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Incident Report v8.1
1
Default Email Name
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2
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3
Incident Report Number
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4
Date of Completion
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Date
Day
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Year
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5
Time of Completion
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Minutes
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6
Your Role During the Incident
*
This field is required.
Please Select
SIA Door Supervisor
SIA Security Guard
Security Supervisor
Security Manager
Assistant Security Manager
Crowd Manager
Administrator
Controller
Area Manager
Regional Manager
Steward
L2 Qualified Steward
L3 Qualified Steward
Coach Driver
Driver
Other Office/Management
Please Select
Please Select
SIA Door Supervisor
SIA Security Guard
Security Supervisor
Security Manager
Assistant Security Manager
Crowd Manager
Administrator
Controller
Area Manager
Regional Manager
Steward
L2 Qualified Steward
L3 Qualified Steward
Coach Driver
Driver
Other Office/Management
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7
Region
*
This field is required.
Please Select
DS North
DS South
DS Midlands
Retail North
Retail South
Retail Midlands
Guarding North
Guarding South
Guarding Midlands
Events North
Events South
Events Midlands
Festivals
Offices
Please Select
Please Select
DS North
DS South
DS Midlands
Retail North
Retail South
Retail Midlands
Guarding North
Guarding South
Guarding Midlands
Events North
Events South
Events Midlands
Festivals
Offices
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8
Site
*
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If your site is not listed, please select 'not listed' as an option.
If the site is not listed, please select 'not listed' as an option
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9
What is your name?
*
This field is required.
Please Select
Elijah Smith
David Triggs
Gerard Kasson
Mohammed Sami
Ibrahim Aluko
Francis Ifiti
Please Select
Please Select
Elijah Smith
David Triggs
Gerard Kasson
Mohammed Sami
Ibrahim Aluko
Francis Ifiti
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10
We Are Waterloo BID Location
*
This field is required.
If your site is not listed, please select 'other' as an option.
If the site is not listed, please select 'not listed' as an option
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11
Permanent We Are Waterloo Bid Location
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12
Was this issue:
*
This field is required.
On Street
In Store
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13
Site Name
*
This field is required.
Enter the SITE NAME
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14
Site Management Email
If completed, a copy of this report will be sent to the site management
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15
Precise Location
*
This field is required.
e.g. stage right bar, smoking area, rear fire exit, or for large/greenfield sites a w3w location
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16
Incident Date
*
This field is required.
Please select the date the incident happened
/
Date
Day
Month
Year
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17
What was the delay on submitting this report?
*
This field is required.
Please state the reason you did not submit this report on the day of the incident
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18
Incident Time
*
This field is required.
Please select the time the incident happened
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Minutes
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19
Is this an Incident or a Near Miss?
A near miss would be an event not causing harm but has the potential to cause injury or ill health
Please Select
Incident
Near Miss
Incident
Please Select
Incident
Near Miss
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20
Incident Type
*
This field is required.
Unacceptable and Nuisance Behaviour
Crime
Health, Safety & Compliance
Report a Concern
Vehicle
Intel
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21
Primary Vehicle Registration Number
*
This field is required.
This is the VRN of the vehicle that you are travelling in or if you were not travelling in a vehicle at the time, the main vehicle involved in the incident.
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22
Purpose of Journey
*
This field is required.
Personal
Travel to/from Customer Site/Office
Ejection
Other Work Related Journey
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23
What was the issue?
*
This field is required.
Breakdown
Damage
Collision
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24
Were there any passengers involved?
*
This field is required.
FGH employees
Friends/Family
Site Customers
Combination
None
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25
Did you take a drugs/alcohol test before driving?
*
This field is required.
Yes - Negative
Yes - Positive
No
N/A - not driving
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26
Which type of Health, Safety & Compliance incident was this?
*
This field is required.
Dangerous Occurence
Damage to Property / Contents
Medical
Crowd
Welfare Concern / Safeguarding
Compliance / Audit / Licencing Visit
Fire Alarm Activation
Panic Alarm
Power Failure
Maintenance / Infrastructure Issue
Other
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27
Which type of Unacceptable/Nuisance Behaviour was this?
*
This field is required.
House Rules / Conduct
Intoxication
Predatory Behaviour
Under Age Limits
Protests
Touts
Rough Sleeping
Trespass (including no/fake tickets)
Banned / Exclusion Order
Other
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28
Which type of Intel was this?
