Hazard Incident Report Form Template for England and Wales

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Key Requirements PROMPT example:

Hazard Incident Report Form

"I need a Hazard Incident Report Form for our manufacturing facility that specifically addresses machinery malfunctions and includes detailed equipment inspection checklists, as we're implementing new automated production lines in January 2025."

Document background
The Hazard Incident Report Form is a crucial document required under English and Welsh health and safety legislation, particularly RIDDOR 2013 and the Health and Safety at Work Act 1974. It must be completed whenever a workplace hazard, incident, or near-miss occurs. The form serves multiple purposes: ensuring legal compliance, maintaining accurate incident records, identifying patterns in workplace safety issues, and supporting the implementation of preventive measures. It forms part of an organization's broader health and safety management system and may be required for insurance purposes or regulatory investigations.
Suggested Sections

1. Incident Details: Date, time, location, and type of incident

2. Person(s) Involved: Details of affected individuals and witnesses

3. Incident Description: Detailed account of what occurred

4. Immediate Actions Taken: Response measures implemented

5. Reporter Information: Details of person completing the report

Optional Sections

1. Environmental Conditions: Details of weather or environmental factors when relevant to the incident

2. Equipment Involved: Details of any machinery or equipment involved in the incident

3. Third Party Details: Information about contractors or visitors involved in the incident

Suggested Schedules

1. Photographic Evidence: Visual documentation of incident scene or damage

2. Witness Statements: Written accounts from witnesses

3. Risk Assessment Review: Updated risk assessment following incident

4. Medical Reports: Medical documentation of injuries if applicable

Authors

Alex Denne

Head of Growth (Open Source Law) @ Genie AI | 3 x UCL-Certified in Contract Law & Drafting | 4+ Years Managing 1M+ Legal Documents | Serial Founder & Legal AI Author

Industries

Health and Safety at Work etc. Act 1974: The fundamental legislation for workplace safety in England and Wales that sets general duties for employers, employees, and self-employed persons regarding workplace safety and health

RIDDOR 2013: The Reporting of Injuries, Diseases and Dangerous Occurrences Regulations 2013 specifies mandatory incident reporting requirements, timeframes, and record-keeping obligations for workplace accidents and incidents

Management of Health and Safety at Work Regulations 1999: Establishes requirements for workplace risk assessments and arrangements for implementing effective health and safety management systems

Data Protection Act 2018: Together with UK GDPR, governs how personal data must be handled, stored, and protected when recording incident information, including data retention periods and privacy requirements

Corporate Manslaughter and Corporate Homicide Act 2007: Legislation that establishes criminal liability for organizations where serious management failures result in a gross breach of duty of care causing death

Safety Representatives and Safety Committees Regulations 1977: Outlines the legal framework for employee representation in workplace safety matters and the establishment of safety committees

Teams

Employer, Employee, Start Date, Job Title, Department, Location, Probationary Period, Notice Period, Salary, Overtime, Vacation Pay, Statutory Holidays, Benefits, Bonus, Expenses, Working Hours, Rest Breaks,  Leaves of Absence, Confidentiality, Intellectual Property, Non-Solicitation, Non-Competition, Code of Conduct, Termination,  Severance Pay, Governing Law, Entire Agreemen

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