Incident form
This form is to report any incident or accident that occurs during a Canoe Sports Trust event whether self managed or managed by CST.It must be completed within 48hrs of the incident occuring. The data will be saved to the company's secure database and retained for 7 years.
Are you reporting an near-miss or accident?
*
Near miss
Accident
Name of the person reporting the incident
*
First Name
Last Name
Contact email of the person completing the form
*
example@example.com
Name of the First Aider if not the above named person
First Name
Last Name
Date of the incident
*
-
Day
-
Month
Year
2 digit day, 2 digit month, 4 digit year
Date
Time the incident took place
*
Hour Minutes
AM
PM
AM/PM Option
Details of the incident, please include as much detail as you can
*
Full name of the casualty if relevant
First Name
Last Name
Were there any injuries that required treatment by the First Aider?
Yes
No
Don't know
Please provide details of any injuries
Please provide details of any First Aid treatment provided
Was the casualty advised to seek medical treatment?
Yes ambulance called
Yes advised to go to A&E
No
Are there any learnings to be taken from this incident? Is there anything we should do differently?
*
Submit
Should be Empty: