Information
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Prepared by
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Venue Number
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Venue Name
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Conducted on
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Duty Manager
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Police reference number
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Type of Incident
- Assault - customer on staff
- Assault - customer on customer
- Robbery - attempted
- Robbery - actual
- Criminal damage - venue
- Criminal damage - machine
- Aggressive or abusive behaviour
- Other
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Please describe incident
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Account of what happened (include details of injuries and damage)
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How many Assailants were involved?
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Name
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Sex
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Age
- Under 18
- 18 - 25
- 26 - 30
- 31 - 35
- 36 - 40
- 41 - 50
- 51 - 60
- 60 +
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Build
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Ethnic Appearance
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Facial Hair
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Glasses
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Hair Colour
- Blonde
- Brown
- Black
- Grey
- Ginger
- Red
- Bald
- Dyed
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Accent
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Tattoo
-
Please add information (Accent, Tattoo)
-
Clothing - please describe
-
Would you like to add another description?
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Name
-
Sex
-
Age
- Under 18
- 18 - 25
- 26 - 30
- 31 - 35
- 36 - 40
- 41 - 50
- 51 - 60
- 60 +
-
Build
-
Ethnic Appearance
-
Facial Hair
-
Glasses
-
Hair Colour
- Blonde
- Brown
- Black
- Grey
- Ginger
- Red
- Bald
- Dyed
-
Accent
-
Tattoo
-
Please add information (Accent, Tattoo)
-
Clothing - please describe
-
Would you like to add another description?
-
Name
-
Sex
-
Age
- Under 18
- 18 - 25
- 26 - 30
- 31 - 35
- 36 - 40
- 41 - 50
- 51 - 60
- 60 +
-
Build
-
Ethnic Appearance
-
Facial Hair
-
Glasses
-
Hair Colour
- Blonde
- Brown
- Black
- Grey
- Ginger
- Red
- Bald
- Dyed
-
Accent
-
Tattoo
-
Please add information (Accent, Tattoo)
-
Clothing - please describe
-
Would you like to add another description?
-
Name
-
Sex
-
Age
- Under 18
- 18 - 25
- 26 - 30
- 31 - 35
- 36 - 40
- 41 - 50
- 51 - 60
- 60 +
-
Build
-
Ethnic Appearance
-
Facial Hair
-
Glasses
-
Hair Colour
- Blonde
- Brown
- Black
- Grey
- Ginger
- Red
- Bald
- Dyed
-
Accent
-
Tattoo
-
Please add information (Accent, Tattoo)
-
Clothing - please describe
-
Would you like to add another description?
-
Name
-
Sex
-
Age
- Under 18
- 18 - 25
- 26 - 30
- 31 - 35
- 36 - 40
- 41 - 50
- 51 - 60
- 60 +
-
Build
-
Ethnic Appearance
-
Facial Hair
-
Glasses
-
Hair Colour
- Blonde
- Brown
- Black
- Grey
- Ginger
- Red
- Bald
- Dyed
-
Accent
-
Tattoo
-
Please add information (Accent, Tattoo)
-
Clothing - please describe
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Name and contact details of any witnesses.
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Is further investigation required?
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Please give details
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Does RIDDOR need to be sent?
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Submitted date
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Have preventative measures been implemented to prevent reoccurrence?
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Please give detail.
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Date Venue Manager was informed.
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Has the incident been reported to Senior Management?
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Please give names
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Working time lost
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Please attach a copy of daily float check (if applicable)
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Have CCTV images been copied?
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Please give details
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Signature
