Health and Safety Incident Report (UK)

Form Template

Please use the Health and Safety Incident Report (UK) mobile app to report all work-related injuries, diseases, ill health and near misses.

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Complete the app immediately after the incident or arrange for someone to do it on your behalf. Email the PDF generated by the completed app to your line manager, supervisor or staff contact without delay. Your line manager will then need to complete an investigation. Note: A separate report form must be completed for each person who is injured as a result of an accident at work. The app documents the following areas: About the Incident, About the Person involved (if applicable), Information Sharing and Person Completing this app.

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