Post Event Report

• Site conducted

  Select

• Conducted on

  Date

• Prepared by

• Location
  Address

General Event Details

• Client Name/Organisation Name

• Event Number

• Event Start Time

  Date

• Event Finish Time

  Date

• What type of event was this?

  Community

  Corporate

  Fundraising

  Activation and Programing

Incident and First Aid

• Did an incident occur/First aid required?

  Yes

  No

  N/A

• Time of Incident

  Date
• Location of Incident
  Address

• Incident Priority?

  Urgent

  High

  Medium

  Low

  Trivial

• Incident Type?

  Select Hazard Near-Miss Evacuation Slip & Fall Accident Injury Theft Fire Property Damage Other

  • Hazard
  • Near-Miss
  • Evacuation
  • Slip & Fall
  • Accident
  • Injury
  • Theft
  • Fire
  • Property Damage
  • Other

• Please describe the type of incident

• Was any equipment/machinery/materials used during the incident?

  Yes

  No

  N/A

• Description of any equipment/building/facilities that were damaged if applicable

• Who was the first response of the incident?

• Was medical attention required or injury occur?

  Yes

  No

  N/A

• Was medical attention required immediately?

  Yes

  No

  N/A

• What kind of medical attention was administered?

  First Aid

  Doctor Consulted

  Hospital

  Ambulance

  Medical Attention Declined

• If person admitted into hospital as patient, for how long?

• Name of facility/hospital/physician if applicable

• Name of facility/hospital/physician if applicable

• Yes

  No

  N/A

• Where was on the body did the injury occur?

  Select General Ailment Head Eye (Left) Eye (Right) Ear Nose Throat Neck Back (Upper) Back (Lower) Arm - Upper (Right) Arm - Upper (Left) Arm - Elbow (Right) Arm - Elbow (Left) Arm - Forearm (Right) Arm - Foreman (Left) Wrist (Right) Wrist (Left) Hand (Right) Hand (Left) Chest Abdominal / Stomach Groin / Anus Leg - Upper (Right) Leg - Upper (Left) Leg - Knee (Right) Leg - Knee (Left) Leg - Lower (Right) Leg - Lower (left) Ankle (Right) Ankle (Left) Foot (Right) Foot (Left) Shoulder (Left) Shoulder (Right) Other

  • General Ailment
  • Head
  • Eye (Left)
  • Eye (Right)
  • Ear
  • Nose
  • Throat
  • Neck
  • Back (Upper)
  • Back (Lower)
  • Arm - Upper (Right)
  • Arm - Upper (Left)
  • Arm - Elbow (Right)
  • Arm - Elbow (Left)
  • Arm - Forearm (Right)
  • Arm - Foreman (Left)
  • Wrist (Right)
  • Wrist (Left)
  • Hand (Right)
  • Hand (Left)
  • Chest
  • Abdominal / Stomach
  • Groin / Anus
  • Leg - Upper (Right)
  • Leg - Upper (Left)
  • Leg - Knee (Right)
  • Leg - Knee (Left)
  • Leg - Lower (Right)
  • Leg - Lower (left)
  • Ankle (Right)
  • Ankle (Left)
  • Foot (Right)
  • Foot (Left)
  • Shoulder (Left)
  • Shoulder (Right)
  • Other

• What type of injury occurred?

  Select Superficial Open Wound Fatality Concussion Sprain Respiratory Eye injury Burn Fracture Electrocution Fall Strain Dislocation Stuck by object Entanglement Assault Muscle& Tendon Nerve & spinal cord Amputation Intracranial Other injury

  • Superficial
  • Open Wound
  • Fatality
  • Concussion
  • Sprain
  • Respiratory
  • Eye injury
  • Burn
  • Fracture
  • Electrocution
  • Fall
  • Strain
  • Dislocation
  • Stuck by object
  • Entanglement
  • Assault
  • Muscle& Tendon
  • Nerve & spinal cord
  • Amputation
  • Intracranial
  • Other injury

What happened?

• Describe what happened. Please be detailed but state only facts.

• What was the weather / environmental conditions at the time of the incident

  Select Clear Cloudy Rain Snow Windy Heatwave Haze Other

  • Clear
  • Cloudy
  • Rain
  • Snow
  • Windy
  • Heatwave
  • Haze
  • Other

• Describe the weather / environemental conditions at the time of the incident

• Which of the following do you need to attach to this report to accurately document this incident?

  Evidence

  Equipment details

  Vehicle Details

  Damages

  Other items

Evidence log

• Please log all relevant evidence below

Evidence

• Please detail any further information regarding this evidence (is applicable)

• Evidence Description

• Evidence ID number (if applicable)

• Type of evidence

  Document

  Photos

  CCTV

  Other

People invovled

• Were emergency services required/notified?

  Yes

  No

  N/A

• Which service?

  Fire

  Police

  Ambulance

• Did police attend?

  Yes

  No

  N/A

• Please provide further details (or report number if available)

  Yes

  No

  N/A

People Involved

• Please document all people involved in this incident, includiong yourself (the person reporting the incident)

  Yes

  No

  N/A
Person

Person

• Full name

• Contact phone number

• What is this person's relation to the incident? (select all that apply)

  Select Reporter of incident Injured person Witness Primary person invovled Secondary involvement On-Duty supervisor Investigator Suspect Other

  • Reporter of incident
  • Injured person
  • Witness
  • Primary person invovled
  • Secondary involvement
  • On-Duty supervisor
  • Investigator
  • Suspect
  • Other

• Describe this person's relation to the incident

• Please describe this person's involvement with the incident

• Does this person wish to make a preliminary statement?

  Yes

  No

  N/A

• Statement regarding incident

• Person signature

  Sign

• Has this person sustained an injury?

  Yes

  No

  N/A

• Please refer to the injury section to details

• What was the cause of this injury or illness?

Corrective Actions:

• Are corrective/further actions required with regard to this incident?

  Yes

  No

  N/A

• Have all required actoins been added as Actions to this report?

  Yes

  No

  N/A

• Please add any corrective actions to the appropriate questions above before completing this incident report

• What is the likelihood of this recorruing?

  Unlikely

  LIkely

  Very Likely

  Certain

Post Event Notes

• Was there a security guard?

  Yes

  No

  N/A

• Security guard feedback:

• Was a guard supposed to be here?

  Yes

  No

  N/A

• Did you contact guarding service and find out where they were?

  Yes

  No

  N/A

• Did they arrive?

  Yes

  No

  N/A

• How many people attended?

• How many were expected?

• Any notable quests?

• Was there bar takings?

  Yes

  No

  N/A

• What were the bar takings?

• Was there a TAB?

  Yes

  No

  N/A

• Was this TAB pre-organised?

  Yes

  No

  N/A

• Was a TAB requested during the event?

  Yes

  No

  N/A

• How much was the TAB?

• Was there any lost property?

  Yes

  No

  N/A

• What was it?

• Where has the item been placed?

• Is there any details on the item?

  Yes

  No

  N/A

• Has the client been contacted?

  Yes

  No

  N/A

• Audience feedback/Response

Staff Rostered

• Record who was rostered and their finish and start times:

• Name

• Duty

• Start time

  Date

• Break start

  Date

• Break end

  Date

• Finish time

  Date

• Total hours

Sign off

• Further action/follow-up/investigation required?

  Yes

  No

  N/A

• Name of person/people to follow up

• Name & Signature of reporter

  Sign