordings of the situation.

Incident Report Examples Injury Incident Report Example. Forklift Accident Report Sample. Fall Incident Report Sample. Hand Injury Incident Report Sample. Exposure Incident Report Sample. First Aid Incident Report Sample. Incident Report Form for a Construction Site. Incident Report for a Hospital/ Medical Clinic (Word/PDF)

The 4 main incident reports that should be on your list are: Near Miss Reports. Near misses are events where no one was injured, but given a slight change in timing or action, someone could have been. ... Injury and Lost Time Incident Report. ... Exposure Incident Report. ... Sentinel Event Report.

The 4 main incident reports that should be on your list are: Near Miss Reports. Near misses are events where no one was injured, but given a slight change in timing or action, someone could have been. ... Injury and Lost Time Incident Report. ... Exposure Incident Report. ... Sentinel Event Report.

Note: This form should be completed whenever an accident or incident occurs which results in injury or damage to personnel or property. If personnel or property WERE NOT injured or damaged during the Accident/ Incident, do not use this form. Use the NEAR MISS REPORT FORM.

Data to include in an HR incident form: Date and time the incident occurred. Location within the premises. A concise and comprehensive description of the incident. Consequences of the incident. Root cause. The likelihood that the event will occur again. Pictures of the area and any resulting damage. Lessons learned.

Provide date and time of the incident and when it was first reported, details of witnesses, and a succinct statement describing the events leading to the incident, the details of the incident, the type of work being undertaken, any hazards involved in the work and any personal protective equipment being used.

An incident report is a tool that documents any event that may or may not have caused injuries to a person or damage to a company asset. It is used to capture injuries and accidents, near misses, property and equipment damage, health and safety issues, security breaches and misconducts in the worksite.

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