*
This field is required.
SDP's / Other Operators
Terror
Local Crime
Suspicious Activity
Other
Reassurance Visit
Member Visit
Rough Sleepers
On Street Beggars
Unlicensed Traders
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29
Which type of Concern was this?
*
This field is required.
Bribes
SIA Licencing of FGH Team Member
Conduct of Team Member
Discrimination
Alleged Lost/Stolen Property
Venue Licencing
Other
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30
Who has made this allegation?
*
This field is required.
FGH Employee
Customer/Client
Member of the public/ site patron
Other agency
Other
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31
Which type of Crime was this?
*
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Assault
Threat of Violence
Arson / Criminal Damage
Drugs
Sexual Offence
Theft
Other
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32
Did this include a weapon?
*
This field is required.
Yes
No
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33
What type of drugs offence was this?
*
This field is required.
Personal
Supply
Other
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34
What happened to the drugs?
*
This field is required.
Venue Amnesty
Police Amnesty
Destruction
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35
Type of Theft
*
This field is required.
From Person
From Property/Store
Consumption / Use Before Payment
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36
Was there any violence?
*
This field is required.
Threat of Violence
Use of Weapon
None
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37
What was the approximate value of the stolen goods?
*
This field is required.
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38
Was the item(s) recovered?
*
This field is required.
Yes
No
Partially
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39
Were any of the following parties involved?
*
This field is required.
Pickpocket
Homeless People
Children under 13
No
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40
Did this result in an emergency procedure(s)?
*
This field is required.
None
Show delay / pause
Show stop
Management meeting called
Gold Command Enacted
Evacuation
Invacuation
Other Agency Takeover
Combination
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41
Name of Agency that assumed command
*
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42
Which action(s) did this result in?
*
This field is required.
None
Ejection
Voluntarily left site
Detained / Arrested
Permitted to stay
Refusal
Happened offsite
Passed to medical / welfare
Retrospective report only
False Arrest
Combination
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43
Was there a concern for welfare?
*
This field is required.
Yes
No
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44
Was the resulting action:
*
This field is required.
Physical (Use of force)
Non-Physical
Compliant
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45
Were there any situational risk factors?
*
This field is required.
e.g. vulnerable bystanders, lack of resource to continue negotiation, long response time expected from additional support including police etc...
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46
What was the justification for use of force?
*
This field is required.
Protect self or others
Prevent crime / Make an arrest
Evict a trespasser
Protect property
Other
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47
What level of resistance was involved?
*
This field is required.
Life Threatening Resistance
Violent Resistance
Active Resistance
Passive Resistance
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48
What action was taken?
*
This field is required.
Proportionate Support (time to sober, charge phone etc...)
Duty of care passed to other agency (medics, police etc...)
Collected by Friends/Family/Taxi
None - refused welfare support and left site
Other
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49
Name of Agency that assumed duty of care:
*
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50
Friend Name/ Taxi Company / VRN
*
This field is required.
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51
Were any Emergency Services called?
*
This field is required.
None
Police
Ambulance
Fire
Coastguard/RNLI
Vehicle Recovery
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52
Was anybody injured?
*
This field is required.
None
FGH Employee
Site Employee
Site Customers
Artist / Performer
Bystander
Other
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53
Please describe the injury(s)
*
This field is required.
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54
Were any of the following injuries sustained?
*
This field is required.
None of the below
Fracture, other than fingers, thumbs and toes
Amputation of any kind
Any injury likely to lead to loss/reduction in sight
Any crush injury to the head or torso causing brain or internal organ damage
Serious burns incl. scalding covering more than 10% of the body and/or causing damage to eyes, respiratory system or vital organs
Any scalping requiring hospital treatment
Loss of consciousness from head injury / asphyxia
Any other injury arising from working in an enclosed space which leads of hypothermia/heat-induced illness and/or requires resuscitation or admittance to hospital for more than 24 hrs
Any injury that may result in a 7 days + absence from work
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55
Details of person(s) involved:
*
This field is required.
Please include the name, description and contact info here. If you do not know, please type 'not known'. This is the person the incident report is about. Age Build Clothing Distinguishing features e.g. colour, scars. tattoos, facial hair Elevation (height) Face Gait (how they walk) Hair (colour, style)
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56
Is there any supporting evidence available?
