Information
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Date of incident
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Location
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Site Name & Cluster
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Personnel injured/involved in incident
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Are the personnel Visionstream employees?
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If No, provide Company name and contact details (if possible)
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Staff dealing with the incident (from VPL or other)
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Responsible Supervisor / Manager
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Description of incident. What happened? Keep to the facts
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Take a photo of the overall scene to assist with the description
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Description of injury (if applicable)
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Low = First Aid Treatment<br>Medium = Taken to the Doctor / Hospital as a precaution<br>serious = Taken to the Doctor / Hospital for treatment
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Name and number of person making this report
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Incident Immediate Response:
- Assist the injured person
- Make the scene safe
- Fill in this form
- Contact CM/PM
- Contact David Wright (SHE Manager) on 0437 410 960
- Don't disturb the scene, other than making it safe, for any incident above a minor unless advice has been sought from the SHE Department
- Take lots of photos
- Ensure the CM/PM has been updated on the condition of any injured person, once more information is known
