University of Worcester Incident Report Form
This document is an Incident, Illness, or Near Miss Report Form designed for the University of Worcester. It must be completed when you're unable to access the Incident Notification Portal. This form ensures that all incidents are documented efficiently and sent to Safety Services for appropriate action.
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How do I fill this out?
Filling out this form requires precision and attention to detail. Begin by entering your personal details along with the specifics of the incident you are reporting. Ensure all relevant information is included to facilitate a thorough review.

How to fill out the University of Worcester Incident Report Form?
1
Identify the type of report: Accident, Illness, or Near Miss.
2
Fill in your personal details including name, contact information, and role.
3
Provide a detailed description of the incident, including location and time.
4
Indicate any immediate actions taken after the incident occurred.
5
Submit the completed form to Safety Services promptly.
Who needs the University of Worcester Incident Report Form?
1
University staff who need to report workplace incidents.
2
Students who require documentation for related medical issues.
3
Visitors to the campus who may encounter accidents.
4
Contractors involved in university projects needing to record events.
5
Safety Services personnel who analyze incident trends for improvements.
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What are the instructions for submitting this form?
After completing the form, submit it via email to safety@worc.ac.uk. Alternatively, you can hand a printed version directly to the Safety Services office. Ensure that the submission is made as soon as possible after the incident occurs for timely response and record-keeping.
What are the important dates for this form in 2024 and 2025?
The reporting form should ideally be submitted within one day of the incident. Ensure all follow-up actions are documented by the end of the incident investigation period. Important dates for 2024 and 2025 will be specified by Safety Services based on university guidelines.

What is the purpose of this form?
The primary purpose of this form is to document incidents, illnesses, or near misses occurring within the University of Worcester. Accurate reporting helps ensure that all safety concerns are addressed promptly. This form serves as a critical tool for improving safety protocols and preventing future incidents.

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

- 1. Surname: The last name of the individual filling out the form.
- 2. First Name: The first name of the individual filling out the form.
- 3. Contact Phone Number: A phone number to reach the individual for further queries.
- 4. Email: The email address of the person reporting the incident.
- 5. Incident Description: Detailed account of what occurred, including context and any relevant images.
What happens if I fail to submit this form?
Failure to submit this form may result in missed opportunities for addressing safety issues. It can hinder incident investigations and the implementation of preventive measures. Additionally, it may affect compliance with safety regulations.
- Inadequate Incident Tracking: Without submission, incidents may not be properly tracked, leading to recurring issues.
- Delayed Response: Response actions may be delayed, placing individuals at further risk.
- Compliance Issues: Failure to report could lead to legal ramifications for the institution.
How do I know when to use this form?

- 1. Accident Reporting: To document accidents that occur on campus.
- 2. Illness Reporting: To report any illnesses related to university activities.
- 3. Near Miss Reporting: To report incidents where an accident nearly occurred but was avoided.
Frequently Asked Questions
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What types of details do I need to fill out?
You will need to fill out personal information, details about the incident, and any actions taken.
How should I submit the filled form?
You can submit the filled form via email or by handing it in directly to Safety Services.
Is this form required for all incidents?
Yes, this form must be completed for all incidents to ensure accurate reporting and follow-up.
What if I need assistance while filling out the form?
If you require assistance, you can contact Safety Services for guidance.
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