*
This field is required.
None
CCTV
BodyCam Footage
Photographs
Witnesses
Documentary
Other
Combination
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57
Do you want to upload evidence now?
*
This field is required.
Yes
No - I will provide later
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58
Upload Images/Video
*
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59
1. Witness Details:
Please include the name, description and contact info here. If you do not know, please type 'not known'.
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60
Was there another witness?
*
This field is required.
Yes
No
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61
2. Witness Details:
Please include the name, description and contact info here. If you do not know, please type 'not known'.
Please include the name, description and contact info here. If you do not know, please type 'not known'.
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62
Please provide a summary of the incident:
*
This field is required.
Please describe what happened and include any external factors, conditions etc...
Please include any external factors, conditions etc...
0/9999
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63
Has this incident been logged with Control/ DSVD/ DOB?
*
This field is required.
A log of this incident being completed should be made in the Site Documentation using the Incident Report Number as a reference
Yes
No
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64
Why has this not been logged?
*
This field is required.
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65
Has any equipment and/or uniform been lost, damaged, stolen or need to be repaired?
*
This field is required.
Yes
No
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66
Please provide details:
*
This field is required.
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67
Do you require any follow up actions?
*
This field is required.
No
Training / Retraining
Manager Site Visit
Manager Employee Meeting
Manager Customer Meeting
Additional Equipment
Corrective Actions
EAP Referral (Welfare Support)
Unsure
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68
Upload Eviction Form
Take Photograph
Upload file
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69
Eviction Form Upload
Upload photo of fully completed eviction form.
Drag and drop files here
Select files to upload
Max. file size
: 10.6MB
Browse Files
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70
Eviction Form Upload
Upload photo of fully completed eviction form.
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71
Confirmation
*
This field is required.
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72
Would you like to remain anonymous?
*
This field is required.
Please note that remaining anonymous may hinder us from conducting a full and complete investigation into this as we will be unable to contact you for follow up questions etc... If you do choose to share your details with us, we will handle this report, and your details with confidentiality.
Yes
No
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73
Your Full Name
*
This field is required.
Please include your first and last name
e.g. John Smith
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74
Your Email
You will receive a copy of this report if completed
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75
Permanent Site
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76
If you have any feedback, or suggestions for this form, please provide it here:
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77
OLD Region
*
This field is required.
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78
OLD Incident Type
*
This field is required.
Aggravated Robbery/Burglary
Arson/Criminal Damage
Assault
Authority Licensing Visit (Police, Fire, SIA)
Drug Offence
Entry Refusal (High conflict)
Fire Alarm Activation
Intelligence Report
Lost Property / Stolen Items
Medical Incident
Non-Aggravated Robbery/Burglary
On Street Issue
Onsite Ejection (Physical/Use of force)
Other Crimes
Possession of Weapon
Public Order Offence
Search (Positive)
Serious Non-Crime Event
Serious Violent Crime (GBH/ABH)
Sexual Offence
Site Maintenance Issue
Suspicious Activity
Theft
Company Vehicle incident/accident
Aggravated Robbery/Burglary
Arson/Criminal Damage
Assault
Authority Licensing Visit (Police, Fire, SIA)
Drug Offence
Entry Refusal (High conflict)
Fire Alarm Activation
Intelligence Report
Lost Property / Stolen Items
Medical Incident
Non-Aggravated Robbery/Burglary
On Street Issue
Onsite Ejection (Physical/Use of force)
Other Crimes
Possession of Weapon
Public Order Offence
Search (Positive)
Serious Non-Crime Event
Serious Violent Crime (GBH/ABH)
Sexual Offence
Site Maintenance Issue
Suspicious Activity
Theft
Company Vehicle incident/accident
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79
OLD Upload images/videos?
No
Yes
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80
OLD Were any FGH employees injured?
No
Yes
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81
OLD Site not listed?
Why is my site not listed? Only permanent sites that have been created with automatic email submission data are listed. Please enter your site manually if it is not listed.
Not listed
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82
OLD Upload images/video
Drag and drop files here
Select files to upload
Browse Files
Cancel
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83
OLD FGH employee injury details
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84
OLD Has a log been made of this incident in the Site Documentation using the Incident Report Number?
The Site/Venue Management should immediately be made aware of all incidents that occur.
Yes
No
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85
Signature
*
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Clear
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