Information

  • Document No.

  • Audit Title

  • Client / Site

  • Conducted on

  • Prepared by

  • Location
  • Personnel

1. INCIDENT DETAILS

  • Date & Time of incident?

  • Incident description, e.g assault

  • Location of incident. (Area of property)

  • Detailed description of Incident:

  • Is there any evidence? E.g knife

  • Description of evidence:

  • Location of evidence:

2. PERSON(S) INVOLVED

  • Name (Person 1):

  • Phone:

  • Sex:

  • Date of birth:

  • Name (Person 2):

  • Phone:

  • Sex:

  • Date of birth:

3. POLICE

  • Did Police attend?

  • Police Officer's name:

  • Station:

  • What did the police do?

4. INJURIES

  • Any injuries occurred?

  • Describe injury.

  • Photo of injury, if applicable.

  • Was first aid administered?

  • If yes, by whom?

  • Detail any first-aid or medical treatment administered:

  • Did a Ambulance attend?

  • If yes, what was the outcome?

5. PROPERTY DAMAGE

  • Was there any property damage?

  • What property was damaged?

  • Further property description:

  • Photo of damage.

  • Photo of damage.

  • Is the damage safe?

  • Immediate (Direct Causes):

  • Corrective Action (Include detail description of action and person(s) responsible for actions)

6. PERSON COMPLETING REPORT

  • Signature

  • Reporting Officer's phone number

  • Security Licence number:

  • Once completed, email Security Incident Report to Manager.

The templates available in our Public Library have been created by our customers and employees to help get you started using SafetyCulture's solutions. The templates are intended to be used as hypothetical examples only and should not be used as a substitute for professional advice. You should seek your own professional advice to determine if the use of a template is permissible in your workplace or jurisdiction. You should independently determine whether the template is suitable for your circumstances.