Personal Details:

Date & Time of Incident: 

Location of Incident: 

Description of Incident: 

Include details of injuries or damages.

Cause of Incident (if known): 

Detail any identified hazards or unsafe conditions

Actions Taken: 

First aid given, hazard removed, reported to site staff, medication given, hospital visit etc.

Who in the School Has Been Informed?

(e.g., Site Manager, Headteacher, School H&S Lead).

Witnesses: 

Further Actions Required: