Ryde House Group Accident Report Form

Ryde House Group Accident and Injury Report Form
Recording Accidents at Work

To comply with regulation, a record of injuries that happen to any person (employee, client, visitor) must be retained.

Safety Representatives are legally entitled to be given/receive information from completed accident forms under the Safety Representatives and Safety Committees Regulations and the Health and Safety (Consultation with Employees) Regulations.

If the injured person consents then the information contained within the record may also be disclosed to other elected Health & Safety representatives and any other third party requiring the information. Where consent is not obtained, the information will be anonymised to enable disclosure.
Reporting of Injuries, Diseases and Dangerous Occurrences Regulations (RIDDOR)

RIDDOR states that an employer must notify, report and record some deaths and injuries that arise from accidents at work.

You can find further guidenance, including what must be reported here https://www.hse.gov.uk/riddor/

1. ABOUT THE PERSON WHO HAS HAD THE ACCIDENT AND INJURY

The injured person must not complete this form. If you have had an accident and injury please speak to another member of staff (senior or manager) who will report it on your behalf.
Is the injured individual a staff member, service user or visitor*

Staff MemberService UserVisitor/OtherMaximus staff memberAgency staff memberMember of the public
Name*

First NameLast Name
Contact number*
Address

Street Address

Street Address Line 2

TownCounty

Post Code
Location of employment
For Outreach support please use 'Outreach'
2. ABOUT YOU, THE PERSON COMPLETING THIS FORM
Name*

First NameLast Name
Location/ Department of employment*
Occupation

Ryde House Group Accident and Injury Report Form