• What occurred in this area that you are following up on?

  • Please list the area you are reassessing: (EG Front of warehouse - Isle number - Yard etc)

  • Is the area that Accident, Incident or Near Miss occurred reopen and operating in a safe manor? (Picture if possible)

  • Add media

  • Have new procedures been put in place by the client to eliminate or lower the chance of reoccurrence? (If yes please list)

  • Are you satisfied that these changes will help to eliminate or lower the chance of reoccurrence?

  • Has consultation & training with the workers occurred on the new procedures? (Please list below : If YES how & when / If NO when will this occur)

  • If first aid was used has the first aid kit been restocked?

  • Add media

  • Client Signature

  • Zoom Representative Signature

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