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Add Incident Report
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Telephone:
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Report Form Type:
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Accident
Asbestos Incident
Environmental Damage
Equipment Nonconformity
Fire
Identified Hazard
Near Miss
Property Damage
Social Care
Verbal Aggression/Assault
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Vulnerable Tenant
Unoccupied Child
Other
Potential RIDDOR?
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No
RIDDOR Category:
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Dangerous Occurrences
Death
Gas Incidents
Occupational diseases
Over-seven day
Specified injury
Days Lost?
Date of Report:
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Time of Report:
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Date of Incident Occurrence:
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Time of Incident Occurrence:
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Address of Incident:
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Building Name:
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Street Number:
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Street Name:
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Town:
County:
Postcode:
Details
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Organisation
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Was there any person(s) involved?
Who was involved? (1)
Telephone
Email
Injury Type:
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Part(s) of the body affected:
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Apparent Cause:
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Did the injured party attend hospital?
Supporting Document(s) & Photography
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