The Health and Safety Incident Report Form is a fundamental tool for maintaining workplace safety compliance in Hong Kong. It is designed to be used immediately following any workplace incident, accident, or near-miss occurrence, facilitating proper documentation and investigation as required by the Occupational Safety and Health Ordinance (Cap. 509) and related regulations. The form helps organizations meet their legal obligations for incident reporting, supports worker compensation claims, and contributes to preventing future incidents through systematic data collection and analysis. It should be readily available in all workplaces and is particularly crucial for timely reporting to the Hong Kong Labour Department when required by law.
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1. Incident Identification Details: Basic information including date, time, location, and reference number of the incident
2. Reporter Information: Details of the person filling out the report including name, position, contact information
3. Incident Description: Detailed account of what happened, including sequence of events and immediate response
4. Affected Persons: Information about all persons involved, injured or affected by the incident
5. Injury/Damage Details: Specific description of injuries sustained or property damage incurred
6. Immediate Actions Taken: Steps taken immediately following the incident including first aid, emergency responses
7. Witness Information: Details of any witnesses to the incident including their contact information
8. Root Cause Analysis: Initial assessment of what caused the incident
9. Preventive Measures: Immediate and long-term measures to prevent recurrence
10. Reporting Requirements: Checklist of necessary notifications to authorities and internal stakeholders
1. Environmental Impact: For incidents involving environmental releases or impacts
2. Equipment/Machinery Involved: Detailed section for incidents involving machinery or equipment failure
3. Chemical Exposure Details: For incidents involving hazardous substances or chemical exposure
4. Third Party Involvement: When contractors, visitors, or members of the public are involved
5. Medical Treatment Details: Extended section for cases requiring medical attention beyond first aid
6. Business Continuity Impact: Assessment of impact on business operations and recovery plans
1. Incident Scene Photographs: Template for documenting and labeling photographic evidence
2. Witness Statement Forms: Standardized forms for collecting detailed witness accounts
3. Risk Assessment Matrix: Tool for evaluating the severity and likelihood of similar incidents
4. Injury Classification Guide: Reference guide for categorizing types and severity of injuries
5. Regulatory Reporting Requirements: Checklist of notification requirements based on incident type
6. Investigation Follow-up Timeline: Template for tracking investigation progress and actions
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