Hazard Incident Report Form Template for England and Wales

A standardized form used in England and Wales for documenting workplace hazards, incidents, and near-misses in compliance with RIDDOR 2013 and the Health and Safety at Work Act 1974. The form captures essential information about the incident, including details of those involved, circumstances, immediate actions taken, and any resulting injuries or damage. It serves as an official record for regulatory compliance and internal risk management.

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What is a Hazard Incident Report Form?

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.

What sections should be included in a Hazard Incident Report Form?

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

What sections are optional to include in a Hazard Incident Report Form?

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

What schedules should be included in a Hazard Incident Report Form?

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

Jurisdiction

England and Wales

Publisher

Genie AI

Document Type

Incident Report

Cost

Free to use

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