Health And Safety Incident Report Form Template for England and Wales

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Key Requirements PROMPT example:

Health And Safety Incident Report Form

"I need a Health And Safety Incident Report Form for our construction company's UK operations that includes specific sections for machinery-related incidents and contractor involvement, compliant with RIDDOR requirements and suitable for implementation by January 2025."

Document background

The Health And Safety Incident Report Form is a crucial document required by law in England and Wales for documenting workplace incidents. It serves multiple purposes: ensuring regulatory compliance with RIDDOR 2013, creating an audit trail for investigations, supporting prevention of future incidents, and providing evidence for insurance or legal proceedings if required. The form must be completed promptly following any workplace accident, injury, near-miss, or dangerous occurrence, capturing detailed information about the incident, affected individuals, and immediate actions taken.

Suggested Sections

1. Incident Details: Date, time, location, and type of incident including RIDDOR classification if applicable

2. Personal Information: Details of injured person(s) including name, job title, department, and contact information

3. Incident Description: Detailed account of what happened, including sequence of events and immediate cause

4. Immediate Actions Taken: Steps taken immediately after incident including first aid, emergency services called, area secured

5. Reporter Information: Details of person completing the report including name, position, and contact information

Optional Sections

1. Environmental Conditions: Details of weather, lighting, or other environmental factors that may have contributed to the incident

2. Equipment Involved: Details of any machinery, tools, or equipment involved in the incident including maintenance records

3. Third Party Details: Information about any contractors, visitors, or members of the public involved in the incident

4. Risk Assessment Review: Review of existing risk assessments and whether they need updating following the incident

Suggested Schedules

1. Photographs and Diagrams: Visual evidence of incident scene, equipment involved, and any relevant markings or damage

2. Witness Statements: Separate forms containing detailed accounts from witnesses to the incident

3. Medical Reports: Copies of any medical assessments, first aid reports, or hospital documentation

4. Investigation Findings: Detailed analysis of root causes and recommendations for preventing future incidents

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

alex.den.21@genieai.co

Relevant legal definitions

Clauses

Relevant Industries

Construction
Manufacturing
Healthcare
Retail
Education

Relevant Teams

Health and Safety
Human Resources
Operations
Legal
Quality Assurance

Relevant Roles

Health and Safety Manager
Site Supervisor
HR Manager
Department Manager
Compliance Officer

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Let's create your Health And Safety Incident Report Form

Authors

Alex Denne

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Download our whitepaper on the future of AI in Legal

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