Information
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We expect incident forms to be completed fully however there may be times when you may not have all the information - please fill in spaces with 'unknown' or 'not applicable'. Email completed forms to finna@activestirling.org.uk
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If the incident is of a serious nature contact your line manager or the Duty Manager at The PEAK on 01786273537 or 01786273555 for further information or so that they can put the Critical Incident Management Plan into action.
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Enter the date and time of the incident
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Enter the address where the incident took place
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Select the business area under which the incident occurred
The Injured Person
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Enter the name of the injured person. Write unknown where applicable.
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Enter the address of the injured person. Write unknown where applicable.
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Enter a telephone number for the injured person.
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What age is the injured person?
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Is the injured person male or female?
Incident Details
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Where did the incident occur? e.g. Sports hall
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Give a full account explaining what happened
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Was there any equipment involved? If yes take photos and explain how and who the equipment belongs to.
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Was an injury sustained? If yes detail what injuries.
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Record any first aid administered.
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Who carried out first aid? (Name and sign)
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Add signature
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Add signature
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Did the injured person go directly to hospital?
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Were there any witnesses to the incident? Take a name and phone number where possible. In the event of a serious incident it may be necessary to take a statement.
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Is there any other information which you think may be relevant? Take photos or notes where possible.
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Write your full name and sign (person completing the form)
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Now that you have completed the incident form please email it to your line manager and finna@activestirling.org.uk
