Page 63 - On Call folder

SF001
Accident Investigation Form Issue 1
03/09/2012

12. Description of Accident/ Incident (continue on separate sheet if necessary)

13. Line Manager / Supervisor Comments & Remedial (Short Term & Long Term) Actions

(Continue on separate sheet if needed)

14. Injured / Involved Persons Comments as to How Accident/ Incident Could Have Been Prevented

(Continue on separate sheet if necessary)

15. Actions

What positive Briefing on correct tools No appropriate action Staff disciplined / briefed
actions have Hazard eliminated Safe system of work introduced Training required
been taken to
prevent Hazard repaired / replaced Safe system of work modified Other (specify below)
reoccurrence? Maintenance procedures reviewed Staff counselled

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