Edinburgh Leisure Accident Report Form
Is the injured person male or female?
Date of birth
Was it a member of staff or public
Was the member of staff off sick due to this incident?
How long were they off for?
Telephone number (if under 18 telephone number of parent/guardian):
- Ainslie Park
- Craiglockhart Leisure and Tennis Centre
- Dalry Swim Centre
- Drumbrae Leisure Centre
- Edinburgh International climbing Arena
- Glenogle Swim Centre
- Gracemount Leisure Centre
- Jack Kane Sports Centre
- Kirkliston Leisure Centre
- Leith Victoria Swim Centre
- Meadowbank Sports Complex
- Portobello Swim Centre
- Royal Commonwealth Pool
- Tumbles at Portobello
- Warrender Swim Centre
Where in the facility did it happen?
Describe what happened giving as much detail as possible:
Describe the injury (if none state 'none')
What first aid was applied (if none state 'none')?
Who was the first aider?
Was the person taken to hospital?
Were there witnesses?
Name of witness 1
Address and phone number of witness 1
Name of witness 2
Address and phone number of witness 2
In the case of an injury to an under 18 ensure the parents/guardians are contacted if not present, record the name and time of contact.
Could anything have been done to prevent this accident/incident?
Detail and follow up actions/things which caused the incident.