Hours at Work
- No Injury
- Head Injury
- Multiple Injuries
- Gradual Process
Where did the Accident/Near Miss Happen?
How did the Accident/Near Miss Happen?
Was the person trained for the task they were doing?
Was a vehicle involved?
Type of Vehicle
Was a significant hazard involved?
What was the significant hazard?
Is the hazard on the hazard register?
How serious could the injuries have been?
Doctor visit is required?
- Able to continue Full Duties
- Able to do Light Duties
- Unable to Work
- Help Available at Home
- Assistance required at home
- Transport Assistance Needed
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Action Plan Summary