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How do I fill this out?
To fill out this form, start by providing your personal and organizational details. Next, accurately describe the incident, including date, time, and location. Finally, ensure all fields are completed before submission.

How to fill out the Health and Safety Reporting Instructions?
1
Provide your full name and job title.
2
Enter your organization name and address.
3
Describe the incident type and details.
4
Fill in the injured person's information.
5
Review your entries and submit the form.
Who needs the Health and Safety Reporting Instructions?
1
Employers need this form to comply with health and safety regulations.
2
Safety officers use this document to report injuries and incidents.
3
Human resources departments require the form for workplace accident records.
4
Insurance professionals may need it for claims processing.
5
Legal professionals use the information for liability assessments.
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What are the instructions for submitting this form?
Complete the form with accurate information and submit it via email to riddor@connaught.plc.uk. Alternatively, use the fax number 0845 300 99 24 for submission. You may also choose to mail it directly to the Incident Contact Centre, Caerphilly Business Centre, Caerphilly Business Park, CF83 3GG.
What are the important dates for this form in 2024 and 2025?
It is crucial to submit this form timely following an incident, ideally within 10 days for reporting requirements. Keep an eye on submission deadlines for internal review processes.

What is the purpose of this form?
This form serves as an official report for workplace injuries and dangerous occurrences. It ensures that employers comply with health and safety legislation. Accurate reporting helps improve workplace safety standards.

Tell me about this form and its components and fields line-by-line.

- 1. Full Name: Enter the complete name of the person filling out the form.
- 2. Job Title: State your current position within the organization.
- 3. Telephone Number: Provide a contact number for follow-up.
- 4. Organization Name: Name of the company or organization.
- 5. Address: Full address including postcode of the organization.
- 6. Type of Work: Briefly describe the nature of work the organization does.
- 7. Incident Date: Date when the incident occurred.
- 8. Incident Time: Time of the incident in 24-hour format.
- 9. Injured Person Name: Enter the full name of the injured individual.
- 10. Injury Details: Describe the injury sustained by the individual.
What happens if I fail to submit this form?
Failing to submit this form may result in non-compliance with health regulations. As a consequence, organizations might face legal penalties or face difficulties during insurance claims.
- Legal Repercussions: Non-submission can lead to fines and legal challenges.
- Insurance Issues: Not reporting may complicate claims and potential payouts.
- Increased Liability: Failure to document incidents can increase employer liability.
How do I know when to use this form?

- 1. Injury Reporting: Use the form to report any injuries sustained by employees.
- 2. Accident Documentation: Essential for documenting incidents for legal and insurance purposes.
- 3. Regulatory Compliance: Required for compliance with health and safety laws.
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What information do I need to fill out the form?
You'll need details about the incident, injured persons, and your organization's information.
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