Accident and incident report form

Select all of the items that apply.

Select all of the items that apply.

Trade Union Safety Representatives appointed by a trade union recognised by the university are also entitled to investigate accidents where they deem necessary. Do you consent to the release of information within this report where requested?

This form will be held by the university for the period detailed in our Record Retention Schedule. The information within it may be used during accident/incident investigation or to prevent reoccurrence. It may also be disclosed to legal or other third party professionals should the need arise.

I confirm that the above information is correct to the best of my knowledge and consent to the release of this information for the purposes mentioned above.