Enter H&S Event Information – OV Group

GDPR Caution:

Do not enter any identifying information regarding employees (names, addresses etc). Only information in the public domain can be used, ie. manager names and job titles. Employees should either be referred to as (IP) Injured Party or by their Employee Number.

Incident Type:

Site Name:

Incident Type RadioB

Was a person involved?

No Yes

Were they injured?

No Yes

Person completing this form:

Name

Job Title

Address

Incident Location:

General Area

Location

Describe the exact location of the event

Admin

Accident Form Number

Date

Time

Hours since Shift Start

Lost Time Incident?

OV Group

Incidents

Risk Assessments

H&S Manual

Setup

GDPR Caution:

Incident Type:

Person completing this form:

Incident Location:

Admin

Details of Person Involved:

Injury Details:

Incident Details:

Investigation: To be completed by an authorised individual

Corrective Actions:

RIDDOR:

The answers given indicate that this is a reportable accident.

Check the current guidance and take action as necessary.

Sign and Date:

Hidden Fields

OV Group

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GDPR Caution:

Incident Type:

Person completing this form:

Incident Location:

Admin

arrowdown Details of Person Involved:

arrowdown Injury Details:

arrowdown Incident Details:

arrowdown Investigation: To be completed by an authorised individual

arrowdown Corrective Actions:

arrowdown RIDDOR:

The answers given indicate that this is a reportable accident.

Check the current guidance and take action as necessary.

arrowdown Sign and Date:

Hidden Fields

Incidents

Risk Assessments

H&S Manual

Setup

Details of Person Involved:

Injury Details:

Incident Details:

Investigation: To be completed by an authorised individual

Corrective Actions:

RIDDOR:

Sign and Date: